Correlates of Life-Time Use of Mental Health Services Among Korean Americans

Background/Purpose: It has been documented that Korean Americans (KAs) tend to underutilize mental health services compared to other ethnic groups. This lower rate may contribute to stigma attached with mental illness, lack of culturally appropriate services, and simply no knowledge about service availability. When KAs are entering treatment, in fact their severity of mental illness is very severe because using mental health service is the last resort. This aim of this study is to examine correlates of mental health utilization using Anderson Health Belief Model. Methods: Cross-sectional survey was used to collect 378 KAs who were 18 years and older and resided in New York State during May 2008 to September 2008. Dependent variable was life-time use of mental health and was measured by a question “have you received mental health service for your psychological distress?” Predisposing factors included gender, age, education, and length of residence in U.S. Enabling factors include income, English language proficiency, insurance, and perception for need for help. Need factors include acculturative stress and depression. Measurement of acculturative stress was adopted from National Latino and Asian American Study. Depression was measured using Patient Health Questinonaire-9 and KAs with 5 or higher scores were considered having depressive symptoms. Perception for need for help was asking a question, “Do you believe you need help for psychological problem? Data analysis included descriptive statistics and logistic regression, using Stata statistical application. Results: Approximately 8.5% of KAs reported their life-time use of mental health service while approximately 25% of KAs showed depressive symptoms. Logistic regression analysis revealed depression and income were significantly associated with use of mental health services. KAs with depressive symptoms were 1.14 times likely to use mental health service than those without depressive symptoms (OR=1.14, CI 95% [1.02, 1.27]). KAs with higher income were 0.24 times less likely to use mental health service compared those with lower income (OR=.24, CI 95% [0.09, 0.67]). Conclusions/Implications: This study showed low rates of use of mental health services despite that KAs may need treatment. Low income and severity of depression are relatively influential factors in using service. As this finding shows that perception for need of help is not related to use of service, this may highlight that KAs even do not perceive they need help even if they are actually suffering from depression and this may be one of barriers to seek help. Social workers help KAs increase their awareness for need of help for their mental health issues and this early intervention may help not to deteriorate their symptoms further so they can be treated at early stage of their mental health problems.