Predictors of Mental Health Help-seeking Attitudes among Older Chinese Immigrants

Abstract

Chinese older adults are a growing population in Canada and data suggest that they are vulnerable to mental health issues. However, research has noted that older adults, especially ethnic minority seniors, underutilize mental health services. The influence of cultural factors on attitudes toward seeking mental health services may be a barrier to mental health utilization among Chinese older adults. Thus, the primary purpose of this study was to investigate a model of attitudes toward seeking mental health services among Chinese older adults. The secondary purpose of this study was to examine the relationships among mental health help-seeking attitudes, mental health utilization, and intentions to use mental health services among Chinese older adults. The current study assessed an adapted model (Kim, Atkinson, & Umemoto, 2001) of mental health help-seeking attitudes that included the predictors of personal factors (e.g., age, gender), environmental factors (e.g., social support), acculturation (participation in the host culture) and enculturation (maintenance of the heritage culture) among 149 middle-aged and elderly Chinese immigrants in Canada (Mage = 73.92 years; SD = 9.99; range: 55 to 95 years old). Although acculturation and enculturation were distinct processes among Chinese older adults, the model of help-seeking attitudes did not demonstrate good fit when evaluated using structural equation modelling. Acculturation and enculturation did not mediate the relationship among the predictors of age, gender, education, and perceived social support, and mental health help-seeking attitudes. More positive attitudes were evident among younger participants and respondents with better social support, but Chinese older adults had less positive attitudes than comparative samples. Attitudes were not related to seeking help from professionals (e.g. family physician), but were associated with seeking help from non-professionals (e.g., family and friends). In terms of mental health utilization, 8% of participants reported seeking help from a family physician, while 11% had sought help from non-professionals. This is the first study to apply the adapted model (Kim et al., 2001) to older Chinese adults and contributes a number of important findings, despite theoretical and methodological limitations inherent to cross-cultural research. The results of this study provide suggestions for future research and implications for practice.