Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Exploring the Socioeconomic and Immigration Health Contexts of Asian Americans

Despite an overall picture of good health for Asian Americans in the aggregate, growing evidence shows that specific subgroups—particularly those with high proportions of immigrants—have diverse patterns relative to socioeconomic position and health. Using data from the largest U.S. state health survey, this study explores the contributions of socioeconomic and immigration factors to health status among Asian American subgroups. Results indicate that level of education, income, and English language ability were significant predictors of health status for the Chinese, Korean, and Vietnamese subgroups. Varying patterns in the results by subgroup are discussed in the context of immigration policy.     

The Influence of Parent Expectations and Parent-Child Relationships on Mental Health in Asian American and White American Families

Previous studies have suggested that Asian parents’ high academic expectations can lead to negative mental health outcomes among Asian American youth. We explore this hypothesis by analyzing data collected in an affluent, suburban high school with a large Asian American population. We examine the relationships between parent expectations, students’ relationships with their parents, and mental health outcomes among Asian American (predominantly Indian American and Chinese American) and white youth. We find that the quality of parent-child relationships is associated with mental health outcomes and that the association between parent expectations and mental health outcomes is insignificant after controlling for these relationships. We discuss significant differences by race and gender. The findings presented expand our understanding of the influence of Asian parents. They suggest that focusing on improving parent-child relationships, as opposed to altering parents’ expectations, might lead to improved mental health outcomes for Asian American youth, particularly for those in affluent communities.     

The Indochinese Refugees

Cambodian, Laotian and Vietnamese refugees who have come to North American host countries via the South Asian camps have been exposed to many potentially traumatic events and have been submitted to an alienating migration process. A comprehensive analysis of their experience both in refugee camps and North American host countries is facilitated by the use of various stress theories. The stressors of change, acculturation, bereavement and trauma are identified with regard to the migration process of the Indochinese refugees as well as to the pre- and post-migration period. Some implications for practice in social, physical and mental health settings are underlined: in particular a sensitivity to the meaning of physical illness within this population, to the cultural reticence towards mental health consultation, to the possibility of longterm vulnerability to post-traumatic stress disorders and to increasing value conflicts within the family. Intervention experiences both in the South Asian refugee camps and in North American host countries suggests the importance of traditional healers and natural support networks.     

Race, ethnicity, and depression in Canadian society

This study examines racial/ethnic differences in mental health using data from the 1996-97 National Population Health Survey. Three hypotheses are tested. First, a socioeconomic hypothesis tests if differences in family income, education, and low income explain racial/ethnic mental health variation. Second, a social resources hypothesis tests if differences in social support explain racial/ethnic mental health variation. Finally, an interaction hypothesis tests if mental health variation stems from specific interactions of race/ethnicity with economic and social factors. Although there are socioeconomic, social resource, and interaction effects, the analysis shows that they do not fully explain racial/ethnic mental health variation. Overall, our results suggest that East and Southeast Asian, Chinese, South Asian, and black Canadians have better mental health than English Canadians. Jewish Canadians have poorer mental health than English Canadians. All other racial/ethnic groupings have similar mental health as English Canadians.     

Child abuse and neglect in Cambodian refugee families: characteristics and implications for practice

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts.     

Perceived discrimination,socioeconomic status,and mental health among Latino adolescents in US immigrant families

The association between interpersonal discrimination and mental health among Latino adolescents has been relatively well studied. Less is known about perceived societal discrimination or how discrimination may differentially impact Latino adolescents with recent immigration histories. Further, while personal and family characteristics have often been posited to influence the association between discrimination and health outcomes, little attention has been paid to potentially moderating influences of social status. Using data from the first two rounds of the Children of Immigrants Longitudinal Study (CILS) study, we estimate a series of logit regression models to investigate the association between discrimination (societal and interpersonal) and mental health (depressive symptoms and self-esteem) among Latino adolescents with recent immigration histories, and test how this association differs by parental socioeconomic status (SES). Results show a negative association between perceived societal and interpersonal discrimination and mental health, inconsistent associations between SES and mental health, and some evidence of a moderating role of parental SES. Specifically, higher SES appears to attenuate the detrimental effect of discrimination on depressive symptoms, particularly in contexts of interpersonal discrimination. Our findings support increased attention to measuring the impact of perceived societal discrimination on mental health outcomes as well as further examination of the intervening role of social status.     

