Does Mental Health Literacy Predict Help-Seeking Behaviors Among Depressed Asian International Students?
DOI:
https://doi.org/10.32674/jis.v14i3.5090Keywords:
college students, international students, Asian, Mental health literacy, help-seekingAbstract
This study aimed to examine whether Asian international students’ mental health literacy predicts mental health help-seeking behaviors above and beyond known influencing factors. Hierarchical logistic regression was conducted in analyzing a national sample of 460 Asian international students who reported depressive symptomatology. Results indicated that students who identified as female and experienced more days of academic impairment were more likely to seek counseling. Additionally, having more knowledge on mental disorders and treatments and campus mental health services were positively related to help-seeking behavior. However, the ability to recognize the development of mental disorders in others was negatively associated with seeking mental health help. Implications for administrators, college program planners, and mental health providers are discussed.
References
Akutsu, P. D., Lin, C. H., & Zane, N. W. S. (1990). Predictors of utilization intent of counseling among Chinese and White students: A test of the proximal-distal model. Journal of Counseling Psychology, 37(4), 445–452. https://doi.org/10.1037/0022-0167.37.4.445
Becker, M., Martin, L., Wajeeh, E., Ward, J., & Shern, D. (2002). Students with mental illnesses in a university setting: Faculty and student attitudes, beliefs, knowledge, and experiences. Psychiatric Rehabilitation Journal, 25(4), 359–368. https://doi.org/10.1037/h0095001
Bonabi, H., Müller, M., Ajdacic-Gross, V., Eisele, J., Rodgers, S., Seifritz, E., Rössler, W., & Rüsch, N. (2016). Mental Health Literacy, Attitudes to Help Seeking, and Perceived Need as Predictors of Mental Health Service Use: A Longitudinal Study. The Journal of Nervous and Mental Disease, 204(4). https://journals.lww.com/jonmd/Fulltext/2016/04000/Mental_Health_Literacy,_Attitudes_to_Help_Seeking,.13.aspx
California Department of Justice. (2021). Hate Crime in California. Retrieved from https://oag.ca.gov/system/files/attachments/press-docs/Hate%20Crime%20In%20CA%202021%20FINAL.pdf
Cascamo Jr, J. A. (2013). Gatekeeper suicide prevention training and its impact on attitudes toward help seeking (Doctoral dissertation, Walden University).
Cheah, C. S. L., Wang, C., Ren, H., Zong, X., Cho, H. S., & Xue, X. (2020). COVID-19 Racism and Mental Health in Chinese American Families. Pediatrics, 146(5). https://doi.org/10.1542/peds.2020-021816
Chen, H.-M., & Lewis, D. C. (2011). Approaching the “Resistant:” Exploring East Asian International Students’ Perceptions of Therapy and Help-Seeking Behavior Before and After They Arrived in the United States. Contemporary Family Therapy, 33(3), 310. https://doi.org/10.1007/s10591-011-9154-6
Cheng, H.-L., Wang, C., McDermott, R. C., Kridel, M., & Rislin, J. L. (2018). Self-Stigma, Mental Health Literacy, and Attitudes Toward Seeking Psychological Help. Journal of Counseling & Development, 96(1), 64–74. https://doi.org/10.1002/jcad.12178
Clough, B. A., Nazareth, S. M., & Casey, L. M. (2020). Making the grade: A pilot investigation of an e-intervention to increase mental health literacy and help-seeking intentions among international university students. British Journal of Guidance & Counselling, 48(3), 347–359. https://doi.org/10.1080/03069885.2019.1673312
Dong, F., Hwang, Y., & Hodgson, N. A. (2022). Relationships between racial discrimination, social isolation, and mental health among international Asian graduate students during the COVID-19 pandemic. Journal of American College Health, 1–8. https://doi.org/10.1080/07448481.2022.2052076
Ee, J. (2013). “He’s an idiot!” Experiences of International Students in the United States. Journal of International Students, 2013 Vol. 3 (1), 72.
