Determinants of Mental Health Service Utilization Among Asian Americans: An Analysis of the 2022 National Health Interview Survey

Background and Purpose: This study aims to advance the understanding of mental health service utilization among Asian Americans by addressing critical gaps in existing research. Previous studies have often focused on specific subgroups or regions, which limits their generalizability, and have overlooked important factors like U.S. citizenship status, educational attainment, and telehealth utilization (Krzya et al., 2023; Ruiz et al., 2023). Moreover, barriers such as economic status and healthcare access remain underexplored (Levesque et al., 2013). By utilizing a nationally representative dataset and applying Andersen’s Behavioral Model (2008), this study aims to offer more comprehensive, generalizable insights into the factors that influence mental health service use among Asian Americans.

Methods: A cross-sectional design was employed using secondary data from the 2022 National Health Interview Survey (NHIS), focusing on a final sample of 1,688 individuals who self-identified as Asian Americans. A weighted hierarchical logistic regression analysis was conducted to examine the relationship between mental health service utilization and various predictor variables, grouped according to Andersen’s Behavioral Model of Health Service Use. The predictors were categorized into three domains: predisposing factors (sex, age, educational attainment, citizenship status, and marital status), need factors (diagnosis of depression or anxiety, recent symptoms of depression or anxiety), and enabling factors (economic status, barriers to healthcare access, and utilization of telehealth services). The analysis applied a stepwise approach, first entering predisposing factors, followed by need and enabling factors, to assess their influence on mental health service utilization among Asian Americans.

Results: The study found that approximately 6.4% of Asian American adults reported using mental health services in the past 12 months. Key findings include that individuals with a bachelor’s degree or higher (odds ratio [OR] = 2.68), a diagnosis of depression (OR = 3.90), a diagnosis of anxiety (OR = 4.21), recent symptoms of anxiety (OR = 2.30), and those using telehealth services (OR = 3.07) had significantly higher odds of utilizing mental health services. In contrast, married or partnered individuals (OR = 0.23) were less likely to seek mental health services compared to their unmarried counterparts. These results highlight the role of both clinical need and socioeconomic factors in predicting mental health service utilization. Specifically, higher educational attainment and mental health diagnoses (depression, anxiety) were consistently associated with a greater likelihood of using mental health services, while marital status and access to telehealth services emerged as significant predictors.

Conclusions and Implications: The findings underscore the importance of addressing the factors that limit mental health service use among Asian Americans, such as barriers to access, low service utilization despite need, and socio-cultural factors like marital status. Public health policies should focus on reducing these barriers and increasing accessibility to mental health services, particularly through telehealth, to improve service utilization. The study also suggests that future research should explore the role of cultural attitudes and stigma in mental health help-seeking behaviors, as well as the impact of telehealth on long-term utilization patterns among diverse ethnic groups.