The African American minister as a source of help for serious personal crises: bridge or barrier to mental health care?

Using data from the National Survey of Black Americans, this article explores the role of African American ministers in the help seeking of African Americans for serious emotional problems. The authors explore which demographic characteristics and psychosocial factors are related to contacting Black clergy for help, whether certain types of personal problems increase the likelihood of clergy contact, and whether those who go to ministers are also likely to seek help from other professional help sources. Results indicate that women are more likely than men to seek help from ministers. People with economic problems are less likely to contact clergy, while those with death or bereavement problems are more likely to seek help from the clergy. Regardless of the type or severity of the problem, those who contact clergy first are less likely to seek help from other professionals. It is recommended that African American clergy and mental health professionals engage in a mutual exchange of information to increase access to professional care among African Americans with serious personal problems.     

Asian-American cultural identity and attitudes toward mental health services.

557 Asian-American students (263 Chinese Americans, 185 Japanese Americans, and 109 Korean Americans) completed a survey consisting of a demographic questionnaire, a modified version of the Suinn-Lew Asia Self-Identity Acculturation Scale, and the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPHS). A 3?×?2?×?2 multivariate analysis with main effects of ethnicity, gender, and level of acculturation and the 4 subscales of the ATSPHS as the dependent variables resulted in a significant F value for acculturation effect and nonsignificant F values for all other main and interaction effects. Regardless of ethnicity and gender, the most acculturated students were: (a) most likely to recognize personal need for professional psychological help, (b) most tolerant of the stigma associated with psychological help, and (c) most open to discussing their problems with a psychologist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental illness stigma as a mediator of differences in Caucasian and South Asian college students' attitudes toward psychological counseling.

Previous research has established that Asian Americans use mental health services less frequently and hold poorer attitudes toward psychological counseling than Caucasians. The authors directly tested whether stigmatizing beliefs regarding mental illness might explain such differential attitudes toward counseling in a South Asian and Caucasian student sample. Using mediation analyses, the authors examined 2 aspects of stigma posited to affect help-seeking attitudes: personal stigmatizing views and perceptions of the public's stigmatizing views directed toward persons with mental illness. First, the authors found that Caucasian (n = 74) college students revealed more positive attitudes toward counseling than did South Asian (n = 54) students. Second, in terms of mediation, increased personal stigma, but not perceived stigma, expressed by South Asians partially mediated and accounted for 32% of the observed difference in attitudes toward counseling services. These findings support a long-standing conjecture in the literature regarding the increased significance of stigma processes on disparities in majority-minority help-seeking attitudes. They also suggest that efforts to reduce disparities in attitudes toward counseling for South Asian students specifically should incorporate interventions to reduce the increased stigma expressed by this community, particularly related to a desire for social distance from persons with a mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural mistrust and mental health help-seeking attitudes among Filipino Americans.

As low as the rate of mental health help-seeking is among Asian Americans, Filipino Americans seek mental health services at a much lower rate even compared with other Asian Americans. Despite the field’s progress in identifying and understanding factors that may influence mental health help-seeking attitudes among Asian Americans, despite research on other minority groups suggesting that cultural mistrust may influence attitudes toward seeking professional psychological help, and despite the abundance of literature documenting the historical and contemporary experiences of oppression by Filipino Americans, the possibility that cultural mistrust may play a significant role in Filipino Americans’ mental health help-seeking attitudes have yet to be empirically investigated. Thus, using a sample of 118 Filipino Americans, the current study demonstrates that higher levels of cultural mistrust is related to lower likelihood of seeking professional psychological help. Furthermore, cultural mistrust predicted variance in mental health help-seeking attitudes that are not accounted for by income, generational status, loss of face, and adherence to Asian cultural values. Implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions of mental illness and judgments about help seeking among Japanese-American and White American students.

