The Impact of Self-Rated Mental Health on Physician Use: A Look at Asian Americans

Background and Purpose:

Despite the burgeoning Asian American population, health research has not addressed the groups' mental health needs. In particular, little attention has focused on older age groups. Past research suggests that low mental health specialist use by Asian Americans is the result of several factors including: systemic barriers due to cultural incongruence, acculturation differences, and stigma.

Mental health research focused on non-traditional settings will deepen the knowledge base, and inform the development of strategies to reduce mental health disparities. Using Andersen's behavioral model, this study examined the effects of perceived mental health need on physician use among older Asian Americans. It was hypothesized that older adults who perceive a mental health need will be more likely to see a physician. By focusing on the perceived needs of older Asian Americans, this study will increase our understanding of how mental health needs relate to physician use.

Methods:

Secondary data analysis methods were used to analyze data from the 2001 California Health Interview Survey. The study sample includes 1041 adults over age 50 from the three most populous Asian ethnic groups (Chinese, Filipino, and Vietnamese) that represent more than half of all Asian Americans. Using three ethnic group increases statistical power and allows for intergroup comparisons. One item was used to assess perceived mental health need, the independent variable. The dependent variable, physician use, assessed whether the respondent had sought care from a physician in the past 12 months. The dependent variable was dichotomously coded and entered into a hierarchical logistic regression model for analysis.

Results:

Controlling for other factors, Asian American older adults who perceived having a mental health need were 19 times more likely to have seen a physician in the past 12 months than those who did not perceive a mental health need. Interethnic differences were found, as Filipino Americans were more likely than Chinese Americans to have seen a physician.

Conclusions and Implications:

This study's findings underscore the need to examine mental health issues in medical settings for older Asian Americans. By working together to assess psychosocial functioning, mental health and health care professionals can reach an underserved minority group. Culturally competent integrated care in a health care setting can reduce stigma toward mental health among Asian American older adults. In addition, by examining models of integrated health care we can better address the lack of empirically-based practices for this rapidly growing racial group. Future research should also examine how culture affects mental health help-seeking behaviors in non-traditional settings.