Mental illness represents 15 percent of all illness in the United States and affects one in five people at some point in their lives. It costs society an estimated $30 billion, says Garyn Tsuru, a University of Hawaiʻi–West Oʻahu assistant professor of psychology.
Overall, less than 20 percent of sufferers receive treatment. For Asian Americans, the picture is even bleaker—about 17 percent of sufferers seek any help, only 6 percent from a mental health professional.
Barriers to treatment include language for more recent immigrants. “Stigma has a particularly huge impact for Asian Americans,” Tsuru says. “The stereotype is for the model Asian American and therefore no problems. But that is far, far from the actual truth.”
With a growing ethnic population—estimated to reach 60 percent by 2020 or 2030—the U.S. Surgeon General has called for more culturally and linguistically appropriate services. But do they work?
To find out, Tsuru and student Yvonne Yokono looked at data on 1,030 clients—adult Asian Americans of Cambodian, Vietnamese, Korean, Chinese and Iu Mien ancestry—receiving psychotherapy from an ethnic-specific provider. They considered rates of premature termination (discontinuing therapy before reaching goals) and performance on the Global Assessment of Functioning.
The researchers found the highest rates for completing therapy among Southeast Asians, clients with higher levels of education, clients whose intake therapist was their primary therapist and clients who used English as a primary language or had therapists proficient in their language.
Pre- and post assessments indicated that therapy made less of a difference for Cambodian Americans, Korean Americans and clients with schizophrenia or psychotic disorders. Therapy made the most difference for clients with higher education levels, likely because there were lower rates of premature termination and less stigma associated with mental illness.
“There may be culturally related factors unique to specific Asian American ethnic groups that may influence differential treatment outcome,” Tsuru says. “Asian Americans should never, ever be evaluated or lumped as one group” when considering what’s ethnically relevant.
The study was accepted for presentation at the August 2010 American Psychological Association annual convention in San Diego.