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Running head: ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 1

Asian Americans and the Relationship between Levels of Acculturation and the Obstacles to

Seeking Psychological Help

Student Name

San Francisco State University

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 2

Studies are conducted to analyze different minority group’s levels of acculturation and

the link they possess to likelihood of seeking medical services. This review will focus

specifically on Asian American individuals and their beliefs regarding mental health/disorders,

and how said beliefs influence the attitudes they hold regarding seeking of psychological

treatment. It should be noted that Asian Americans as a group are very diverse and should not

necessarily be grouped as a whole when analyzing social theories and trends. The

underutilization of mental health resources by Asian Americans is a topic that is still in the

process of being studied, though there are studies and analysis available. In this review

acculturation shall viewed as one’s ability to become acquainted with, knowledgeable of, and

comfortable participating in the beliefs and systems of their second culture. Enculturation should

be defined as one’s level of adhering to their original culture (Lin 2014). Startling statistics such

as the fact that about 70 percent of Vietnamese refugees meet the criteria for PTSD yet are the

group underutilizes mental health resources the most (Nguyen 2013) make it clear that there is a

problem present. Asian Americans have historically low rates of utilization of mental health

resources (Frey & Roysircar 2006). This is due in part to one’s culture and beliefs about health

and medicine. Furthermore, levels of acculturation and enculturation are proven to be related to

attitudes and willingness to seek psychological help (Lin 2014). I hypothesize that higher levels

of acculturation will be linked to a more positive view of Western medicine and treatment

regarding mental health.

Methods

Information was gathered for this review through extensive searches in scholarly

databases. Dissertations and theses using ProQuest under the databases: “Ethnic NewsWatch”,

“Social Sciences”, and “Sociological Abstracts”. The topic of the relevancy of acculturation in

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 3

regards to likelihood of seeking psychological treatment amongst the Asian American population

seemed intriguing mainly due to the fact that it has never been properly addressed. I found when

searching through various articles that depending on the group (i.e. Vietnamese, Laotian, and

Japanese) there were different trends and rates of turnout.

Questions that guided research into this topic were: “Why do Asian American

populations historically underutilize mental health resources?”, “Why is acculturation have such

an identifiable link to whether someone of Asian American decent has positive or negative

attitudes about seeking help for mental problems?”, “What values and beliefs from one’s

original culture discourage people from seeking help for mental problems?”, “What are barriers

are present that make it difficult for someone to seek out help even in their second culture?”,

“Why is mental health stigmatized in Asian American culture, therefore leading many to be

hesitant to seek out help even once moved into the new culture that is accepting?”, and “Is it

possible to be both fully enculturated in one’s original Asian culture, whilst also acculturated in a

new one and possess positive attitudes towards seeking psychological treatment?”.

Many of the answers to these questions were found in studies conducted on college

students in the US of various ethnicities that fall under the “Asian American” umbrella. When

searching under the various databases listed previously, many studies appeared that addressed

refugees and immigrants. A common trend amongst articles and experiments conducted was the

usage of the term “help-seeking attitudes” when referring to how certain populations viewed the

stigma of receiving help for their psychological problems.

Once conducting an ample amount of research into the articles and dissertations

available it quickly became apparent that due to a lack of field research into the topic, in order to

collect a sufficient amount of credible evidence it would be better to center my analysis on the:

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 4

beliefs, stigmas and trends, of help-seeking attitudes amongst AAPI populations as a whole. This

involved focusing on acculturation in a more macro, holistic level in the AAPI community.

Results/ Discussion

Research suggests ideas and values about health in Asian culture plays a large factor in

the correlation between level of acculturation and help-seeking attitudes. There are noticeable

disparities and differences between concepts about mental health in Asian culture and

American/western culture. Asian American families often believe that mental l problems or

disorders should not be brought outside of the home like physical ones (Lin, 2014). A concept

such as yin/yang is present across many Asian cultures which influences views on health, but

also lifestyle as a whole. The concept of mind and body being linked and harmonious is present

cross-culturally amongst Asian countries. As expressed by (Lin, 2014) a mental problem or

disorder is often described as “demons, spirits, punishment, or a weak mind”. In this case, a less

acculturated individual is less likely see the importance of seeing a counselor or mental health

professional. Research suggests that South East Asians specifically, see mind and body being

inseparable. An example of this is what Western medicine would describe as anxiety, a South

East Asian would describe as a result of something physical such as kidney malfunction (Frey &

Roysircar, 2006). Psychotherapy and medicine involving the mind is foreign to many Asian

cultures. This being said, if an individual is less acculturated to Western society, they are less

likely to have knowledge on or put much focus into their mental health therefore explaining the

low rates of utilization by Asian Americans. Going by the unilineal model of acculturation, it can

be assumed that the more entrenched one is in the ideas of their original culture (i.e. mental

problems are demons), the less acculturated they are in the ideas of their new one (mental

problems are common and can be fixed) (Lin, 2014). Therefore, someone who is less

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 5

acculturated to Western ideals of medicine is less likely to go out of their way to seek help for

their mental health problems. This might also explain the historically low levels of utilization of

psychotherapy by Asian Americans.

