Development and Testing of a Pilot Brief Peer-Led Culturally Responsive Mental Health Literacy and Engagement Intervention for Asian American Young Adults

Background and Purpose: Racially and ethnically diverse individuals are utilizing mental health services at lower rates than Whites, with Asian Americans using the least. Mental health literacy is identified as a critical prerequisite for early intervention and intervention in mental disorders. While emerging adults report having increased knowledge and awareness of mental health symptoms, evidence suggests that appraisal of need for mental health help is less understood. For Asian American young adults, this appraisal process is further determined by culturally specific views of mental health and stigma, leading to resistance or delays in engaging in mental health services. To date, no mental health literacy interventions have considered how culturally nuanced beliefs about experiences of mental health impact help seeking. Further, none has integrated how dimensions of identity (e.g. race, ethnicity, gender) and culture influence individuals’ knowledge, attitudes and responses towards mental health problems. Informed by the perspectives of young adult Asian Americans from the community, this project developed and piloted a brief, peer-led culturally responsive mental health literacy and engagement intervention for Asian American young adults.

Methods: A brief culturally responsive, peer-led mental health literacy and engagement intervention was developed and piloted with 30 Asian American young adults. The engagement intervention consisted of 3 sessions where a trained peer led discussions on: 1) recognizing distress through evaluating Asian American young adults’ nuanced understandings of mental distress, 2) determining thresholds of mental health need, and 3) identifying approaches to help seeking, through the lens of understanding one’s identities, culture and context. A multiple based line design was employed to test the effects of this individual-level mental health literacy and engagement intervention. Multiple base line designs use repeated measurements over a period of time and interventions are introduced on a staggered schedule. To test the effectiveness of the intervention, we measured client reported attitudes towards professional help seeking, culturally based responses to mental distress (hiding mental distress from others and enduring/tolerating mental distress. Paired two-tailed T tests were used to measure significant changes in survey scores before and after the intervention. In addition, we examined attendance rates of participants across all 3 sessions.

Results: Results indicated that at post-intervention, participants reported significantly higher scores for attitudes towards professional help seeking. In addition, participants reported significantly lower scores in hiding their mental distress from others and enduring/tolerating mental distress. Examination of attendance rates of all participants across the 3 sessions indicate a 100% participation rate.

Conclusions and Implications: The 100% retention rate suggests that the peer-led mental health literacy and engagement intervention was effective in engaging participants in the intervention. The significant changes in attitudes towards help seeking and culturally driven responses to mental distress indicate that the brief intervention was effective in changing Asian American young adults’ openness to responding to their mental health problems in proactive ways. The current findings indicate that the brief peer-led intervention is a promising engagement intervention that can potentially reduce negative attitudes towards help seeking and hence, mental health disparities among Asian American young adults.