Chinese-Australians' Knowledge of Depression and Schizophrenia in the Context of Their Under-Utilization of Mental Health Care: an Analysis of Labelling
Restricted accessResearch articleFirst published online September, 2007
Chinese-Australians' Knowledge of Depression and Schizophrenia in the Context of Their Under-Utilization of Mental Health Care: an Analysis of Labelling
Background: Low knowledge of and discrimination regarding mental disorders (MDs) may underpin lower access to mental health care by ethnic minority groups.
Aims: In Chinese-Australians, in relation to schizophrenia and depression, to assess (a) labels attached to MDs, (b) conceptual distinctiveness of MDs, (c) labelling accuracy against an Australian representative sample, (d) how syndrome variations may influence labelling, and (e) effects of exposure to MDs on labelling.
Method: 418 subjects were asked to indicate the labels they would apply to vignettes of depression and schizophrenia and whether they were exposed to these disorders personally or socially.
Results: The sample was broadly representative of the Australian-Chinese community: 51% and 47% `correctly' labelled the vignettes. Depression and schizophrenia labels were consistently discriminated and clustered with different other labels. Labelling accuracy surpassed Australians'. Labelling did not vary substantially between syndromes. Exposure related to increased labelling accuracy for depression.
Conclusions: Accuracy in labelling major forms of MDs does not appear low in Chinese-Australians and seems higher than in the Australian community. MDs were discriminated although syndrome variations were not. Findings dispute that low mental health care access and uptake is due to low recognition and discrimination of MDs in Chinese-Australians.
Al-Krenawi, A. (1999) Explanations of mental health symptoms by the Bedouin-Arabs of the Negev . International Journal of Social Psychiatry, 45, 56-64 .
2.
Andrews, G. , Henderson, S. & Hall, W. (2001) Prevalence, comorbidity, disability and service utilisation: an overview of the Australian national mental health survey . British Journal of Psychiatry, 178, 145-153 .
3.
Atkinson, D.R. & Gim, R.H. (1989) Asian-American cultural identity and attitudes toward mental health services . Journal of Counselling Psychology , 36(2), 209-212 .
4.
Bruxner, G. , Burvill, P. , Fazio, S. & Febbo, S. (1997) Aspects of psychiatric admissions of migrants to hospitals in Perth, Western Australia . Australian & New Zealand Journal of Psychiatry, 31, 532-542 .
5.
Chan, F. , Hedl, J.J. , PARKER, H.J., LAM, C.S., CHAN, T.-N. & YU, B. (1988) Differential attitudes of Chinese students toward people with disabilities: a cross-cultural perspective . International Journal of Social Psychiatry, 34(4), 267-273 .
6.
Chan, Y.F. & Quine, S. (1997) Utilisation of Australian health care services by ethnic Chinese . Australian Health Review, 20, 64-77 .
7.
Cheung, F.M. (1986) Conceptualization of psychiatric illness and help-seeking behavior among Chinese. Culture , Medicine and Psychiatry, 10, 97-106 .
8.
Cheung, F.M. & Lau, B.W.K. (1982) Situational variations of help-seeking behavior among Chinese patients . Comprehensive Psychiatry, 23, 252-262 .
9.
Cheung, F.M. , Lee, S.-Y. & Chan, Y.Y. (1983) Variations in problem conceptualizations and intended solutions among Hong Kong students . Culture, Medicine and Psychiatry, 7, 263-278 .
10.
Cheung, F.M. , Lau, B.W.K. & Wong, S.-W. (1984) Paths to psychiatric care in Hong Kong . Culture, Medicine and Psychiatry, 8, 207-228 .
11.
Greenacre, M. (2002) Correspondence analysis of the Spanish National Health Survey . Gazeta Sanitaria, 16(2), 160-170 .
12.