Eisenberg, D., Golberstein, E., & Gollust, S. E. (2007). Help-Seeking and Access to Mental Health Care in a University Student Population. Medical Care, 45(7), 594–601. https://doi.org/10.1097/MLR.0b013e31803bb4c1
Farrer, L., Leach, L., Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008). Age differences in mental health literacy. BMC Public Health, 8(1), 125. https://doi.org/10.1186/1471-2458-8-125
Federal Bureau of Investigation. (July, 2022). Hate Crime in the United States Incident Analysis, 2020. Retrieved from https://crime-data-explorer.fr.cloud.gov/pages/explorer/crime/hate-crime
Flum, M. E. (1998). Attitudes toward mental health and help-seeking preferences of chinese, japanese, and korean international college students. Dissertation Abstracts International Section A: Humanities and Social Sciences, 59(5-A), 1470.
Fritz, M. V., Chin, D., & DeMarinis, V. (2008). Stressors, anxiety, acculturation and adjustment among international and North American students. International Journal of Intercultural Relations, 32(3), 244–259. https://doi.org/10.1016/j.ijintrel.2008.01.001
Furnham, A., Cook, R., Martin, N., & Batey, M. (2011). Mental health literacy among university students. Journal of Public Mental Health, 10(4), 198–210. https://doi.org/10.1108/17465721111188223
Gorczynski, P., & Sims-Schouten, W. (2022). Evaluating mental health literacy amongst US college students: A cross sectional study. Journal of American College Health, 1–4. https://doi.org/10.1080/07448481.2022.2063690
Gorczynski, P., Sims-schouten, W., Hill, D., & Wilson, J. C. (2017). Examining mental health literacy, help seeking behaviours, and mental health outcomes in UK university students. The Journal of Mental Health Training, Education and Practice, 12(2), 111–120. https://doi.org/10.1108/JMHTEP-05-2016-0027
Hamamura, T., & Laird, P. G. (2014). The Effect of Perfectionism and Acculturative Stress on Levels of Depression Experienced by East Asian International Students. Journal of Multicultural Counseling and Development, 42(4), 205–217. https://doi.org/10.1002/j.2161-1912.2014.00055.x
Healthy Minds Network (2022). Healthy Minds Study among Colleges and Universities, year (2018-2019) [Data set]. Healthy Minds Network, University of Michigan, University of California Los Angeles, Boston University, and Wayne State University. https://healthymindsnetwork.org/reserach/data-for-researchers
Hwang, W.-C., & Goto, S. (2008). The impact of perceived racial discrimination on the mental health of Asian American and Latino college students. Cultural Diversity and Ethnic Minority Psychology, 14(4), 326–335. https://doi.org/10.1037/1099-9809.14.4.326
Hyun, J., Quinn, B., Madon, T., & Lustig, S. (2007). Mental Health Need, Awareness, and Use of Counseling Services Among International Graduate Students. Journal of American College Health, 56(2), 109–118. https://doi.org/10.3200/JACH.56.2.109-118
Jang, Y., Gum, A.M., & Chiriboga, D.A. (2011). Knowledge of depression among Korean American older adults. Journal of Applied Gerontology, 30, 655–665.
