Willingness to Seek Mental Health Services Among Korean Immigrants in the U.S

Background and Purpose: It is well recognized that immigrants are at higher risk of developing a mental health problem. Immigration-related stressors such as language barriers, acculturative stressors, and income-loss have been found as major triggers for mental health problems. Despite the heightened mental health needs, immigrant populations present underutilization of mental health services. Research of immigrant populations has focused predominately on Latinos, while other ethnic groups, such as Asians (one the fastest growing immigrant groups in the U.S.) have received considerably less attention.

Given that culturally constructed beliefs function as a gateway to mental health help-seeking, willingness to seek mental health services may very by ethnicity. Drawing on Andersen’s behavioral models’ predisposing, need, and enabling variables as a framework, this study aims to increase knowledge of mental health help-seeking of Korean immigrants by exploring factors that influence their willingness to seek mental health services. A comprehensive assessment of specific need and enabling variables has not been studied extensively among this unique population.

Methods: The sample of 205 Korean immigrants (ages 18-45) was drawn from a community survey conducted in Florida. The outcome variable, willingness to seek mental health services for depression, was measured as a yes/no question. Independent variables included: predisposing—demographics, need—depressive symptoms (CES-D), and enabling variables—health insurance, acculturation, and personal beliefs about depression (adopted from the National Mental Health Association Survey). Logistic regression was conducted to identify factors associated with willingness to seek mental health services.

Results: Approximately 60% of the sample indicated willingness to use mental health services.  The sample presented a high level of depressive symptoms but had generally negative beliefs about depression. More than 44% viewed having depression as sign of personal weakness, 25% believed that keeping emotional troubles to oneself is a virtue, and 6.4% thought having a mentally ill family member brings shame to the whole family. On the other hand, about 85% believed that depression is a medical condition.  In the multivariate model, gender, depressive symptoms, acculturation, and the belief that depression is a medical condition were identified as significant predictors.  Women were nearly three times (OR=2.52, p < .01) more likely to be willing, while the odds of willingness decreased among participants experiencing more depressive symptoms (OR= .89, p<. 05). The odds of the willingness increased among individuals with higher level of acculturation (OR=1.09, p < .05) and with the belief that depression is a medical condition (OR=4.71, p < .01). 

Conclusions and Implications: Findings indicate that individuals who view depression as a medical condition, a proxy for having mental health literacy, are considerably more likely to be willing to use mental health services. Educational interventions focused on increasing mental health literacy may be more beneficial in promoting mental health services for Korean immigrants.

Keywords: mental health, mental health help-seeking, willingness to seek mental health services, depression, Korean immigrant, ethnic minorities