Abstract
Ethnic and racial group differences in help-seeking are a barrier to the effective and equitable delivery of mental health services. Asian American populations demonstrate relatively low levels of help-seeking. Explanations for this effect typically point to elevated levels of stigma in these populations. An alternative explanation is that low help-seeking might also reflect holding a relatively circumscribed concept of mental disorder. Individuals and groups with less inclusive concepts of disorder may be less likely to identify problems as appropriate for mental health treatment. This study aimed to test whether group differences in the breadth of the mental disorder concept account for group differences in help-seeking attitudes. A sample of 212 American participants (102 Asian Americans and 110 White Americans) were assessed on personal stigma, help-seeking attitudes, and mental disorder concept breadth. Mediation analyses examined whether stigma and concept breadth mediated group differences in attitudes. Compared to White Americans, Asian Americans reported higher levels of stigma and narrower concepts of mental disorder, both of which were associated with less positive help-seeking attitudes. Stigma and concept breadth both partially mediated the group difference in attitudes. Theoretical and practical implications for mental health promotion and culturally sensitive clinical practices are explored.
Highlights
Many people who might benefit from mental health treatment do not receive it (Corrigan et al, 2014)
In addition to asking whether broader concepts of disorder are associated with more positive attitudes to mental health help-seeking, we examined whether stigma and concept breadth mediate the group difference in these attitudes
The 102 Asian Americans (Mage = 32.57, SD = 7.93) were younger than the 110 White Americans (Mage = 39.22, SD = 11.42), t(195.35) = −4.95, p < 0.001, 95% CI [−9.30, −4.00], and more educated (Mdn(Asian) = 4, Mdn(White) = 4; U = 4672.50, p = 0.03, r = 0.15) and had higher annual income (Mdn(Asian) = 3, Mdn(White) = 2; U = 3686.50, p < 0.001, r = 0.32)
Summary
Many people who might benefit from mental health treatment do not receive it (Corrigan et al, 2014). The underutilization of services has been identified as a barrier to improved public mental health, and promoting appropriate help-seeking is an essential step to overcoming it (Boonstra et al, 2012; Anderson et al, 2013). Understanding why people do not seek available help is a pressing concern. Help-seeking refers to any initiatives people take to engage with care (Kovandžić et al, 2011). Featherstone and Broadhurst (2003) argued that all models follow a three-stage structure: recognizing a Concept Breadth of Mental Disorder psychological problem (stage 1), deciding to seek help (stage 2), and actively seeking help (stage 3). Help-seeking behavior, depends on people’s pre-existing beliefs and attitudes about mental disorders and their treatment (Loya et al, 2010). Studying the predictors of help-seeking attitudes is a research priority
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