Mental Health Diagnosis and Patterns of Mental Health Care Utilization Among Asian-American Women Who Were Sexually Assaulted

Background: Women who are sexually assaulted suffer from a range of mental health problems and often require mental health services. However, shame and stigma related to victimization is common among Asian cultures and may result in patterns of mental illness and service use among Asian-American women that vary from the general population. To date, there are no studies examining the relationship between sexual assault, mental heath and substance use disorders and mental health service utilization among Asian-American women.. We investigate three primary research questions in this paper: 1)what is the prevalence of sexually assault among Asian American women; 2) what is the likelihood of being diagnosed with a mental health or substance use disorder among sexually-assaulted Asian-American women compared to their counterparts who report no history of sexual assault and; 3) to what extent do Asian-American women who report a history of sexual assault use mental health specialty care and receive adequate mental health specialty services compared to Asian American women who report no history of sexual assault, controlling for demographic covariates?

Methods: We used data from the National Latino and Asian American Study. Among Asian-American women (n = 1094), we compared rates of psychiatric and substance use disorders and mental health specialty care between those reporting lifetime sexual assault and those reporting no experience of sexual assault. We estimated logistic regression models adjusting for demographic covariates.

Results: Approximately 14% of Asian-American women (n =165) endorsed lifetime history sexual assault. Sexual assault was associated with a higher risk of any anxiety disorder (OR= 1.6), Post Traumatic Stress Disorder (OR= 5.9), any mental disorder excluding alcohol and drug dependence (OR=2.4), and any mental disorder including alcohol and drug dependence (OR= 2.5). Despite the greater risk of mental health disorders among sexually assaulted women, no statistical difference in the use of mental health specialty care between those reporting a history of sexual assault compared to those reporting no history of sexual assault was detected.

Conclusion: Similar to White, Black, and Hispanic women who report a history of sexual assault, Asian-American women experience significantly higher rates of a wide range of mental health disorders as compared to their non-victimized counterparts. Our results suggest urgency of identifying and linking sexually assaulted Asian-American women to mental health care specialty care in order to prevent the onset and/or mitigate the severity of mental health disorders.