Acculturation, Mental Health, and Mental Health Service Use among Older Adults from Five Asian Ethnic Groups

Abstract

As the number of older Asian immigrants grows in the U.S., attention to their mental health disparities and mental health care has been increasing. This study aims to identify differences among five ethnic subgroups (Chinese, Japanese, Korean, Filipino, and Vietnamese) of older Asian immigrants in California and to examine predictors of mental health service utilization within each ethnic subgroup. The Behavioral Model for Vulnerable Populations (BMVP) was used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the 2009, 2011-2012, and 2013 California Health Interview Survey (CHIS). ANOVA and chi square tests were used to examine group differences and logistic and linear regression analyses were performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. The older Asian immigrant samples were not homogeneous. The Japanese and Filipino samples had better socioeconomic status and higher level of acculturation than others. The Korean sample had the lowest level of mental distress and least use of mental health services. Help-seeking patterns regarding mental health care differed across subgroups. Decreasing age (Chinese and Japanese), female (Vietnamese), not being married (Korean), lower education (Japanese), decreasing perceived safety (Vietnamese), higher levels of mental distress (all), and having perceived need (all) were associated with an increasing likelihood of using mental health services. Not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. Mental health seeking patterns differed by ethnicity within the older Asian immigrant sample. Findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.