Asian Americans demonstrated lower rates of any type of mental health-related service use than did the general population, although there are important exceptions to this pattern according to nativity status and generation status. Our results underscore the importance of immigration-related factors in understanding service use among Asian Americans.

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This study used generational status and the Suinn-Lew Asian Self-Identity Acculturation scale to examine unidimensional versus multidimensional approaches to the conceptualization and measurement of acculturation and their relationships to relevant cultural indicator variables, including measures of Individualism-Collectivism, Independent-Interdependent Self-Construal, Loss of Face, and Impression Management. Multivariate analyses of covariance and partial correlations were used to examine the relationship between the acculturation models and each set of cultural indicator variables while controlling for socioeconomic status. Given that acculturation differences are often cited as evidence for a culture effect between groups, the present findings of an uneven nature of these relationships as a function of the particular acculturation measurement strategy have important implications for research on Asian Americans.

Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored.

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What do health care practitioners need to know about providing adequate care for depressed minority women? This article examined the prevalence of depressive symptoms and clinical depression in ethnic minorities, the extent to which current health service utilization is congruent with needs, and the effectiveness of treatments provided to ethnic minorities in the primary care setting. The impact of ethnic minority women's sociocultural context on symptom expression and help-seeking behavior is also discussed. Finally, the clinical implications for accurate assessment and treatment of ethnic minority women by both medical and mental health practitioners working in the primary care sector are addressed.

Models of mental health service deliiery in managed care have evolved without considering the needs of ethnic minorities in any systematic manner. Consequently, these new systems may pose additional banie n t o access and treatment. In this article, the impact of the health care crisis on mental health service deiivery to ethnic minorities in terms of access, cost, and quality of care issues in managed care systems is explored. A quality-of-cam iramewodc is used for addressing the notion of cultural competence as a critical dlmsnslon of quality of care for ethnic minority populations. Research in minority mental health and quality of care is integrated in order to explore how various structures, processes, and outcomes in managod care systems (e.g., cost containment structures for controlling the supply and demand of mental hoalth sewicos, utilization management and gatekeeping processes) may impact mental health sonice delivery to ethnic minorities. Cultural competence is conceptualized as a critical componont of quality care for ethnic minority populations.

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