Perceived causes of mental illness and help-seeking preferences among Japanese-American and White American college students (72 men and 72 women in each ethnic group) were compared in order to investigate the reported underuse of mental health services by Japanese Americans. Results of a 2 (ethnicity of S)?×?2(severity of disorder)?×?2(gender of person with disorder)?×?2(gender of S) multivariate analysis of variance (MANOVA) revealed that Japanese-American students were more likely than White American students to attribute mental illness to social causes, to resolve problems on their own, and to seek help from family members or friends or both. Possible barriers to use of services by this sample of Japanese Americans include both a preference for informal resources and the stigmatization of mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help-seeking attitudes and perceptions of counselor behavior.

Evaluated with 219 female undergraduates the Fischer-Turner Attitudes Toward Seeking Professional Psychological Help inventory and its component factor scales in terms of their "known groups" validity and their predictive utility in counseling research. Ss reporting prior professional assistance for psychological problems espoused more favorable attitudes (including greater recognition of need, stigma tolerance, interpersonal openness, and confidence in mental health practitioners) than Ss without such professional contact. Ss listened to taped counseling interviews and rated the counselors on several perceptual and expectancy variables (including the Relationship Inventory). Help-seeking attitudes were found to represent a significant positive influence on the counselors' perceived expertise, trustworthiness, regard, empathy, genuineness, and general helpfulness; on Ss' expected willingness to return for a 2nd interview; and on their expectancies of improvement across a variety of personal problems. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help is where you find it: Four informal helping groups.

Investigated the nature of help-giving provided by 90 hairdressers, 62 family-practice attorneys, 97 industrial supervisors, and 76 bartenders. It was found that moderate to serious personal problems were raised with all groups, but particularly with hairdressers and lawyers. Although those problems in the aggregate were similar to those brought to mental health professionals, somewhat different problems came up with different groups. Ss used a variety of handling strategies, some of which were similar to those used by mental health professionals. The special ecologies of the several situations related both to the number of personal problems raised and to how they were handled. Most Ss felt good about providing interpersonal help and believed that they did so moderately well. It is concluded that more precise knowledge of society's de facto help-giving mechanisms is an essential precondition for rational future planning by mental health professionals. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National Asian American Psychology Training Conference.

Describes a conference convened to explore problems and issues in training psychologists to serve Asian Americans and their communities and to provide a setting for administrators, faculty, practitioners, and students to share perspectives on the mental health needs of Asian Americans. Among the outcomes were recommendations concerned with appropriate models and approaches of psychology for Asian Americans and appropriate training of psychologists for Asian-American communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The mental health of Asian Americans.

Reviews the book, The mental health of Asian Americans by Stanley Sue and James K. Morishima (1982). In The Mental Health of Asian Americans, Sue and Morishima assess the current status of theory and research strategies in this field and initiate dialogue regarding future directions for our investigative energies and service delivery efforts. They are largely successful at this ambitious mission. Their work represents one of the best and most comprehensive texts on the special issues related to Asian-American mental health. Although this book was published in 1982, the theories presented and issues discussed remain extremely pertinent to the problems encountered today in providing services to this population. The authors' major intent is not to demonstrate how to deal with cross-cultural issues in treating Asian-American clients, although therapeutic techniques with a particular client may be extrapolated from their discussion and numerous case examples. Instead, the authors focus on strategies for improving research and delivery of mental health services, and attaining a theoretical understanding of treatment issues within the cultural context. The content is aimed at those who are in training or currently participating in mental health research and service delivery to persons of Asian descent. Yet, this book is of interest to all professionals who are seeking a well-researched text which is grounded in theory and describes the importance of cultural factors in developing mental health services to an ethnic minority population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural commitment and attitudes toward seeking counseling services in American Indian college students.

