Why do Chinese Canadians not Consult Mental Health Services: Health Status, Language or Culture?

Abstract

Data from the Canadian Community Health Survey Cycle 1.1 showed that Chinese immigrants to Canada and Chinese individuals born in Canada were less likely than other Canadians to have contacted a health professional for mental health reasons in the previous year in the province of British Columbia. The difference persisted among individuals at moderate to high risk for depressive episode. Both immigrant and Canadian-born Chinese showed similar characteristics of mental health service use. The demographic and health factors that significantly affected their likelihood to consult mental health services included Chinese language ability, restriction in daily activities, frequency of medical consultations, and depression score. Notwithstanding lower levels of mental illness in ethnic Chinese communities, culture emerged as a major factor explaining differences in mental health consultation between Chinese and non-Chinese Canadians.

Common mental health problems in immigrants and refugees: general approach in primary care

“…[58][59][60][61][62][63] This can reflect both structural and cultural barriers, including the lack of mobility or ability to take time away from work, lack of linguistically accessible services, a desire to deal with problems on one's own, the concern that problems will not be understood by practitioners because of cultural or linguistic differences, and fear of stigmatization. [64][65][66][67][68] In many developing countries, mental health services are associated only with custodial or hospital treatment of the most severely ill and psychotic patients. Partly as a consequence, and also because of specific cultural explanations of illness, mental disorders are highly stigmatized in most countries, and patients are extremely reluctant to attribute symptoms to a mental disorder.…”

Evidence-based clinical guidelines for immigrants and refugees

“…Linguistic and cultural differences may constitute substantial barriers to recognition of depression and subsequent treatment negotiation and delivery. 413,414 Medical interpreters, "culture brokers," bilingual and bicultural mental health practitioners, clinician training in cultural competence and cultural consultation may mitigate these potential barriers. 52,[415][416][417] Screening for depression produces benefits only when it is linked to an integrated system of care.…”

Why do ethnic Chinese in the Netherlands underutilize mental health care services? Evidence from a qualitative study

“…This has implications for the training of medical staff and the formulation of quality standards. The use of "cultural mediators" is another strategy that can be employed to bridge the gaps in language, knowledge, and culture between care users and professionals (Chen et al, 2009;Green et al, 2005).…”

“…Lower utilization of mental health services by ethnic Chinese living in the West has been widely reported (e.g., Abe-Kim et al, 2007;Chen, Kazanjian, & Wong, 2009;Kung, 2003). Almost all of the research on this topic has been carried out in English-speaking countries such as Australia, Canada, New Zealand, the United Kingdom, and the US; very few Dutch studies have investigated the issue (exceptions are Liu, Ingleby, & Meeuwesen, 2011;Liu et al, 2008;Schellingerhout, 2011;Smits, Seeleman, van Buren, & Yuen, 2006).…”

“…Communication barriers between Chinese users and health professionals are reported very frequently (Chen et al, 2009;Kung, 2004;Liu et al, 2011). Crosscultural communication is not just a matter of understanding words, but also of appreciating idioms and cultural or social references.…”