Integrating creative art into a community-based mental health program for Asian American transition age youth

This paper advocates for the use of creative art as an adjunct in the delivery of mental health care for Asian American transition age youth in the United States. A case study of a participant in a community-based mental health program called Project FOCUS in Orange County, California details how art was used to assist a young woman to identify and achieve her personal goals, mitigate her emotional and behavioral problems, and reach a sense of overall well-being. The findings in this paper lay the groundwork for future research into how art can be systematically incorporated into community-based mental health programs to facilitate service utilization. Further, this study demonstrates that Asian American transition age youth face mental health challenges typical of their cohorts, despite being putative members of a “model minority.” The use of creative art transcends cultural and language barriers, and empowers Asian American transition age youth to explore their identity and express their emotions, which ultimately promotes their mental well-being.     

Family separation and refugee mental health–A network perspective

How do the structure and relational features of family networks affect refugees’ mental health after migration, particularly when refugees are geographically separated from their family? Using the first wave of the IAB-BAMF-SOEP Survey of Refugees, which is representative of the population of refugees who arrived in Germany between 2013 and 2016, this study finds that the size of the nuclear family has a significant positive relationship with refugees’ mental health, whereas family separation has a significant negative relationship. In addition to members of the nuclear family, only fathers show a significant positive correlation with refugees’ mental health. The structural and relational aspects are discussed in light of health literature focusing on migration stressors and their relationship with mental health as well as in the context of changing family reunification policies in Germany amid the increase in immigration of refugees since 2015.     

Diversity Among Southeast Asian Ethnic Groups

Abstract

In research on mental health disorders, Southeast Asian ethnic groups have been aggregated into a single, undifferentiated category referred to as Southeast Asians. This onegroup approach risks the misrepresentations of the mental health needs of each of the groups involved in the category. As such, this study tested assumptions of homogeneity among Southeast Asians. A total of 422 Southeast Asians-including Cambodians, Laotians, Miens, and Vietnamese-were compared in the four mental health domains of emotional distress, psychotic symptoms, antisocial behaviors, and community living. The results confirmed the diversity in mental health among Southeast Asians and the need for multiethnic agencies and the multicultural education of clinicians.     

Asian Americans and Mental Health Services

Abstract

Research in the 1970s and 1980s revealed that Asian Americans, compared with other ethnic groups, tended to under-utilize mental health services. This article is aimed at adding new information to the literature by examining data from the 1990s. The raw data comprised 97,212 total admissions representing 45,774 total individuals utilizing mental health services during a four-year period in San Diego County, California. By comparing our findings with previous research cases on utilization patterns of mental health services, new evidence is found about Asian Americans in terms of their (1) underrepresentation in mental health services, (2) presentation of more severe symptoms than those of other racial/ethnic groups when first seen at clinics, (3) lower dropout rates and higher average lengths of stay than other racial/ethnic groups, and (4) higher percentages of using day treatment and outpatient programs but lower percentage of using inpatient programs.     

Children and Families Seeking Asylum in Northern Norway: Living Conditions and Mental Health

The mental health of children seeking asylum and their families is a somewhat neglected area of research. Research on refugee children and children living with adversities suggests that environmental factors are crucial in preventing mental health problems. In this study, we aim to identify central environmental conditions that affect the mental health of children living with their families at governmental asylum processing centres in northern Norway. This study has a qualitative design, and is based on 11 focus group interviews with the staff at asylum processing centres. The interviews were transcribed verbatim and analysed focusing on important risk and protective factors for mental health problems presented by the informants. The results highlighted time spent at asylum centres and the parent's mental health as the most important risk factors. Schooling, activities, general living conditions and poor economy were also seen as crucial. The findings suggest that these children are indeed vulnerable, and at high risk of developing mental health problems. Their rights are, however, open to local interpretations, and they fall between two stools; their right to proper health care, and national and international immigration policies.     