Counseling attitudes were assessed for American Indian college students rating themselves as either strongly or weakly committed to both Tribal and Anglo cultures. Participants strongly committed only to Tribal culture displayed more negative attitudes toward seeking counseling, recognizing a personal need for counseling, having confidence in mental health professionals, and interpersonal openness than those strongly committed only to the Anglo culture or to both cultures. Strongly committed participants demonstrated more negative attitudes toward interpersonal openness than those weakly committed to both cultures. Women showed more positive attitudes toward these issues than did men. It is recommended that counselors consider cultural commitment in understanding the hesitancy among potential American Indian clients to use conventional psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health service utilization among African American and Caucasian mothers and fathers.

Mental health services have been routinely underutilized. This study investigated the influence of parents' gender, race, and psychopathology on perceived barriers and attitudes toward mental health utilization for themselves and for their children. A unique contribution of this study is the examination of father, mother, and child factors influencing service utilization from the parents' perspective. A total of 194 African American and Caucasian parents were recruited from the community to participate. Parents completed measures on barriers and attitudes toward treatment for themselves and for their children, history of mental health service utilization for themselves and for their children, and their own current psychological symptoms. Results indicated that 36.3% and 19.4% of parents and children, respectively, had used mental health services during their lifetime. Parents perceived fewer barriers and had more positive attitudes toward seeking services for their children than for themselves. Race and gender differences were found in parents' perceptions of barriers and attitudes toward treatment. Furthermore, barriers, attitudes, and psychopathology predicted parents' plans for future utilization of mental health services. The clinical implications of this study and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Asian-American mental health and help-seeking behavior: Comment on Solberg et al. (1994), Tata and Leong (1994), and Lin (1994).

Research on Asian Americans has traditionally been ignored or has failed to create a realistic understanding of their status in society. There is widespread belief that Asians in the US are a model minority who are somehow immune to the stresses of minority status and in need of no special consideration. The 3 studies in the special section on Asian Americans Seeking Counseling (V. S. Solberg et al, S. P. Tata and F. T. Leong, and J. C. Lin; see PA, Vol 81:39326, 38266, and 38246, respectively) contribute greatly to dispelling false images and stereotypes about the mental health needs of Asian Americans. Despite the importance of these studies, future research would profit from a focus on the diversity of the Asian-American population and the development of theories and practices indigenous to Asian culture. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Culture and social support.

Social support is one of the most effective means by which people can cope with stressful events. Yet little research has examined whether there are cultural differences in how people utilize their social support networks. A review of studies on culture and social support presents evidence that Asians and Asian Americans are more reluctant to explicitly ask for support from close others than are European Americans because they are more concerned about the potentially negative relational consequences of such behaviors. Asians and Asian Americans are more likely to use and benefit from forms of support that do not involve explicit disclosure of personal stressful events and feelings of distress. Discussion centers on the potential implications of these findings for intercultural interactions and for the use of mental health services by Asians and Asian Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal violence and mental health outcomes among Asian American and Native Hawaiian/other Pacific Islander college students.

In a cross-sectional survey of college students (N = 614), we studied interpersonal violence victimization, perpetration, and mental health outcomes in an ethnoracially diverse rural-based sample of Asian Americans (27%) and Native Hawaiian/Other Pacific Islanders (25%), two groups vastly underrepresented in trauma research. High rates of interpersonal violence (34%), violence perpetration (13%), and probable psychiatric diagnoses (77%), including posttraumatic stress disorder, were found. Exposure to physical violence, sexual violence, and life stress all were predictive of psychopathology. Female participants were associated with higher likelihood of sexual violence victimization compared to male participants, and Asian American status (especially among males) was associated with lower likelihood of physical and sexual violence compared with European Americans. These data enhance our understanding of interpersonal violence and mental health outcomes among previously understudied minority groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help seeking and problem perception among Asian Americans.

