About this poster

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Panel information
Panel 7. Health and Wellbeing

Abstract

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Purpose: Asian American young adults report alarming rates of mental health distress but notably underutilize mental health services. The culturally infused engagement model suggests that multi-level individual and contextual factors may influence the mental health seeking behaviors through perceived public stigma toward mental health service use (herein referred to stigma). However, limited studies have explored the mediating mechanisms with AA young adults. More importantly, few have investigated culturally anchored processes of help seeking that are alternative to the dominant biomedical framework of mental health seeking. To fill this gap, this study examined whether stigma mediates the relationships between past-year mental health service use and its predictors organized into three clusters (1) individual mental health status (depressive symptoms), (2) ethnic-cultural values (“saving face” -- keeping family matters privately to avoid shame), and (3) racially minoritized status (model minority stereotype and perpetual foreigner stereotype).

Methods: Data are from the Midwest Longitudinal Study of Asian American Families (MLSAAF) that longitudinally survey-interviews Filipino American and Korean American families in the Midwestern U.S. The first wave was collected in 2014 from 378 Filipino American and 408 Korean American youth (MAGE=15, female=51.2%). Retention rates were 77% at Wave 2 in 2016 (N=604), 82% at Wave 3 in 2018 (N=641), and 77% at Wave 4 in 2022 (N=612, MAGE =21.3, female =53.7%). This study used the first and fourth waves of youth data. Adjusting for control variables (age, nativity, biological sex, English proficiency, and family socioeconomic status), we examined a mediating effect of stigma in the link between multi-layered predictors and mental health service use across Asian American ethnic subgroups.

Results: For Filipino Americans, depressive symptoms and internalized model minority stereotype were significantly mediated by stigma to predict mental health service use. That is, depressive symptoms (b=0.26, p<.001) and internalized model minority stereotype (b=0.24, p< .05) were associated with more stigma, which in turn predicted fewer mental health service use (b=–0.7, p<.05). For Korean Americans, depressive symptoms, saving face, and internalized model minority stereotype were directly, but not indirectly, associated with mental health service use. Specifically, depressive symptoms were related to more mental health service use (b=1.0, p< .001), whereas saving face (b= –0.84, p<.05) and internalized model minority stereotype (b=– 0.49, p<.05) were related to less frequent mental health service use in the past year.

Conclusions and Implications: The comprehensive approach in this study highlights that intervention efforts should go beyond individual or familial level factors, which has largely been of focus in the field and seriously consider addressing contextual factors such as racial stereotypes. Equally important, we found differential mechanisms of how stigma mediates mental health uses across Asian American ethnic subgroups. For example, the findings suggest that stigma should be a target of intervention for Filipino Americans but racial/cultural factors would be direct targeted for Korean Americans. This study highlights the importance of data disaggregation for Asian Americans and the significance of group specific interventions to be effective in addressing unmet mental health needs in Asian American communities.

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