| Poster | Poster Session 05 Program Schedule
02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes
Final Abstract #57
Role of Racial Disparities on Mental Health Help-Seeking Attitudes in Asian Americans: A Systematic Review
Jia Kim, Columbia University Vagelos College of Physicians and Surgeons, New York, United States
Paul Lewis, Columbia University Vagelos College of Physicians and Surgeons, New York, United States
Category: Inclusion and Diversity/Multiculturalism
Keyword 1: cross-cultural issues
Keyword 2: depression
Keyword 3: minority issues
Objective:
Research on Asian Americans and mental healthcare services has been inconsistent, containing numerous gaps in evaluating structural and cultural disparities. This study aims to understand how different racial disparities, including model minority stereotypes, perceived discrimination, culture, and structural barriers, contribute to mental health help-seeking attitudes in Asian Americans.
Participants and Methods:
A systematic review was conducted following PRISMA guidelines using various iterations of keywords such as ‘mental health help-seeking’, ‘racial disparity’, and ‘Asian Americans’ in Pubmed, Google Scholar, and Cochrane. A total of 212 articles were found after duplicate removal and limiting to 2006-2023. During abstract review (n=212) followed by full-text review (n=43), results were excluded based on language (not in English), credibility (not peer-reviewed), and relevance (mental illness or disease other than mood and anxiety disorders). 19 studies were included in the final synthesis.
Results:
Studies could be classified into five different major themes: racial discrimination, clinical disparities, mental health literacy, cultural barriers, and socioeconomic barriers. Racial discrimination and positive stereotype endorsement, such as model minority, was a barrier that ignored the psychological difficulties and led to negative help-seeking attitudes to meet certain expectations (p<0.038). Clinical disparities included misdiagnosis, underdetection, and lack of adequate care (p<0.001), which arise from somatic symptom descriptions prevalent in Asian Americans and a lack of culturally sensitive healthcare professionals. This leads to mistrust of healthcare systems that limit Asian Americans' use of health services. Mental health literacy included the group’s awareness and knowledge of mental health, perceived need, and recognition of symptoms. Experience of former service use was also positively associated with mental health service use (p<0.001). Cultural barriers had consistent comments among studies. Asian Americans reported family conflicts including parents who did not welcome their mental health service use or worries about burdening their families (p<0.001). Stigma in the context of family and community decreased help-seeking and utilization of health services (OR=2.4, p<0.03). Additionally, self-stigma was observed (p<0.03), which limited individuals from seeking help. Socioeconomic factors included education (p=0.023), marital status (p=0.001), and age of immigration (p=0.047). Language barriers were found to be insignificant in influencing mental health service use (95% CI[0.07–1.27]), which indicates that disparities in health system use extended beyond language proficiency. Generational status had consistent comments, with Asian Americans who immigrated to the United States at a younger age or lived in the United States for longer than 10 years having more positive attitudes towards mental health services than those who did not (p<0.046). Second-generation Asian Americans were found to be more likely to use mental health services (p<0.05).
Conclusions:
Overall, racial disparities have been associated with Asian Americans’ mental health help-seeking attitudes. Deeply rooted stereotypical, structural, and cultural barriers present areas that can be addressed to decrease the healthcare disparities posed to Asian Americans. Further research on barriers to mental healthcare may assist public health efforts regarding mental healthcare.
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