Jin, L., & Acharya, L. (2022). Developing Tailored Messages to Improve Mental Health and Adjustment of Asian International Students . Journal of International Students, 12(4), 817–842. https://doi.org/10.32674/jis.v12i4.3934
Jochman, J. C., Cheadle, J. E., Goosby, B. J., Tomaso, C., Kozikowski, C., & Nelson, T. (2019). Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study. Socius, 5, 2378023119842728. https://doi.org/10.1177/2378023119842728
Johnson, L. R., Seifen-Adkins, T., Singh Sandhu, D., Arbles, N., & Makino, H. (2018). Developing Culturally Responsive Programs to Promote International Student Adjustment: A Participatory Approach. Journal of International Students, 8(4), 1865–1878. https://doi.org/10.32674/jis.v8i4.235
Jorm, A. F. (2000). Mental health literacy: Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177(5), 396–401. Cambridge Core. https://doi.org/10.1192/bjp.177.5.396
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231–243. https://doi.org/10.1037/a0025957
Jorm, A. F., Christensen, H., & Griffiths, K. M. (2005). Public beliefs about causes and risk factors for mental disorders. Social Psychiatry and Psychiatric Epidemiology, 40(9), 764–767. https://doi.org/10.1007/s00127-005-0940-z
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182–186. https://doi.org/10.5694/j.1326-5377.1997.tb140071.x
Jung, H., von Sternberg, K., & Davis, K. (2017). The impact of mental health literacy, stigma, and social support on attitudes toward mental health help-seeking. International Journal of Mental Health Promotion, 19(5), 252–267. https://doi.org/10.1080/14623730.2017.1345687
Kim, J. E., & Zane, N. (2016). Help-seeking intentions among Asian American and White American students in psychological distress: Application of the health belief model. Cultural Diversity and Ethnic Minority Psychology, 22(3), 311–321. APA PsycArticles. https://doi.org/10.1037/cdp0000056
Koo, K., Kim, Y. W., Lee, J., & Nyunt, G. (2021). “It’s My Fault”: Exploring Experiences and Mental Wellness Among Korean International Graduate Students. Journal of International Students, 11(4), Article 4. https://doi.org/10.32674/jis.v11i4.2801
Koo, K., & Nyunt, G. (2022). Pandemic in a Foreign Country: Barriers to International Students’ Well-being during COVID-19. Journal of Student Affairs Research and Practice, 1–14. https://doi.org/10.1080/19496591.2022.2056476
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lam, A. Y., Jorm, A. F., & Wong, D. F. (2010). Mental health first aid training for the Chinese community in Melbourne, Australia: Effects on knowledge about and attitudes toward people with mental illness. International Journal of Mental Health Systems, 4(1), 18. https://doi.org/10.1186/1752-4458-4-18
Lee, D. L., & Ahn, S. (2011). Racial Discrimination and Asian Mental Health: A Meta-Analysis. The Counseling Psychologist, 39(3), 463–489. https://doi.org/10.1177/0011000010381791
Li, J., Wang, Y., Liu, X., Xu, Y., & Cui, T. (2018). Academic Adaptation Among International Students from East Asian Countries: A Consensual Qualitative Research. Journal of International Students, 8(1), Article 1. https://doi.org/10.32674/jis.v8i1.160
Li, P., Wong, Y. J., & Toth, P. (2013). Asian International Students’ Willingness to Seek Counseling: A Mixed-Methods Study. International Journal for the Advancement of Counselling, 35(1), 1–15. https://doi.org/10.1007/s10447-012-9163-7
Lian, Z., & Wallace, B. C. (2020). Prevalence of past-year mental disorders and its correlates among Chinese international students in US higher education. Journal of American College Health, 68(2), 176–184. https://doi.org/10.1080/07448481.2018.1538147
Liao, H.-Y., Rounds, J., & Klein, A. G. (2005). A Test of Cramer's (1999) Help-Seeking Model and Acculturation Effects With Asian and Asian American College Students. Journal of Counseling Psychology, 52(3), 400–411. https://doi.org/10.1037/0022-0167.52.3.400
Liu, H., Wong, Y. J., Mitts, N. G., Li, P. F. J., & Cheng, J. (2020). A Phenomenological Study of East Asian International Students’ Experience of Counseling. International Journal for the Advancement of Counselling, 42(3), 269–291. https://doi.org/10.1007/s10447-020-09399-6
Ma, K. (2021). Facilitating Recovery through Building an Interconnected Community: From Awareness to Action. Journal of International Students, 11(4), Article 4. https://doi.org/10.32674/jis.v11i4.3303
Ma-Kellams, C. (2014). Cross-cultural differences in somatic awareness and interoceptive accuracy: A review of the literature and directions for future research. Frontiers in Psychology, 5, 1379.
Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. (2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health, 10(6), 574–582. https://doi.org/10.1080/13607860600641200
Maeshima, L. S., & Parent, M. C. (2020). Mental health stigma and professional help-seeking behaviors among Asian American and Asian international students. Journal of American College Health, 70(6), 1761-1767. https://doi.org/10.1080/07448481.2020.1819820
Marangell, S., & Baik, C. (2022). International Students’ Suggestions for What Universities Can Do to Better Support Their Mental Wellbeing. Journal of International Students, 12(4), 933–954. https://doi.org/10.32674/jis.v12i4.3877
Milin, R., Kutcher, S., Lewis, S. P., Walker, S., Wei, Y., Ferrill, N., & Armstrong, M. A. (2016). Impact of a Mental Health Curriculum on Knowledge and Stigma Among High School Students: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 55(5), 383-391.e1. https://doi.org/10.1016/j.jaac.2016.02.018
Mojtabai, R., Evans-Lacko, S., Schomerus, G., & Thornicroft, G. (2016). Attitudes Toward Mental Health Help Seeking as Predictors of Future Help-Seeking Behavior and Use of Mental Health Treatments. Psychiatric Services, 67(6), 650–657. https://doi.org/10.1176/appi.ps.201500164
Morgan, N. T., & Robinson, M. (2003). Students’ Help-Seeking Behaviours by Gender, Racial Background, and Student Status. Canadian Journal of Counselling, 37(2), 151–166.
Mori, S. C. (2000). Addressing the Mental Health Concerns of International Students. Journal of Counseling & Development, 78(2), 137–144. https://doi.org/10.1002/j.1556-6676.2000.tb02571.x
Mosher, D. K., Hook, J. N., Captari, L. E., Davis, D. E., DeBlaere, C., & Owen, J. (2017). Cultural humility: A therapeutic framework for engaging diverse clients. Practice Innovations, 2(4), 221–233. https://doi.org/10.1037/pri0000055
National Center for Education Statistics. (2020) Digest of Educational statistics. Washington, D.C: National Center for Education Statistics, Office of Educational Research and Improvement, U.S. Dept. of Education.
Nilsson, J. E., Berkel, L. A., Flores, L. Y., & Lucas, M. S. (2004). Utilization Rate and Presenting Concerns of International Students at a University Counseling Center. Journal of College Student Psychotherapy, 19(2), 49–59. https://doi.org/10.1300/J035v19n02_05
Nilsson, J. E., Butler, J., Shouse, S., & Joshi, C. (2008). The relationships among perfectionism, acculturation, and stress in Asian international students. Journal of College Counseling, 11(2), 147–158. https://doi.org/10.1002/j.2161-1882.2008.tb00031.x
Penman, J., Malik, G., Chu, E., Kett, G., Hampton, K., Thomacos, N., Ebrahimi-Zanjani, M., Zhong, Y., & McKenzie, W. (2021). Empowering International Students to Succeed: An Innovative and Beneficial Initiative for Health Professions . Journal of International Students, 11(4), 832–852. https://doi.org/10.32674/jis.v11i4.2226
Poyrazli, S., Kavanaugh, P. R., Baker, A., & Al-Timimi, N. (2004). Social Support and Demographic Correlates of Acculturative Stress in International Students. Journal of College Counseling, 7(1), 73–82. https://doi.org/10.1002/j.2161-1882.2004.tb00261.x
Reavley, N. J., McCann, T. V., & Jorm, A. F. (2012). Mental health literacy in higher education students. Early Intervention in Psychiatry, 6(1), 45–52. https://doi.org/10.1111/j.1751-7893.2011.00314.x
Smith, C. L., & Shochet, I. M. (2011). The Impact of Mental Health Literacy on Help-Seeking Intentions: Results of a Pilot Study with First Year Psychology Students. International Journal of Mental Health Promotion, 13(2), 14–20. https://doi.org/10.1080/14623730.2011.9715652
Summers, L. M., & Nelson, L. (2022). Multicultural Counseling: Responding With Cultural Humility, Empathy, and Advocacy (1st ed., pp. 978-0-8261-3953–3955). Springer Publishing Company. https://doi.org/10.1891/9780826139535
Surapaneni, S. (2018). The Role of Parental Stigma on Self-Stigma and Help-Seeking Intentions: Differences Between Asian, Asian American, and Caucasian American Populations (Order No. 10826636). Available from ProQuest Dissertations & Theses Global. (2121083422)
Tan, J. B., & Yates, S. (2011). Academic expectations as sources of stress in Asian students. Social Psychology of Education, 14(3), 389–407. https://doi.org/10.1007/s11218-010-9146-7
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125.
