"Helping the search process is an important filter, and only a subset of people who need professional mental health treatment actually seek this help"
Ponterotto et al. [1995], p. 416
Suspected reason for the obstacle
It is well known that minority groups remain silent on seeking mental health assistance and those who do suffer from premature termination. In a study of 135 African-American outpatients, only 25% of white therapists returned after the first visit, while 43% saw the same ethnic therapist suggesting that the client'srapist's racial match was a Key factor. Interestingly, these figures show that 57% of people see the same ethnic therapist not returning, which suggests that racial matching is far from a complete solution. Another similar study was conducted at 17 community mental health centers in the Seattle area of the United States - more than 50% of Asian patients discontinued treatment prematurely after one treatment, compared with 29% of Caucasian patients. These observations are based on differences in attitudes and beliefs about mental illness and psychotherapy, and the failure of the therapist to consider these attitudes leads to failure to build trust, rapport, and effective treatment relationships. In a study that recruited 83 blacks and 66 white college students by phone, the white group was six times more likely to seek help from a psychologist or psychiatrist than the black group.
Semi-structured interviews were conducted with 48 psychiatric patients recruited from mental health institutions. The Asian group [consisting of Filipinos, Koreans, Japanese, and Chinese] has the longest delay between the diagnosis of mental health problems and participation in treatment programs, indicating a reluctance to participate in the help seeking process. During this period, it was found that the family's participation in this group was higher, longer lasting and closer than that of the black or Caucasian population. The authors comment that the mental problems of Asian families may be seen as a threat to the dynamic balance of the entire family. The family actively participated in denying these problems.
Using a sample of random immigrants from India to the United Kingdom, other researchers found that they showed less evidence of emotional disability than matched English samples, and the evidence used had been validated by the relevant groups. This raises the question - are Asians less likely to use services because they have no reason to do so, rather than having access to such help? If there are the same number of stressful life events, as the social support system increases, people will expect a lower likelihood of experiencing psychological distress [and subsequent counseling]. As we all know, Asian communities in the UK are often closely linked to the extended family, and family homes are sometimes composed of three generations. It may be that this support acts as a buffer during periods of emotional difficulty. Other findings refute this suggestion - depression is thought to be less common in West Indian and Asian patients at psychiatric hospitals than in the UK, although this does not reflect the actual incidence of depression in the community.
What are the known obstacles?
There may be barriers at the institutional level - mental health services are inaccessible to ethnic communities; lack of childcare services; focus on inner mental models and strict adherence to timelines. In one study, environmental restrictions ranked second because of premature departure from treatment. Similarly, there may be financial barriers [such as medical insurance in some countries or vacations to participate in work]; cultural barriers [such as language and attitudes toward mental health issues]. It is believed that language barriers and cultural differences are not a problem for second- or third-generation Chinese who are integrated into the host country. In fact, English has a wealth of adjectives to describe internal experiences - such as frustration, despair, disillusionment, pessimism, unhappiness, misery, etc. - There may not be as many direct equivalents in Asian languages. More likely, Asian customers may find it difficult to find English equivalents of words they are familiar with in their native language.
Interviews were conducted with more than 2,000 adults to understand their views on the obstacles that helped to find two specific problems - alcoholism and serious emotional problems. The Caucasian community has fewer barriers than any other Asian population, and this situation persists after controlling for various sociodemographic variables. Shame is rated quite high in each non-Caucasian group, which will be discussed in more detail later in this section. The second most popular response across groups is that the service is not appropriate, or they just don't know about them. Interestingly, the least important factor is the availability of the service and the racial match of the therapist. In one of the few studies conducted with Indian participants, a content analysis of the reaction of Tamil women suffering from depression in India was conducted. Consistent with earlier findings, the search for treatment was affected by the stigma associated with his condition, and another deterrent was the lack of knowledge available for treatment. The shame problem seems to further emphasize that women express the feeling of wanting to "kill" rather than seek treatment.
Need to ask for help
For the victim and the family, shame is equal to the mental health of Asians - perhaps because it reflects a failure in education, or some genetic factors affect families in the community. Asians seem to regard mental illness as a weakness of their personality, and the need to seek professional help is seen as a shame. In Eastern thought, people are convinced that all events are affected to some extent by invisible forces, and that any personal difficulties reflect the misfortune of the victims. Isolation can be set up, and people in the community tend to avoid contact with such people or families. It has been argued that the ancient Indian code meant that people with mental illness were not eligible for certain social privileges, and this shame for mental illness clearly exists in contemporary India. Escape from this stigma may be to cover up the difficulties - perhaps in the process of avoiding the level of awareness of professional sources of help and in negating all non-material problems in the subconscious. For the Chinese, mental illness seems to be seen as a shame, and patients become the secret of the family, as long as the disease is not properly cared for.
It is well known that stressful situations that are assessed as threats to self-esteem can trigger a "self-control" response [ie, suppression or restraint of ongoing thoughts, emotions, and behaviors]. The stigma associated with mental health issues may be related to this threat to self-esteem - perhaps the unwillingness to seek professional help is an extension of this self-control response. Avoiding shame and avoiding seeking help as a mechanism is one of many withdrawals. The concept is to quit the situation that may be ashamed. This may be due to failure to achieve spiritual or cultural ideals, similar to other failures discussed in the literature.
Unable to achieve the ideal shame
Within the religious or spiritual framework of Asians, followers are often eager to surrender to the divine will - accepting their lives and thanking them for what they have, rather than being frustrated by the difficulties or gaps in their lives. For Indians, religion is often a core part of family life. For Indians living outside their country of origin, worship has played an extra role in maintaining identity and maintaining social networks within the community. Some may suggest that people standing in this social and religious field be asked where mental health problems arise. After all, mediocrity is about misfortune, which is against religious ideals. If you lose hope, what is your trust in God? If you don't believe that God knows and does the best, how can you be a believer? This internal dialogue may not only affect the internal judgment of the self [internal shame], but may also influence the judgment of the opinions held by others in the community [external shame]. The inner shame comes from how the self judges the self and thinks that it is bad, flawed, worthless and unattractive. In addition, shame must include a concept of a place or location that people don't want to enter, or an image that people don't want to create - perhaps because the image or location is related to negative aversion attributes that people can't escape. These ideas provide a useful background for Asian families to pay more attention to what must be considered when a family member is hospitalized for overdose.
Shame caused by professional consultation
A factor that doesn't cause much attention is the shame that professionals can cause. Depressed patients who participate in GP surgery may struggle because of symptoms, but feel more painful because they cannot fully express their concerns. If there is a case where Asian groups show different psychological symptoms and expressions, they may not understand the questions asked in the consultation - this dynamic itself may be...
Orignal From: Asian Mental Health (Part 3)
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