Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 2
Overview of Cultural Diversity and Mental Health Services
Asian Americans/Pacific Islanders
The prevalence of mental illness among Asian Americans is difficult to determine
for methodological reasons (i.e., population sampling). Although some studies
suggest higher rates of mental illness, there is wide variance across different
groups of Asian Americans (Takeuchi & Uehara, 1996). It is not well known how
applicable DSM-IV diagnostic criteria are to culturally specific symptom
expression and culture-bound syndromes. With respect to treatment-seeking
behavior, Asian Americans are distinguished by extremely low levels at which
specialty treatment is sought for mental health problems (Leong & Lau, 1998).
Asian Americans have proven less likely than whites, African Americans, and
Hispanic Americans to seek care. One national sample revealed that Asian
Americans were only a quarter as likely as whites, and half as likely as African
Americans and Hispanic Americans, to have sought outpatient treatment (Snowden,
in press-a). Asian Americans/Pacific Islanders are less likely than whites to be
psychiatric inpatients (Snowden & Cheung, 1990). The reasons for the
underutilization of services include the stigma and loss of face over mental
health problems, limited English proficiency among some Asian immigrants,
different cultural explanations for the problems, and the inability to find
culturally competent services. These phenomena are more pronounced for recent
immigrants (Sue et al., 1994).
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