Wendt, D., & Shafer, K. (2016). Gender and Attitudes about Mental Health Help Seeking: Results from National Data. Health & Social Work, 41(1), e20–e28. https://doi.org/10.1093/hsw/hlv089
Wong, D. F. K., Lam, A. Y. K., Poon, A., & Chow, A. Y. M. (2012). Gender differences in mental health literacy among Chinese-speaking Australians in Melbourne, Australia. International Journal of Social Psychiatry, 58(2), 178-185.
Xiong, Y. (2018). An Exploration of Asian International Students’ Mental Health: Comparisons to American Students and Other International Students in the United States [Ohio University]. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou152595195493441
Xiong, Y., & Pillay, Y. (2022). A national study of the mental health status of Asian international students in the United States. Journal of Multicultural Counseling and Development, n/a(n/a). https://doi.org/10.1002/jmcd.12238
Xiong, Y., Rose Parasath, P., Zhang, Q., & Jeon, L. (2022). International students’ perceived discrimination and psychological distress during the COVID-19 pandemic. Journal of American College Health, 1–12. https://doi.org/10.1080/07448481.2022.2059376
Xiong, Y., & Yang, L. (2021). Asian international students’ help-seeking intentions and behavior in American Postsecondary Institutions. International Journal of Intercultural Relations, 80, 170–185. https://doi.org/10.1016/j.ijintrel.2020.11.007
Yakunina, E. S., & Weigold, I. K. (2011). Asian international students’ intentions to seek counseling: Integrating cognitive and cultural predictors. Asian American Journal of Psychology, 2(3), 219–224. https://doi.org/10.1037/a0024821
Yao, C. W., & Mwangi, C. A. G. (2022). Yellow Peril and cash cows: The social positioning of Asian international students in the USA. Higher Education. https://doi.org/10.1007/s10734-022-00814-y
Yeh, E., Sharma, R., Jaiswal-Oliver, M., & Wan, G. (2021). Culturally Responsive Social Emotional Learning for International Students: Professional Development for Higher Education. Journal of International Students, 12(1), 19–41. https://doi.org/10.32674/jis.v12i1.2976
Yoon, E., & Jepsen, D. A. (2008). Expectations of and Attitudes toward Counseling: A Comparison of Asian International and U.S. Graduate Students. International Journal for the Advancement of Counselling, 30(2), 116–127. https://doi.org/10.1007/s10447-008-9050-4
Young, J. T. (2017). Confucianism and accents: Understanding the plight of the Asian international student in the US. Journal of International Students, 7(3), 433–448.
Zhang, N., & Dixon, D. N. (2003). Acculturation and Attitudes of Asian International Students Toward Seeking Psychological Help. Journal of Multicultural Counseling and Development, 31(3), 205–222. https://doi.org/10.1002/j.2161-1912.2003.tb00544.x
Zhang, N., & Dixon, D. N. (2001). Multiculturally responsive counseling: Effects on Asian students' ratings of counselors. Journal of Multicultural Counseling and Development, 29(4), 253-262. https://doi.org/10.1002/j.2161-1912.2001.tb00468.x
Zhou, X., Zhou, A. Q., & Sun, X. (2022). Prevalence of common mental concerns and service utilization among international students studying in the U.S. Counselling Psychology Quarterly, 35(3), 483–502. https://doi.org/10.1080/09515070.2021.1875400
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