Parent perceptions of mental illness in Chinese American youth.

BACKGROUND: Although parents are often the first to facilitate help-seeking in their children, parental perceptions regarding mental health serve as a significant barrier to the access of mental health services. This study examined mental health perceptions held by Chinese immigrant parents of youth. METHODS: Eighteen parents (13 female, 5 male), who identified as having children between the ages of 13 and 21 years, participated in audio-recorded interviews using five vignettes depicting depression with and without a somatic emphasis, schizophrenia with paranoid features, attenuated psychosis syndrome, and social anxiety in youth. Questions about potential causes, likely diagnosis, and health-seeking behaviors in relation to these vignettes were asked. Interviews were analyzed for themes using a deductive-inductive hybrid approach, informed by the explanatory models that have shed light on Asian perceptions of mental illness and approaches to help-seeking. RESULTS: While Asian groups are often considered as lacking in mental health knowledge, we found that Chinese immigrant parents were comfortable with psychological terminology as it pertained to identifying causes and describing supportive strategies and the seeking of Western-based providers. However, the majority of Chinese immigrant parent respondents did not easily note suicidality. Furthermore, respondents did not consider social anxiety as a major mental health issue among Chinese immigrant parents and attributed social anxiety to personality or cultural differences. DISCUSSION: These findings provide an understanding of how Chinese immigrant parents conceptualize mental illness and help-seeking, which may be helpful for providers when working with Chinese immigrant parents of children that have a mental health concern.

Intrapersonal and interpersonal determinants of smoking status among Asian American adolescents: findings from a national sample.

INTRODUCTION: Asian American youth are one of the fastest growing populations in the United States. This present study examined intrapersonal and interpersonal determinants of smoking status among Asian American adolescents. METHODS: Using data from the 2006 National Youth Tobacco Survey, 1,368 Asian American adolescents in Grades 6 through 12 were selected. RESULTS: Findings revealed that one eighth (12%) experimented with cigarettes, 3% smoked occasionally, and 2% smoked regularly. High school students reported higher rates for experimental, occasional, and regular smoking than middle school students. More male than female youth reported the three types of smoking status. Multivariate analyses showed that, compared with nonsmoking, age, weekly income, family members' smoking, refusal of cigarettes from best friends predicted experimental smoking; and positive images of smoking, perception of safety of smoking for only 1 year, awareness of the harmful effects of secondhand smoking, refusal to smoke, and absence from school predicted occasional smoking. Age interacted with refusal to smoke in predicting occasional smoking. Male gender, awareness of the harmful effects of secondhand smoking, refusal to smoke, absence from school, and receptivity to tobacco marketing were determinants of regular smoking. DISCUSSION: This study uniquely examined how the impacts of multiple intrapersonal and interpersonal predictors differed by various stages of smoking in a nationally representative sample of Asian American adolescents. Our findings underscore that smoking treatment and prevention programs should consider predictors of risk for different stages of adolescent smoking.

Failure to seek health care among the mentally ill.

This study describes failure to seek health care among 673 new adult clients seeking mental health services in the San Francisco Bay area. Overall, 49% (n = 328) reported a failure to seek health care they believed was needed in the past year. People with dual diagnosis, severe depression, chronic physical illness, fear of coercive treatment, private insurance, and no insurance were more likely to fail to seek health care. Greater use of private physicians decreased the odds of failure to seek health care. These findings highlight the need to target groups at risk for failure to seek health care and the need to design nonthreatening programs to improve health access for people with mental illness.

Acculturation and parental attachment in Asian-American adolescents' alcohol use.

PURPOSE: To test whether the degree of acculturation predicts subsequent alcohol use among Asian-American adolescents, and to test the moderating effect of parental attachment. METHODS: This was a prospective study using a subsample of the National Longitudinal Adolescent Health data set. A nationally representative sample of 714 Asian-American boys (n = 332) and girls (n = 382) in grades 7-12 was analyzed. In-home self-report data were collected on two types of acculturation status, alcohol use, demographics, and parental attachment. After controlling for acculturation status and background variables at Wave I, logistic regression analysis was used to estimate the odds ratios to assess the association between acculturation and alcohol use at Wave II for adolescents. RESULTS: Asian-American adolescents with the highest level of acculturation (English use at home, born in the United States) were identified as the highest risk group. For adolescents with low parental attachment, the odds of alcohol use were 11 times greater in the highly acculturated group than in the least acculturated group. However, the odds of alcohol use for adolescents with moderate or high levels of parental attachment did not vary across acculturation groups. CONCLUSIONS: Overall, a greater level of acculturation was associated with greater alcohol use. However, when parental attachment was taken into account, highly acculturated adolescents with moderate or high parental attachment had no greater risk than adolescents with same levels of parental attachment who were less acculturated. Thus, it appears that acculturation per se was not a risk factor unless it was accompanied by a low level of parental attachment.

Adolescent victimization and subsequent use of mental health counseling services.

PURPOSE: To test the extent to which adolescent victimization predicts subsequent use of mental health services in a prospectively assessed nationwide sample of high school students. METHODS: Data were analyzed from 4590 adolescents participating in Waves I and II of the National Longitudinal Survey of Adolescent Health. In-home self-report data were collected on four types of personal victimization, mental health service use, demographics, psychological symptoms/needs, and family connectedness. Using logistic regression analysis, adolescents' victimization and background variables at Wave I were entered as predictors of subsequent mental health service use, measured at Wave II. RESULTS: In this national sample, 19.6% of the respondents stated that they had experienced at least one of four forms of personal victimization in the prior year. Of those reporting personal victimization, 11.0% stated they had used mental health services at 1-year follow-up, as compared to 9.2% of those who did not report any personal victimization. After controlling for background variables in logistic regression analyses, however, adolescents' victimization reported at Wave I was associated with significantly lower odds of subsequent mental health service use at Wave II. CONCLUSIONS: Evidence does not indicate that adolescents' victimization prompts mental health service use, and rather indicates that in some instances victimization is associated with lower odds of subsequent mental health service use. These findings raise questions about the degree to which adolescents receive needed professional mental health supports in the wake of serious violence exposure.