Willingness to use mental health counseling and antidepressants in older Korean Americans: the role of beliefs and stigma about depression

Abstract

Objectives: Despite a high prevalence of mental health problems, racial/ethnic minorities are often reluctant to seek mental health services. Their reluctance may be shaped by cultural beliefs and stigma about mental health. The present study examined how beliefs and stigma about depression (e.g. disbelief in depression as a health-related condition, perception of depression as a normal part of aging, and/or depression as a sign of personal weakness/family shame) pose barriers to older Korean Americans' willingness to use mental health counseling and antidepressants.

Method: Data were drawn from surveys with 420 Korean American older adults (M_age= 71.6, SD = 7.6) living in the New York City metropolitan area in 2010. Using a separate logistic regression model, the role of beliefs and stigma about depression in predicting participants' willingness to receive mental health counseling and to take antidepressants was tested. Based on Andersen's behavioral health service use model, the analysis was conducted in consideration of predisposing characteristics (age, gender, marital status, education, and acculturation), mental health needs (anxiety, depressive symptoms, and self-rated mental health), and enabling/hindering factors (beliefs and stigma).

Results: Similar proportions of the sample (69-70%) indicated their willingness to use mental health counseling or antidepressants. Willingness was more likely among participants who had beliefs about depression as a health-related concern (OR = 1.94, 95% CI = 1.15-3.27 for mental health counseling; OR = 4.47, 95% CI = 2.59-7.70 for antidepressants) and less likely among those who associated depression with family shame (OR = .55, 95% CI = 0.33-0.91 for mental health counseling; OR = .56, 95% CI = 0.33-0.95 for antidepressants).

Conclusion: In addressing mental health problems and promoting the use of mental health services, cultural beliefs and stigma shared within an ethnic community should be considered. Given that disbelief in the medical model of depression and family shame reduced willingness to use mental health counseling and antidepressants, promoting mental health literacy for older immigrants could be beneficial.

Keywords: Willingness to use mental health counseling; beliefs about depression; older Korean Americans; stigma; willingness to use antidepressants.