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Social and Cultural Contributions to Mental Health Service Utilization for Asian Americans: Expanding Andersen’s Behavioral Model

Lee, Hyung Jik (2018) Social and Cultural Contributions to Mental Health Service Utilization for Asian Americans: Expanding Andersen’s Behavioral Model. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Research suggests that Asian Americans underutilize mental health services, but there has not been sufficient examination of the multiple factors within Asian American culture that could contribute to underutilization. Much research on racial/ethnic disparities in mental health service utilization adopt the framework of Andersen’s Behavioral Model, categorizing the barriers into need factors, enabling factors, and predisposing factors. While this framework has helped to understand the mental health service use of Asian Americans, much variance is left unexplained.

The purpose of this study is to examine the impact of understudied social cultural factors on Asian American’s utilization of mental health services. Asian Americans have a unique culture with features that might affect mental health service use. Asian Americans who tend to be collectivistic view themselves in relation to social roles and obligations. Thus, the important relationships may influence their decision to seek services.

The NLAAS enables us to operationalize family cohesion, social support, ethnic identity, and social cohesion. In this study, 370 Asian Americans who had mental health needs were analyzed. First, each variable was examined to determine whether it made a criterion using univariate logistic regression. Second, variables that met the criterion are examined in a stepwise logistic regression where the previously known variables were tested in step one, and the social relationship factors were added in step two.

Findings show that only one-third of the Asian Asians with mental health needs used any type of mental health service. Contrary to predictions and previous research, only perceived discrimination, ethnic identity, and social cohesion met the criterion in the univariate analyses. In the multivariate analysis, only social cohesion was positively associated with mental health service use.

This study reveals that, while underutilization of mental health service among Asian Americans with needs is evident, it is still unclear what the predictors are. The results show that the mental health service use models should include more cultural factors unique to Asian culture that may explain their help-seeking behaviors. This includes developing sociocultural constructs to measure collectivistic values accurately as well as exploring for new factors.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Lee, Hyung Jikkodelaw@gmail.comhyl22hyl22
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGreeno, Catherinekgreeno@pitt.edukgreeno
Committee MemberEngel, Rafaelrengel@pitt.edurengel
Committee MemberShook, Jeffreyjes98@pitt.edujes98
Committee MemberDocumet, Patriciadocumetp@gmail.compdocumet
Date: 15 August 2018
Date Type: Publication
Defense Date: 17 July 2018
Approval Date: 15 August 2018
Submission Date: 12 August 2018
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 180
Institution: University of Pittsburgh
Schools and Programs: School of Social Work > Social Work
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: mental health service use, Asian Americans, NLAAS; Andersen’s Behavioral Model, collectivism, family cohesion; social support, ethnic identity, social cohesion
Date Deposited: 15 Aug 2018 12:57
Last Modified: 15 Aug 2020 05:15


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