Assignment 7: Final Paper

Despite showing signs of mental illness, disorders such as schizophrenia and ADHD in Asian American adults (age 20-60) living in the United States are rarely diagnosed or treated by a doctor.

Passive surveillance from records of the prevalence of mental illnesses in adults of various ethnicities show higher or equal levels of mental illness in Asian Americans compared to the other ethnic groups. Active surveillance show lower levels of Asian Americans utilizing mental health services. Both types of surveillance help us identify that there Asian Americans are not utilizing mental health services despite having the same or higher levels of mental illnesses as other groups.

There is admittedly still few direct statistics regarding the underutilization of mental health services by Asian Americans, as the few studies that have been done have been mostly qualitative observational studies. The National Co-morbidity Survey Replication Study, one of a few that measured the utilization of mental health-related services, suggested that Asian Americans have lower rates of use when compared with the general population. Only 8.6% of Asian Americans sought help from any services versus 17.9% of the general population. However, even these statistics may not be accurate as they were taken from a study that was survey-based and the respondents may have under or over reported their use of mental health services. Most studies discussing the issue of underutilization of mental health services by Asian Americans emphasize the need for more statistics, both from survey based studies and more concrete studies, that would be direct indicators of the phenomenon.

Comparatively, there are many indirect indicators that are mentioned in studies that explore the underutilization of mental health services by Asian Americans. The two main ones that are referred to are the levels of general insurance coverage and levels of "foreign born" Asian Americans. General insurance coverage is important as those with insurance coverage are more likely to be informed about mental health facilities and have access to them. If they know about them and have more access to them, they are likely to utilize them. The levels of general insurance coverage among Asian Americans varies widely but statistics indicate that the less time Asian Americans have spent in the United States, the more likely they are to be uninsured. Though the low level of insurance coverage may be in part due to the immigrant status of Asian Americans, statistics show that even among fellow immigrants from other countries of origin, Asians have a low rate of insurance. This is another issue with several reasons that can be discussed further, but for our purposes, this indicates that Asians are less likely to utilize mental health services because they lack access or information about them. The second indirect indicator of underutilization of mental health services by Asian Americans would be the levels of "foreign born" Asian Americans which indicates the number of Asian Americans who maintain a strong tie with their ethnic cultures. This measure matters because Asian cultures may influence the Asian Americans to decide to underutilize mental health services due to stigma against mental illnesses within the culture. Though the levels of "foreign born" Asian Americans also vary widely, most are well tied to their culture's attitudes toward mental illness either themselves or through parents and other influential family members. For example, among Korean Americans, approximately two-thirds of Korean Americans are foreign born and first generation members according to a study done by the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine.


Sources:

http://dx.doi.org/10.4306/pi.2008.5.1.14
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446276/pdf/10846509.pdf
http://synapse.koreamed.org/search.php?where=aview&id=10.4306/pi.2008.5.1.14&code=0162PI&vmode=FULL
http://ehis.ebscohost.com/ehost/detail?sid=a167a6d9-08de-44a4-b6b3-7cc922c868aa%40sessionmgr198&vid=1&hid=109&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=pdh&AN=1999-00182-004