Level of adherence to one’s original culture and ideas about medicine previously

mentioned seemed to be a common theme throughout various pieces of research. Adherence to

traditional Asian values was proven by to have a direct correlation to help-seeking attitudes. The

higher the level of enculturation, the more negative ideas toward seeking help for mental health

(Yin, 2014). Asian cultures are collectivist cultures stated by (Frey&Roysircar, 2006). This

seemingly impacts how their help-seeking attitudes because collectivist societies emphasize the

importance of the greater group as a whole and discourage complaining about individual

problems one may possess. Another value expressed in Asian culture is the importance of

‘saving face’ so to speak, which is used to maintain harmony in collectivist cultures (Nguyen,

2013). The emphasis of the goals of the group rather than the individual, especially in family,

likely explains why less acculturated individuals are hesitant to seek treatment. Asian families

are also more likely to make decisions as a group (Nguyen, 2013) so if a problem is seen as

‘weak’ or shameful (such as depression or anxiety) the problem will likely stop there without

publically seeking help. When comparing the ideas of Western culture (where it is indeed

acceptable for a child to individually seek help from a counselor or other mental health

professional) and Asian culture (where it is discouraged, not thought of as critical, and often

shamed) it becomes clear why there is a link between level of enculturation and help-seeking

attitudes.

A final theme discovered is the correlation between length of stay in the new culture, and

help-seeking attitudes. One example of this is a study referenced by (Nguyen,2013) that involved

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 6

a study of 202 Asian American college students that found that higher levels of acculturation

correlated with a positive view of help-seeking for mental problems and vice versa. This once

again shows a direct link between acculturation and likelihood of seeking help at least among

college students. In addition, level of acculturation has been proven to influence one’s preference

of ethnicity when looking for a counselor (Frey&Roysircar, 2006) and considering there is

significant lack of culturally representative/sensitive healthcare available in Western medicine it

is no surprise that many individuals are hesitant or reluctant to seek help. A study also conducted

by (Frey&Roysircar, 2006) showed the significance of gender in being likely to seek help. The

study showed that Asian American women were much more likely to have positive-health

seeking attitudes towards seeking help for mental illnesses possibly due in part to the fact that it

is more acceptable for women to show emotion in Asian culture. Cutting out half of the

population of Asian Americans (men) from the group of people likely to seek psychological

help, might help explain the low levels of utilization by Asian American individuals if they are

heavily encultured in their original culture and possess beliefs on gender roles that are

synonymous to said culture.

Conclusion

In conclusion, after conducting research into the topic of acculturation and correlation to

help-seeking attitudes amongst Asian Americans I noticed several themes. It is clear that

traditional Asian values about mental health and health as a whole, influence individuals that are

residing in their new culture. Secondly, the attitudes common in Asian societies such as

collectivist ideals on group goals and views on weakness influence many Asian Americans in

their decision making when contemplating help-seeking. The more someone is anchored in the

beliefs of their specific Asian culture and is less impacted by Western medicine ideas, the more

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 7

likely they are to avoid seeking help for mental problems or disorders. Lastly, it is clear that the

more time spent in Western culture, the more positive the help-seeking attitudes due to the

accepting nature of psychotherapy in Western culture.

These results are significant to Asian American health because it displays a hole in our

healthcare system. Mental health is important and arguably makes up half of one’s health status,

which would make it concerning that there such a disparity between Asian American mental

health resource utilization and Caucasian’s. Levels of mental disorders such as depression,

anxiety, bipolar disorder, are serious problems and it is dangerous to wait until the situation is

dire.

If I had to make recommendations for future research into the topic, I would suggest

conducting experiments and analysis on more age groups (as opposed to solely college students)

and focus on specific groups within the race as a whole. Studies also appeared to be relatively

new which indicates a need for more research in mental health seeking tendencies amongst Asian

Americans in general. A few conflictions were apparent between various studies which possibly

made findings less definitive than desired, proving furthermore a need for more research into the

topic. These things are needed in order to produce more concrete evidence.

ASIAN AMERICANS, ACCULTURATION, AND SEEKING OF PSYCHOLOGICAL HELP 8

References

Frey, L.L., & Roysircar, G. (2006). South Asian and East Asian International Students’

Perceived Prejudice, Acculturation, and Frequency of Help Resource

Utilization(Unpublished master’s thesis). Journal of Multicultural Counseling and

Development; Washington. Doi:http://search-proquest-

com.jpllnet.sfsu.edu/ethnicnewswatch/docview/235999332/fulltextPDF/17AA839B73D0

41D8PQ/1?accountid=13802

Lin, R. (2014). Asian American Acculturation and Psychological Help-Seeking Attitudes: Meta-

Analysis(Unpublished master’s thesis). Wheaton College. Retrieved December 15, 2017,

from http://search-proquest-

com.jpllnet.sfsu.edu/dissertations/docview/1609204968/358ADE8925CD4861PQ/2?acco

untid=13802

Nguyen, M. V. (2013). The Effects of Psychoeducation on the Help-Seeking Attitudes of

Vietnamese Refugees for Post-Traumatic Stress Disorder(Master’s thesis, The Chicago

School of Professional Psychology). Proquest Disserations Publishing. doi:http://search-

proquest-

com.jpllnet.sfsu.edu/ethnicnewswatch/docview/1524722566/2321DF8ABFB94C54PQ/1

4?accountid=13802