The Effects of Self-Construal and Masculinity vs. Femininity: A Comparison of American and Japanese Attitudes toward Mental Health Services
Yamawaki, Niwako, Journal of Mental Health Counseling
This study investigated how interdependent/independent self-construals (SC) and maseulinity or femininity moderated Japanese and American college students 'attitudes toward mental health services. Data were analyzed from a survey that asked 316 American students (122 men and 194 women) and 362 Japanese students (147 men and 215 women) about their attitudes toward seeking professional help, their sense of self in relation to others, and their level of masculinity or femininity. Japanese and male participants tended to hold more negative help-seeking attitudes than did American and female participants. In both countries individuals with independent SC held positive attitudes. However, the roles of interdependent SC and masculinity/femininity were different for Japanese and American participants. While previous studies indicated that SC and gender have predictive roles, mental health counselors should be aware that other factors, such as indigenous beliefs about mental illness, may explain the national difference in help-seeking attitudes. Implications for mental health professionals are addressed.
The prevalence of psychological problems in the United States has been well-documented. It is estimated that the incidence of one-year psychological and addictive disorder rates ranges from 19% to 30%, and that lifetime prevalence rates are approximately 50% (Kessler et al., 1994; Narrow, Rae, Robins, & Regier, 2002; Regier et al., 1984). Though the literature on psychological and behavioral disorders among the Japanese is limited, similar problems have been reported in Japan. The lifetime prevalence of major depression in Japan has been found to be 19% (Kitamura, 1998; Nakane, 1995). Nakane reported that about 5% of outpatient visits in Japan were for generalized anxiety disorder, 3.7% for alcohol dependence syndromes, and 2.6% for depression. Furthermore, a 2004 World Health Organization (WHO) study found that Japan had one of the highest suicide rates in the world, almost double that of the United States (2003), and that mental disorders were the most powerful risk factor for suicide, playing a role in 80% to 90% of all suicide deaths (Abe, Shioiri, & Someya, 2007).
Despite evidence for some similarities between the prevalence of psychological problems in the United States and Japan, researchers have found significantly different patterns in the use of mental health services (Herrick & Brown, 1998; Leong, 1994; Zhang, Snowden, & Sue, 1998). In the United States, there is considerable evidence that Asian Americans underutilize mental health services (President's Commission, 1998; Sue & McKinney, 1985). Like other ethnic minority groups, Asian Americans who do make use of mental health services have significantly higher drop-out rates than do European American clients (Sue, 1997; Yamamoto, James, & Palley, 1998). Using a large sample from the World Mental Health version of the WHO Composite International Diagnostic Interview, Naganuma et al. (2006) in a study in Japan found that the majority of participants with psychiatric disorders did not access mental health care or other support systems, even though the mental health care system in Japan has improved over the past decade. In addition, Abe et al. (2007) found that of those who died by suicide, three-fourths had not received psychiatric treatment in the previous year.
Though there are many reasons why one may or may not seek help from mental health professionals (for discussion, see Goodman, Swell, & Jampol, 1984; Subich & Coursol, 1985; Tinsley, de St. Aubin, & Brown, 1982), one of the key factors in understanding the use or nonuse of available services is attitude toward mental health services. The decision to seek professional help is largely influenced by an individual's general attitude toward help-seeking. Attitude is in turn a function of specific beliefs about the consequences of performing the behavior and an evaluation of those consequences (Halgin, Weaver, Edell, & Spencer, 1987). …