Compared the presenting concerns of 3,050 counseling center clients (undergraduate and graduate students) as those concerns varied by ethnicity, gender, and previous counseling experience. Asian-American clients were much more likely to perceive themselves as having educational or vocational concerns, whereas White clients were disproportionately more likely to admit to personal or emotional concerns. The comparison among 7 different Asian-American groups revealed that Filipino-American and Asian-American/White mixed clients were more likely to endorse personal or emotional concerns than other Asian-American groups. Gender and previous counseling experience were found to be related to the presenting concern, but the effects were the same in each ethnic comparison. Results are interpreted with respect to (1) what counselors should be aware of in interacting with Asian-American clients and (2) how they differ both from White clients and among themselves. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological distress and help seeking in rural America

The implications of exposure to acute and chronic stressors, and seeking mental health care, for increased psychological distress are examined. Research on economic stress, psychological distress, and rural agrarian values each point to increasing variability within rural areas. Using data from a panel study of 1,487 adults, a model predicting changes in depressive symptoms was specified and tested. Results show effects by size of place for men but not for women. Men living in rural villages of under 2,500 or in small towns of 2,500 to 9,999 people had significantly greater increases in depressive symptoms than men living in the country or in larger towns or cities. Size of place was also related to level of stigma toward mental health care. Persons living in the most rural environments were more likely to hold stigmatized attitudes toward mental health care and these views were strongly predictive of willingness to seek care. The combination of increased risk and less willingness to seek assistance places men living in small towns and villages in particular jeopardy for continuing problems involving depressed mood.     

Cohort differences in attitudes toward mental health services among older persons.

In order to investigate historical shifts in attitudes toward mental health and mental health services, two independent samples of older adults separated by a 14-year time interval were administered questionnaires. There were 91 in the 1977 sample (mean age 69.91 yrs) and 116 in the 1991 sample (mean age 71.94 yrs). Four newly created, internally consistent scales assessed multiple dimensions of their mental health attitudes (breadth of conceptions, bias, openness to help, range of problems). Analyses suggested that the younger cohorts of older adults held more positive attitudes toward mental health and mental health services than the older cohorts. These cohort differences remained when controlled for age, level of education, self-reported health, and income. These data indicate a positive cohort shift in attitudes toward mental health, a finding with numerous implications for the design and implementation of mental health services for future cohorts of older persons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thai and American perspectives on over- and undercontrolled child behavior problems: Exploring the threshold model among parents, teachers, and psychologists.

When a child has psychological problems, what determines whether adults will consider the problems serious or whether they will seek professional help? One determinant may be cultural: Prevailing social values may help set adult thresholds for concern over child problems. We explored this possibility, comparing adults in Thailand and the United States, two countries where social values and perspectives on childhood differ markedly. Thai and American parents, teachers, and clinical psychologists made judgments about two children, one with overcontrolled problems (e.g., shyness, fear) and one with undercontrolled problems (e.g., disobedience, fighting). Consistent with some of the literature on Thai Buddhist values, Thais (compared with Americans) rated problems of both types as less serious, less worrisome, less likely to reflect personality traits, and more likely to improve with time. Cross-national differences in perceived seriousness were more pronounced for parents and teachers than for psychologists, suggesting that professional culture may mitigate the effects of national culture. Evidently, adults' judgments about child clinical problems can differ markedly as a function of their cultural context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homeless youths and young adults in Los Angeles: prevalence of mental health problems and the relationship between mental health and substance abuse disorders

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.     

Cultural differences in optimism, pessimism, and coping: Predictors of subsequent adjustment in Asian American and Caucasian American college students.

Cultural differences were examined between 111 Asian American and 111 Caucasian American students matched on age and sex in a prospective design study. Using separate optimism and pessimism scores, Asian Americans were found to be more pessimistic than Caucasian Americans. Asian Americans were also found to use more problem avoidance and social withdrawal coping strategies than Caucasian Americans. When health outcomes were assessed 6 weeks later, Asian Americans were found to report more depressive and psychological symptoms, but not more physical symptoms, than Caucasian Americans. Results of separate regression analyses for each ethnic group indicated that along with different coping strategies, lack of optimism predicted all 3 health outcomes for Asian Americans, whereas pessimism predicted 2 of the 3 health outcomes for Caucasian Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)