Older Chinese participants exhibited less positive attitudes that were significantly associated with Chinese cultural beliefs and values. Implications for practice with older Chinese adults are also discussed.

In light of these results, it is clear that older Chinese immigrants would benefit from information regarding the symptoms, etiology, and treatment of depression, and that this information may begin to address the serious underutilization of mental health services among this group. Our discussion highlights practice implications and promising interventions.

Research on underutilization patterns of mental health services among older Chinese immigrants is limited, partly due to the absence of translated, psychometrically sound measures for assessing attitudes towards seeking help. In this study we interviewed 200 older Chinese Canadian immigrants using a translated version of the Inventory of Attitudes Toward Seeking Mental Health Services scale (IASMHS), and assessed mental health care utilization over the past 12 months and intentions to seek help. Confirmatory factor analysis failed to replicate the original three-factor structure; thus, we used exploratory factor analysis to create a 20-item Chinese version, the C-IASMHS. It had acceptable internal consistency and was positively correlated with intentions to seek help. The Help-Seeking Propensity subscale had the strongest psychometric properties whereas the Psychological Openness subscale performed poorly based on factor analysis results and unacceptable internal consistency. Future research should focus on the conceptual equivalence of psychological openness among Chinese older adults.

Cultural adaptation is important to assess; however, most acculturation measures are unidimensional with little psychometric data for older immigrants. This study assessed a bidimensional measure, the Vancouver Index of Acculturation (VIA; Ryder, Alden, & Paulhus, 2000), among 149 (mean age: 73.92 years) Chinese Canadians. Internal consistencies were .84 and .83 for the Mainstream and Heritage subscales respectively, and they were orthogonal. Convergent and discriminant validity were demonstrated by predicted correlations between the VIA subscales and age at immigration, years in Canada, English fluency, and the Belief in Chinese Culture and Values Scale (BCCV; Lai & Chau, 2007). The VIA accounted for significantly more variance in language ability than the BCCV, above and beyond acculturation proxies. Exploratory factor analysis replicated the two-factor structure reported by Ryder et al. (2000). A confirmatory factor analysis indicated poor fit. This study supports a bidimensional model of cultural adaptation among older Chinese Canadians.

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