Do Family Relation and Immigration Influence Mental Health Service Use Among Asian Americans?

Background and Purpose: Representing the fastest growing racial group in the U.S., Asian Americans are found to be vulnerable to mental illnesses, while significantly under-using mental health services. However, despite of the central role of family in the collectivist Asian culture, little is known about if and how family relation may affect Asian Americans’ mental health service use. Moreover, studies have established that immigration influences the mental health outcome and service use among Asian Americans. Yet, there is scant literature on whether immigration-related factors may interact with family relation and influence service use among this particular population. In light of the knowledge gap, this study examines the impact of family relational factors independently, and jointly with immigration-related factors, on mental health service utilization among Asian Americans.

Methods: Drawing on data from the National Latino and Asian American Study, this study uses multiple logistic regression models to estimate the independent influence of family relational factors, namely family cohesion and family conflict, on 12-month mental health service utilization among Asian Americans, controlling for needs for services and demographic variables. The study further explores the interaction between family relational and immigration-related factors and estimates their joint effect on 12-month mental health service use, using a series of multiple logistic regression models. Types of mental health-related services examined include: specialty mental health services, general health services, human or alternative services, and any type of mental health-related services.

Results: Family cohesion and family conflict are both found to have significant influence on Asian Americans’ use of general health services and any type of mental health-related services. Additionally, family conflict is found as a predictor to the receipt of human or alternative services among Asian Americans. Findings also suggest that interaction effect between immigration and family relation may exist to affect the rate and type of service use. In particularly, results from the study reveal that immigration generation status interacts with family cohesion and jointly influence the use of general health services among Asian Americans.

Conclusions and Implications: Family relation plays a key role in affecting the rate and type of mental health-related service use among Asian Americans. Tailored policies and interventions, with a focus on family and consideration of immigration generation status, are recommended to better address Asian Americans’ mental health service under-utilization issue.