Sunday, 16 January 2005 - 10:15 AM

This presentation is part of: Mental Health Service Utilization

How Symptom Manifestations Affect Helpseeking for Mental Health Problems Among Chinese Americans

Purpose: Depending on the way that symptoms of emotional distress are manifested, individuals’ attentiveness to the problem, its interpretation and thus helpseeking behavior could be affected. It has been suggested that in Chinese culture, due to strong stigmatization of mental illness, somatization is seen as a culturally acceptable way to acknowledge emotional distress. This study attempts to test this hypothesis by examining whether somatoform disorders, compared to anxiety disorder or depression, would give people more legitimacy to seek help. Partly due to stoic values, Chinese are said to be less likely to seek help unless the emotional distress disrupts their social functioning. This study also examines if social disruptiveness of symptoms affects helpseeking.

Method: This investigation is based on the Chinese American Psychiatric Epidemiological Study, a 3-stage strata-cluster random sampling community survey of 1747 respondents in the Los Angeles area. A subsample of 185 individuals with diagnosable pure forms of somatoform, anxiety, and depressive disorders are included in the analyses. In addition to bivariate analyses, logistic regressions with hierarchical block entries are computed to examine the prediction of disorder type on seeking help from medical doctors, mental health professionals, and other professionals (e.g. ministers, monks, etc.). Also examined in the regression analyses are somatization scores, social disruptiveness and severity of symptoms, acculturation, and cultural and practical barriers to helpseeking.

Results: Bivariate analyses indicate that individuals with somatoform disorders are about 4 times more inclined to seek help from medical doctors (chi square = 16.8, p<.001) and 4 and 7 times more from other professionals than those having anxiety and depressive disorders respectively (chi square = 24.6, p<.001). In the multivariate analyses, as hypothesized, disorder type, social disruptiveness are significant in predicting the use of medical and other professional help. While somatization increases respondents’ tendency to seek medical help, it has no significant effect on the use of help from other professionals. Symptom severity, however, increases the use of other professional help but not medical help. Both sets of variables denoting acculturation, cultural and practical barriers are not significant in predicting any helpseeking. Between anxiety and depressive disorders, no significant difference is detected for the use of mental health service in either bivariate or multivariate analyses.

Implications: Since Chinese Americans with higher tendencies to somatize their emotional distress are more likely to seek medical help for their problems, it is imperative that primary care physicians be alerted to explore with these patients possible psychological distresses beyond the presenting somatic complaints. As a result, appropriate referrals for mental health services could be made. Public mental health education to the Chinese American population should also be stepped up to help increase their knowledge about the various manifestations of emotional distress in addition to physical symptoms so that they could seek professional help at an earlier stage of their mental problems.

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