Perceived Mental Health and Depression: The Mediating Role of Depression Literacy in a Sample of Korean Americans

Background/Purpose: Ethnic minority groups experience disproportionate mental health burdens and inequities in healthcare. In particular, Asian Americans are uniquely challenged as they face language and cultural barriers in accessing or navigate the complex U.S. behavioral healthcare system. It has been documented that Asian Americans underutilize mental health services compared to other ethnic groups. This lower rate may be the result of stigma attached to mental illness, lack of culturally appropriate services, and lack of awareness and general knowledge of mental health disorders. The aim of this study is to examine the interrelationships among the variables, perceived mental health, depression literacy and depression among Korean Americans.

Methods: In the spring of 2018, a cross-sectional survey was conducted to collect data from Korean Americans residing in New York (NY) and New Jersey (NJ), aged 18 years and older. The study sample consisted of 689 participants (290 male, 399 female, M=54.39, SD=18.99). Depression was measured using the Center for Epidemiologic Depression Scale-Korean Version (CESD-K) consisting of 20 items (M=0.78, SD=0.47, range 0 to 2.4). Perceived mental health was measured using a single-item question on a scale of 1 (Excellent) to 4 (Terrible) (M=2.09, SD=0.73, range 1 to 4). Depression literacy was measured using the 22-item Depression Literacy Questionnaire Scale (D-Lit) (M=9.18, SD=4.37, range 0 to 20). Descriptive statistics and mediation analysis using the Hayes PROCESS macro via bootstrapping in SPSS were used for data analysis.

Results: The results of the simple mediation analysis showed that depression literacy partially mediated the relationship between perceived mental health (IV) and depression (DV). The path a, from IV to DV, was significant (β = -0.5252, SE = 0.2436, p = 0.03), as was the path b, from mediator to DV (β = -0.0115, SE = 0.004, p = 0.0045). The total effect, path c, was significant (β = 0.2658, SE = 0.0242, p = 0.0001), as was the direct effect, path c' (β = 0.2597, SE = 0.0242, p = 0.0001). These findings suggest that depression literacy partially mediated the relationship between perceived mental health and depression (indirect effect=0.0061, 95% C=.002 - .011).

Conclusions/Implications: This study found that depression literacy partially mediated the relationship between perceived mental health and depression among Korean American adults. The results of our finding suggest that increased awareness of one’s own mental health and general knowledge of depressive symptoms can buffer against depressive symptoms among Korean Americans. Community based mental health educational programs can be utilized to mitigate depression in this group by helping people increase awareness of their mental health and acquire general knowledge of depressive symptoms which can help them take control over their health.