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Amer.
J.
Orthopychiat.
64(3),
July
1994
PUBLIC OUTPATIENT MENTAL HEALTH SERVICES:
Use and Outcome Among Asian Americans
Yu-Wen Ying,
Ph.D.,
and Li-tze Hu,
Ph.D.
Use
of
public outpatient mental health services and treatment outcomes were
studied among Chinese, Japanese,
Filipino,
Korean, and Southeast-Asian Amer-
icans in
Los
Angeles
County.
Filipinos were underrepresented in the system,
whereas Southeast Asians were overrepresented and had higher utilization rates,
but showed less improvement, than
did
the other groups. The influence
of
thera-
pist-client ethnic match and
of
clinicians 'professional status were assessed, and
recommendations are made for Jirrther research based
on
present findings.
eeting the mental health needs of the
M
diverse population of the United
States continues to be a major challenge to
mental health policy makers and providers.
A recent assessment of service use and out-
come among Asian, African, Mexican, and
white Americans
(Sue, Fujino,
Hu,
Ta-
keuchi,
&
Zane,
1991)
found that Asian
Americans underutilized mental health ser-
vices. The present investigation seeks to
examine that finding more closely by com-
paring use and treatment outcomes across
major Asian groups in the Los Angeles
public mental health system.
The size of the Asian-American popula-
tion is increasing rapidly. In Los Angeles
County, it more than doubled between
1980
and
1990
(U.S.
Bureau
of
Census,
1982,
1992).
Although Asians are gener-
ally viewed as
a
single group, they are not
homogeneous; they differ in cultural back-
ground, history, and time of migration, as
well as in acculturation level
(Tukaki,
1989;
Wong,
1982).
A recent status report by the US. Gen-
eral Accounting Office
(1990),
based on
government documents and community-
based data, demonstrated the diversity
of
Asian Americans. As shown in
TABLE
1,
Japanese Americans were found to speak
English better than all other Asian Ameri-
cans except Filipinos, to be more likely to
have been born in the United States and to
have graduated from high school (all of
which mediate greater acculturation), and
to have higher per capita income than other
Asians. In contrast, Southeast Asians (in-
cluding Vietnamese, Cambodians, Lao-
tians, and the Hmong) were the least accul-
turated, having arrived in the U.S. during
the last two decades as
a
consequence of
the wars in Southeast Asia; many came
from rural settings and have experienced
severe culture shock
(Strand
&
Jones,
A revised version
of
a paper submitted to the Journal in July
1993.
This study was supported in part by
National Institute
of
Mental Health Faculty Scholar Award
5TOl
MH19178
to the first author, and National
Institute
of
Mental Health Grant
ROI
MH44331.
Authors are at: School
of
Social Welfare, UniversirjJ
of
California at Berkeley fling); and Department
of
Psychology, University
of
Calvornia
at
Santa
Crw
(Hu).
448
0
1994
American Orthopsychiatric Association, Inc.
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