Jorm, T. , Korten, A.E. , Jacomb, P.A. , Christensen, H. , Rodgers, B. & Pollitt, P. (1997) Public knowledge and beliefs about mental disorders . Medical Journal of Australia, 166, 182-186 .
13.
Ju-K'ang, T. (1985) Traditional Chinese beliefs and attitudes toward mental illness . In Chinese Culture and Mental Health (eds W.S. Tseng & D.Y.H. Wu), pp. 67-84 . Orlando, FL: Academic Press .
14.
Kessler, R.C. , Mcgonagle, K.A. , Zhao, S. , Nelson, C.B. , Hughes, H. , Esheleman, S. , Wittchen, H.U. & Kendler, K.S. (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States . Archives of General Psychiatry,51, 8-19 .
15.
Kleinman, A. (1980) Patients and Healers in the Context of Culture . An Exploration of the Borderland between Anthropology, Medicine and Psychiatry. Berkerley: University of California Press .
16.
Kleinman, A. , Eisenberg, L. & Good, B. (1978) Culture, illness and care: clinical lessons from anthropologic and cross-cultural research . Annals of Internal Medicine, 88, 251-258 .
17.
Klimidis, S. , Lewis, J. , Miletic, T. , Mckenzie, S. & Stolk, Y. (1999) Mental Health Service Use by Ethnic Communities in Victoria. Parts I & II. Melbourne: Victorian Transcultural Psychiatry Unit.
18.
Klimidis, S. , Mckenzie, D.P. , Lewis, J. & Minas, I.H. (2000) Continuity of contact with psychiatric services: immigrant and Australian-born patients . Social Psychiatry and Psychiatric Epidemiology, 35(12), 554-563 .
19.
Klimidis, S. & Minas, I.H. (1999) Mental illness in elderly immigrants: a need to focus on the issues . Migration Action, April, 23-27 .
20.
Klimidis, S. , Stuart, G. , Minas, I.H. & Ata, A.W. (1994) Immigrant status and gender effects on psychopathology and self-concept in adolescents: a test of the migration-morbidity hypothesis . Comprehensive Psychiatry, 35(5), 393-404 .
21.
Lam, A.P. & Kavanagh, D.J. (1996) Help seeking by immigrant Indochinese psychiatric patients in Sydney, Australia. Psychiatric Services, 47(9), 993-995 .
22.
Lam, L.C.W. , Chan, C.K.Y. & Chen, E.Y.H. (1996) Insight and general public attitude on psychotic experiences in Hong Kong . International Journal of Social Psychiatry, 42(1), 10-17 .
23.
Lee, S. & Wong, K.C. (1995) Rethinking neurasthenia: the illness concepts of Shenjing Shuairuo among Chinese undergraduates in Hong Kong . Culture, Medicine and Psychiatry, 19, 91-111 .
24.
Lin, K.-M. , Inui, T.S. , Kleinman, A.M. & Womack, W.M. (1982) Sociocultural determinants of help-seeking behavior of patients with mental illness . The Journal of Nervous and Mental Disease, 170, 78-85 .
25.
Lin, K.-M. (1985). Mental disorders and psychiatry in Chinese culture: characteristic features and major issues . In Chinese Culture and Mental Health (eds W.S. Tseng & D.Y.H. Wu), pp. 369-93 . Orlando, FL: Academic Press .
26.
Lin, K.-M. & Cheung, F.M. (1999) Mental health issues for Asian Americans . Psychiatric Services, 50(6), 774-780 .
27.
Lin, T.-Y. & Lin, M.-C. (1978) Service delivery issues in Asian-North American communities . American Journal of Psychiatry, 135, 454-456 .
28.
Lin, T.-Y. , Tardiff, K. , Donetz, G. & Goresky, W. (1978) Ethnicity and patterns of help-seeking . Culture, Medicine and Psychiatry, 2, 3-13 .
29.