Mental health status of the Hmong Americans in 2011: three decades revisited

This article provides a comprehensive overview of the Hmong in America and encompasses their mental health status for the past 35 years. Since their mass arrival to the United States in 1975, limited research has been compiled to track the specific mental health issues that affect this collective community alone. Major chronological research findings were compiled for this article and specific findings concerning the Hmong and their mental health issues were compared to findings for other Southeast Asian groups. In conclusion, the findings of this article indicate that the Hmong still have higher rates of being diagnosed with depression, the lowest help-seeking behaviors in utilizing Western medicine, and the lowest arithmetic average of "happiness" scaled on an assessment tool. The purpose of this article is to better steer future research projects that entail tracking and differentiating the specific mental health domains of the Hmong.     

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008)

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.     

Editorial

Immigrants from Asian countries who are living in Canada are more likely to live with extended families than Canadian-born seniors. This article focuses on the living arrangements of 161 South Asian immigrant seniors in Edmonton, Alberta, Canada, and examines the relative importance of various factors that influence living arrangements. Demographic characteristics were associated with living arrangements; seniors who immigrated when they were young and were married were the most likely to live independently. Logistic regression analyses suggest that economic and cultural factors were more important than health and availability of kin factors in explaining living arrangements, after controlling for demographic and immigration variables.     

Demographic Profiles of Asian Immigrant Elderly Residing in Metropolitan Ethnic Enclave Communities

Abstract

This study reports the demographic characteristics of six groups of Asian American elders (Chinese, Korean, Indian, Filipino, Vietnamese, and Japanese) in a regional probability sample (n = 407). The findings confirm the heterogeneity of the Asian American elderly population, who differ in terms of demographics, immigration and acculturation experiences, language proficiency, educational attainment, and financial status. Findings point to the importance of taking careful consideration of the specific needs of different population groups of Asian American elders when planning social and support services. Additionally, cultural competence training for health and social service professionals is needed in order to address the special needs, variability, and differences among these Asian ethnic populations.     

The mental health recovery movement and family therapy, part I: consumer-led reform of services to persons diagnosed with severe mental illness

In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commission's recommendation that public mental health organizations adopt a "recovery" approach to severe and persistent mental illness, including services to those dually diagnosed with mental health and substance abuse issues. By formally adopting and promoting a recovery orientation to severe mental illness, the United States followed suit with other first-world nations that have also adopted this approach based on two decades of research by the World Health Organization. This movement represents a significant paradigm shift in the treatment of severe mental health, a shift that is more closely aligned with the nonpathologizing and strength-based traditions in marriage and family therapy. Furthermore, the recovery movement is the first consumer-led movement to have a transformational effect on professional practice, thus a watershed moment for the field. Part I of this article introduces family therapists to the concept of mental health recovery, providing an overview of its history, key concepts, and practice implications. Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts.     

Language proficiency and health status: are bilingual immigrants healthier?

Bilingual immigrants appear to have a health advantage, and identifying the mechanisms responsible for this is of increasing interest to scholars and policy makers in the United States. Utilizing the National Latino and Asian American Study (NLAAS; n = 3,264), we investigate the associations between English and native-language proficiency and usage and self-rated health for Asian and Latino U.S. immigrants from China, the Philippines, Vietnam, Mexico, Cuba, and Puerto Rico. The findings demonstrate that across immigrant ethnic groups, being bilingual is associated with better self-rated physical and mental health relative to being proficient in only English or only a native language, and moreover, these associations are partially mediated by socioeconomic status and family support but not by acculturation, stress and discrimination, or health access and behaviors.