Attitudes of Older Korean Americans Toward Mental Health Services

Abstract

Given the increasing evidence that older ethnic minorities underuse mental health services, the present study assessed determinants of attitudes toward mental health services with a sample of older Korean Americans (N = 472). Adapting Andersen's behavioral health model, predisposing factors (age, sex, marital status, education, length of residence in the United States), mental health needs (anxiety, suicidal ideation, depressive symptoms), and enabling factors (personal experiences and beliefs) were considered as potential predictors. Shorter residence in the United States and higher levels of depressive symptoms were associated with more-negative attitudes toward mental health services. Culture-influenced personal beliefs (knowledge about mental illness and stigmatism) were found to play a substantial role in shaping individuals' attitudes toward mental health services. Findings call attention to the need to investigate how culture influences the response to mental health needs and to develop community education and outreach programs to close the gaps between mental health needs and service utilization in older ethnic minority populations.Keywords mental health; service utilization; Korean American; older adults Asian Americans are one of the fastest growing minority groups in the United States. Currently constituting nearly 4% of the total U.S. population, they are projected to reach 10% by 2050, 1 but little is known about this population, especially in the mental health arena. 2,3 Given the heterogeneity of Asian Americans, the present study focuses on one group: older Korean Americans. Korean Americans have been identified as one of the most understudied populations 4 despite the fact that they constitute one of the largest and fastest-growing segments of Asian Americans. 1 Their reportedly high risk for mental health problems also indicates the need for more research on Korean Americans. 4Although service underutilization of Asian Americans is well documented, 3-5 there is little research on their attitude toward mental health services and its correlated factors. Exploring variables associated with the perceptions of mental health service use will help identify facilitators and barriers to service utilization. Because attitudes have been shown to be a critical determinant of help-seeking behaviors, 6,7 this line of research may inform about how to design and implement effective interventions to reduce disparities in mental health services. Need constitutes the second explanatory factor. Just as physical health problems such as illness and chronic conditions represent needs for medical service, mental health problems represent needs for mental health services. In a prospective study based on medical records, level of depression was found to be the most significant predictor of service use. 16 Nevertheless, despite the fact that psychological morbidity and severity of conditions indicate a need for service, there seems to be a wide gap between mental health needs and care.Enabling factors encompass a...

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Depressive symptoms, chronic medical illness, and health care utilization: findings from the Korean Longitudinal Study of Ageing (KLoSA)

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