Influences on Mental Health Service Utilization for Vietnamese Young Adults

BACKGROUND: Vietnamese-Americans underutilize mental health services. Several factors have been proposed to influence rates of service utilization within this population, including cultural identification and families' acceptance of such services. Most measures of cultural identification are lengthy and burdensome. Furthermore, studies examining the link between parental attitudes towards mental health services and their children's attitudes have only included children who were under the age of 18 - therefore unable to legally seek their own services. This study was designed to address these gaps by developing and testing brief scales of identification with Vietnamese and American culture, and obtaining information about the influence of parents' attitudes on older adolescents and young adults in this cultural group where a strong family orientation persists through the lifespan. A third aim of the study was to examine the role of the participants' acceptance of mental health services both as a predictor for utilization of such services, and as a mediator between other predictors and utilization. SUBJECTS: The participants in the study included a total of 87 Vietnamese-American young adults between the ages of 18 to 30 years old. Participants were recruited from the Texas Exes Asian Alumni Network (TEAAN) in Austin, Texas and from the Mother of Perpetual Faith Catholic Church's youth group. Recruitment also occurred through a method called the "snowball effect," where those involved in the study were asked to help recruit additional participants. METHOD: Surveys were completed on-line. Participants reported their mental health service utilization in the past 12 months. They also were administered measures of potential predictors: cultural identification scales, the participants' distress level, perceived stigma towards mental health services, perceived parental acceptance of mental health services, and their own (personal) acceptance of mental health services. RESULTS: The psychometric properties of the brief cultural identification scales were examined; the scales have good validity, but slightly low reliability. None of the proposed factors were found to be significant predictors of formal mental health service utilization, but items assessing distress level were found to correlate with service utilization at a trend level. The only factor found to predict personal acceptance was perceived parental acceptance of these services. Because personal acceptance was not found to be a predictor of mental health service use, it could not serve as a mediating variable between the other factors and service utilization. DISCUSSION: Before the originally developed cultural identity scales can be used for research, further development of the scales will be necessary. A limitation of this study is that there were very few participants who reported formal mental health service utilization, reducing the power to determine prediction to this variable. In this sample, only distress was found to be even a marginal predictor of mental health service use, suggesting that the low rates of mental health service utilization found in these Vietnamese young adults may in fact be due to actual low levels of psychological distress. The fact that parental acceptance significantly predicted personal acceptance of mental health services among participants supports the idea that parental attitudes towards mental health services may have been adopted by their children, even after they were independent enough to seek their own services. Future research and clinical implications are discussed.