Underutilization of mental health services by Asian immigrants has been an ongoing concern for those attempting to provide accessible care for people suffering from mental illness. The author investigated Korean immigrants' help-seeking behaviors for depression to understand their underutilization of mental health services. The study involved 6 focus group discussions and 24 in-depth interviews with 70 Korean immigrants in New York City. Prolonged care within family and traditional Asian practices led to a delay in seeking mental health services, keeping many Korean immigrants with depression out of the delivery system. The lack of interface between formal service providers and psychiatric service providers also caused delayed treatment. This study suggests the need for a comprehensive care model based on community education, linking mental health care with other services, and cultural brokering, as ways to connect population needs with mental health service delivery.

Immigrant mental health issues, especially depression in relation to discrimination and acculturation, are reported to be serious problems in the United States. The current study examines the prevalence of depressive symptoms among Korean immigrants in New York City (NYC) and its relation to self-reported discrimination and acculturation. A sample of 304 Korean immigrants residing in NYC completed a survey utilizing the Center for Epidemiologic Studies Depression Scale-Korean version, Discrimination Scale, and Acculturation Stress Scale. Results indicated that 13.2% of the sample population demonstrated some symptoms of depression and that variable such as living alone, marital status, education, years in US and income impact high depression scores. Results also indicate that higher self-reported exposure to discrimination and lower selfreported language proficiency were related to higher depressive symptoms. In a regression analysis, discrimination and English language proficiency were significant predictors of depression, but acculturation stress was not significantly related to depression.

This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services.

Depression among immigrant groups, especially Korean immigrants, has often lacked a comprehensive understanding by the providers of Western health care. This study aims to explore the subjective experience of Korean immigrants suffering from depression during resettlement in the United States. A series of focus groups and in-depth interviews were conducted with Korean immigrants in New York City who identified themselves as depressed. Participants described their depression as manifested through the feeling of an "unbalanced self " and tended to express dysphoric symptoms in somatic terms. These differences need to be reflected in the assessment and treatment of depression in Korean immigrants.

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Objectives This study examined the independent and interactive effects of chronic medical conditions and sleep disturbance on depressive symptomatology. The sample (N = 675) consisted of community-dwelling Korean American older adults, a group that has been found to be particularly high in depressive symptomatology. Methods A hierarchical regression model of depressive symptoms was estimated with an array of predictors: (a) demographic variables, including immigration history, (b) chronic medical conditions, (c) sleep disturbance, and (d) an interaction between chronic medical conditions and sleep disturbance. Results After controlling for the effects of demographic variables, both chronic medical conditions and sleep disturbance were identified as independent risk factors for depressive symptoms. Moreover, their interaction was significant, indicating that the coexistence of chronic medical conditions and sleep disturbance was significantly associated with higher levels of depressive symptoms (β = 0.15, p < 0.01). Conclusion Our findings call attention to sleep hygiene among older individuals with chronic medical conditions and recommend that sleep quality should be closely monitored and assessed by healthcare professionals.

This study examines whether race, specifically Asian, contributes to longer inpatient stays for patients with psychiatric diagnoses in a large American city. Secondary data analyses were conducted using Statewide Planning and Research Cooperative System data sets for 983,584 inpatient discharges with psychiatric diagnoses in New York City between 1995 and 1999. Asians were admitted more often through the emergency room and showed a higher incidence of emergency admission than non-Asians. Greater percentages of Asians were diagnosed with schizophrenic disorders and affective psychoses compared to non-Asians. Furthermore, Asians were about 70% less likely to utilize inpatient services but stayed considerably longer than non-Asians when hospitalized. Study findings will assist in development of policy to improve service utilization for this vulnerable population.

Aim To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD). Methods The analysis was conducted with the California Health Interview Survey (CHIS) 2011–2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen’s Health Care Utilization Model. Results The prevalence of DM and SPD were 10.9% and 3.4%, respectively, among participants in the survey. The participants with DM were more likely to experience SPD than those without DM (OR 1.46, 95% CI=1.11–1.91, p=0.006). Participants with combined DM and SPD, the most underserved, were less likely to perceive the need for mental health services and less likely to seek help, compared to those with only SPD. Need factors (SPD status and perceived need) were significantly associated with help-seeking behaviors for mental health, along with predisposing factors (age, gender, obesity, race, and employment), and enabling factors (insurance, English proficiency). Conclusions Perceptions about need for seeking help seem to play an important role in receiving mental health services in addition to other predisposing or enabling factors. Identification of these factors may improve clinical outcomes related to DM and SPD.