Exploring Factors Associated with Asian Americans' Mental Health Service Underutilization: An Application of Andersen's Behavioral Model of Health Service Use

Background and Purpose: Representing the fastest growing racial/ethnic group in the United States, 21 million Asian Americans currently live in the U.S. This number is predicted to reach 41 million by 2050. The rapid growth of Asian American population places a crucial task in the mental health field. Particularly, Asian Americans are found to be vulnerable to mental health problems, yet significantly underuse mental health services. This study examines the prevalence and pattern of mental health-related service utilization in a nationally representative sample of Asian Americans. Types of mental health-related service use examined include: specialty mental health services, general health services, human or alternative services, and any type of mental health-related services. Further, guided by Andersen’s health behavioral model, this study focuses on exploring the influencing factors and their impact to Asian Americans’ mental health service use.

Methods: Data and samples: This study features a secondary data analysis. Data are derived from the National Latino and Asian American Study (2002-2003). Asian Americans origin from China, Vietnam, and Philippines are included in the current study. Measures: A series of bivariate analyses are conducted to examine if association exists between any of the independent variables (including predisposing, enabling, and need factors), and past year service provider use (including specialty mental health service use, general health service use, human or alternative service use, and any mental health-related service use). Further, a logistic regression analysis is employed to estimate the effects of the factors that are found significantly associated with past year service provider use in bivariate analysis.

Results: Approximately 6.8% of the total sample (n=1628) used any type of mental health-related services in past year. Among those who have used any type of services to address their mental health problems in the past 12 months, a slightly higher percentage of respondents would choose to use specialty mental health services (3.1%) over other type of services. A closer look at Asian Americans’ choice of service type suggests that they tend to use human or alternative services to address mental health problems, aside from specialty mental health services. Several factors are found significantly correlated to utilization of certain types of mental health-related services. Among which, marital status, age at immigration, and past year DSM-IV diagnosis are found to have significant association with each and any type of services. Respondents who are previously married, US born, or having DSM-IV diagnosable psychiatric disorder in past 12-month are more likely to use any type of mental health-related services.

Conclusions and Implications: The overall prevalence of mental health-related service use is low among Asian Americans. Findings from the study expand extant knowledge on factors that influence Asian Americans’ use and choice of mental health-related services. Follow-up studies that establish causal relationship, policies that combat cultural and structural barriers, and tailored interventions that effectively provide and deliver culturally and linguistically appropriate services, are suggested to address the service under-utilization issue among Asian Americans.