Correlates of Stigma Toward Mental Health Service Use Among Filipino and Korean Americans

Background and Purpose: Asian Americans are significantly less likely than Whites to seek care for their mental health problems and when they do, there is a substantial delay in help-seeking that would exacerbate the problem. This pattern is particularly serious among certain subgroups, such as Filipino Americans and Korean Americans. Stigma toward mental health service use is a major barrier to help-seeking among Asian Americans. Although a handful empirical studies have identified several determinants of the stigma, there is a dearth of research that accounts for multiple factors to examine joint as well as unique contributions of each predictor. Previous efforts were further hampered by aggregating diverse Asian American subgroups. This study examined a set of predictors of stigma toward mental health service use that are organized into three clusters of factors related to (a) racial minority status (racial discrimination and colonial mentality), (b) traditional values (“saving face” regarding family matters and fatalism), and (c) Asian American family process (intergenerational cultural conflict and gendered norms).

Methods: Data are from the first wave of Midwest Longitudinal Study of Asian American Families that survey-interviewed 376 Filipino American and 412 Korean American parents in 2014 (M_AGE=45, 96% Mothers). Adjusting for control variables (age, years of living in the U.S., income, English proficiency, history of service use, and child mental health), each cluster of predictors was respectively regressed as a block first, and then added together in hierarchical regressions. These analyses were conducted within each ethnic group.

Results: After accounting for control variables, racial minority status variables predicted more stigma in both groups. Traditional values were particularly salient predictors of stigma among Korean Americans. Specifically, saving face and fatalism were related to more stigma among Korean Americans, whereas saving face was the only significant predictor of stigma among Filipino Americans. Intergenerational cultural conflict and gendered norms predicted more stigma in both ethnic groups. In the final model when all clusters were included, traditional values remained significant among Korean Americans and racial minority status factors remained significant among Filipino Americans.

Conclusions and Implications: This study demonstrates how multi-layered contextual factors are differently related to stigma toward mental health service across Filipino Americans and Korean Americans living in the Chicago metropolitan area. Specifically, the results show that racial discrimination is a particularly prominent factor among Filipino Americans, whereas traditional values and Asian American family process are notable among Korean Americans. These findings are significant because Filipino Americans are regarded as more racially marginalized among Asian Americans and Korean Americans are one of the most culturally separated subgroups. This study highlights the significance of group specific interventions to be effective in addressing unmet mental health needs in Asian American communities.