Mental Health Service Use and Unmet Need for Mental Health Care in Asian Americans

Background and Purpose: The present study focuses on Asian Americans, the fastest growing minority group and the largest group of new immigrants in the U.S. whose needs for mental health care are not much known. With an effort to address the target population’s cultural, ethnic, and linguistic diversities, the aims of the present study were: (1) to explore the overall status of mental health, mental health service use, and unmet needs for mental health care and (2) to identify factors that determine the use of mental health services and unmet needs for mental health care.

Methods: Data were drawn from 2,609 participants (age range = 18−98) in the 2015 Asian American Quality of Life Survey, conducted in Central Texas. In order to reach out to diverse groups of Asian Americans, culturally and linguistically sensitive approaches (e.g., survey questionnaire in Asian languages, bilingual/bicultural recruiters and survey assistants, and partnerships with key individuals and organizations within ethnic communities) were employed, resulting in a sample almost half of which were surveyed in their native languages. For the main analyses, logistic regression models of mental health service use and unmet needs for mental health care were estimated with background variables (age, gender, marital status, education, time in the U.S., English proficiency, health insurance, and chronic medical condition), ethnicity, and mental health status, indicated by mental distress (Kessler 6 [K6] ≥ 6) and serious mental illness (SMI, K6 ≥ 13).  

Results: More than 44% of the sample were categorized as having mental distress and 6.1% as having SMI. About 23% had used services (mental health specialist, general doctor, and/or religious leader) for their emotional concerns during the past year, and about 7% reported unmet mental health needs (i.e. there was a time that they needed mental health care but could not get it). In the multivariate analyses, the presence of mental distress and SMI increased the odds of using any service and having unmet needs. Those who had used services exhibited higher odds of reporting unmet needs, calling concerns about the quality of services and user satisfaction.

Conclusions and Implications:

Findings add to our knowledge concerning the care-seeking processes of Asian Americans and suggest ways to promote their utilization of mental health services. We found the poor mental health status, low use of specialty mental health care, and high levels of unmet needs in our sample, which calls further attention to Asian Americans in mental health services research and practice. The variables identified as significant predictors of service use and unmet needs should be utilized in efforts to prioritize risk groups and to promote the access to and satisfaction with mental health services. Also, the findings on ethnic differences should be used in developing intervention programs tailored to the preference and needs of the community.