Lin, T.-Y. & Lin, M.-C. (1981) Love, denial and rejection: responses of Chinese families to mental illness . In Normal and Abnormal Behavior in Chinese Culture (eds I.A. Kleinman & T.-Y. Lin), pp. 387-401 . Dordrecht: D. Reidel .
30.
Loo, C. , Tong, B. & True, R. (1989) A bitter bean: mental health status and attitudes in Chinatown . Journal of Community Psychology, 17, 283-294 .
31.
Luk, C.-L. & Bond, M.H. (1992) Chinese lay beliefs about the causes and cures of psychological problems . Journal of Social and Clinical Psychology, 11(2), 140-157 .
32.
Mcdonald, B. & Steel, Z. (1997) Immigrants and Mental Health: An Epidemiological Analysis. Sydney: Transcultural Mental Health Centre.
33.
Mclennan, W. (1998) Mental Health and Wellbeing: Profile of Adults, Australia 1997. Canberra: Australia Bureau of Statistics .
34.
Minas, I. (1990) Mental health in a culturally diverse society . In The Health of Immigrant Australia: a Social Perspective (eds J. Reid & P. Trompf), pp. 250-287 . Sydney: Harcourt, Brace Jovanovich .
35.
Parker, G. , Gladstone, G. & Chee, K. (2001) Depression in the planet's largest ethnic group: the Chinese . The American Journal of Psychiatry, 158, 857-864 .
36.
Rogler, L.H. (1993) Help-seeking pathways: a unifying concept in mental health care . The American Journal of Psychiatry,150(4), 554-561 .
37.
Seigel, S. (1956) Nonparametric Statistics for the Behavioural Sciences . Tokyo: McGraw-Hill Kogakusha .
38.
Sheikh, S. & Furnham, A. (2000) A cross-cultural study of mental health beliefs and attitudes towards seeking professional help . Social Psychiatry and Psychiatric Epidemiology, 35, 326-334 .
39.
Stuart, G.W. , Minas, I.H. , Klimidis, S. & O'Connell, S. (1996) English language ability and mental health service utilisation: a census . Australian and New Zealand Journal of Psychiatry, 30, 270-277 .
40.
Stuart, G.W. , Klimidis, S. & Minas, I.H. (1998) The treated prevalence of mental disorder amongst immigrants and the Australian-born: community and primary care rates . International Journal of Social Psychiatry, 44, 22-34 .
41.
Sue, S. & Sue, M. ( 1974) MMPI comparisons between Asian-American and non-Asian American students utilizing a student health psychiatric clinic . Journal of Counselling Psychology, 21, 423-427 .
42.
Tabora, B.L. & Flaskerud, J.H. (1997) Mental health beliefs, practices, and knowledge of Chinese American immigrant women . Issues in Mental Health Nursing, 18, 173-189 .
43.
Takeuchi, D.T. , Leaf, P.J. & Kuo, H.-S. (1988) Ethnic differences in the perception of barriers to help-seeking . Social Psychiatry and Psychiatric Epidemiology , 23, 273-280 .
44.
Trauer, T. (1995) Ethnic differences in the utilisation of public psychiatric services in an area of suburban Melbourne . Australian and New Zealand Journal of Psychiatry, 29, 615-623 .
45.
Wig, N. ( 1990) Indian concepts of mental health and their impact on care of the mentally ill . International Journal of Mental Health , 18(3), 71-80 .
46.
Yarrow, M.R. , Clausen, J.A. & Robbins, P.R. (1955) The social meaning of mental illness . The Journal of Social Issues, XI(4), 33-48 .
47.
Yeung, A. , Gresham, R.L.J. , Nierenberg, A.A. & Fava, M. (2004) Illness beliefs of depressed Chinese American patients in primary care . Journal of Nervous and Mental Disease, 192(4), 324-327 .
48.
Ying, Y.-W. (1990) Explanatory models of major depression and implications for help-seeking among immigrant Chinese-American women. Culture , Medicine and Psychiatry, 14, 393-408 .
