Academic journal article Social Work

Help-Seeking Behaviors among Chinese Americans with Depressive Symptoms

Academic journal article Social Work

Help-Seeking Behaviors among Chinese Americans with Depressive Symptoms

Article excerpt

Depression is a serious mental health issue that occurs in people of all ages, genders, and socioeconomic backgrounds; however, not all cultures view depression as a mental illness. Chinese Americans seldom discuss their mental health problems (Hwang & Myers, 2007). Even if expressed, their "problems" are mainly tied to health care concerns, parental expectations, acculturation, or discrimination, as indicated in recent research (Grossman & Liang, 2008; Juang, Syed, & Takagi, 2007; S. Lee, Lee, Rankin, Weiss, & Alkon, 2007; Ying, 2007). In studies of Chinese Americans, help seeking has been found to be related to "environmental or hereditary causes" and has seldom been reported as personal or psychological problems (Chen & Mak, 2008).

Chinese Americans seldom seek mental health services. According to the U.S. Census Bureau (2008), Chinese Americans made up more than 20 percent of the 11.9 million Asians living in the United States, representing the largest Asian group in this country. Research has shown that Asian Pacific Americans, including Chinese Americans, tend to underutilize mental health services (Abe-Kim, Hwang, & Takeuchi, 2002; Matsuoka, Breaux, & Ryujin, 1997). A study conducted by Loo, Tong, and True (1989) showed that only 5 percent of the 108 Chinese Americans sought mental health services when needed. Data from the Chinese American Psychiatric Epidemiology Study (CAPES) revealed that only 17 percent of 1,747 Chinese Americans sought help when dealing with major depression and other psychiatric problems (Spencer & Chen, 2004). Among the help seekers in CAPES, only a small percentage had received services from professionals, such as mental health professionals (6 percent) and medical doctors (4 percent), in the previous six months, whereas the majority (90 percent) received informal support from religious leaders or friends (Spencer & Chen, 2004).

Although depression is widely underreported, research findings reveal that Chinese Americans are not free of mental health problems, and underutilization of mental health services is a great concern (Chen & Mak, 2008; S. Sue, Fujino, Hu, Takeuchi, & Zane, 1991). In addition, not all Chinese Americans are well-adjusted to their environment, and many do not feel comfortable communicating their problems to others (Grossman & Liang, 2008; J. Lee, Lei, & Sue, 2001; Yick, 2000). Spencer and Chen (2004) found that the main reason Chinese Americans did not seek help was related to language-based discrimination. The data from 1,747 CAPES respondents showed that "language-based discrimination was associated with higher levels of use of informal services and seeking help from friends and relatives for emotional problems" (Spencer & Chen, 2004, p. 809). As a result, many of these respondents showed negative attitudes toward professional mental health services and indicated preferences for informal and family support. Both Mui (1996) and Cheung (1989) shared the findings that depression can be prevented if Chinese immigrant clients receive help from their families and obtain external support to stay healthy. In this article, the literature is used to address help-seeking behaviors among Chinese Americans, and findings are reported from a research project conducted in a large city in the United States to illuminate factors contributing to Chinese Americans' depressive symptoms.

STIGMA OF DEPRESSION

Most Chinese Americans define depression differently from the Western way of diagnosis and treatment. Such differences may be related to migration experiences; ethnic identity; and family structure, including parental roles and marital relationships (Juang et al., 2007; Takaki, 1989; Uba, 1994). Because of the diverse views on mental health that may have influenced clients' help-seeking behaviors, depression treatment should be mindfully planned with consideration of cultural factors (Hsu et al. …

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