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A Sociodemographic Profile of Asian Americans Served in Community Mental Health Centers for a Diagnosis of Schizophrenia Spectrum Disorder

  • Caroline LimEmail author
  • Mercedes Hernandez
  • Lizbeth Gaona
  • Paula Helu-Brown
  • Concepción Barrio
Original Article
  • 3 Downloads

Abstract

Little is known about Asian Americans treated for serious psychiatric disorders in the public mental health system. We characterized 75 Asian Americans seen at community mental health centers for a diagnosis of schizophrenia spectrum disorder to anticipate likely clients and gain insights into their service needs. Participants completed in-person interviews and self-report questionnaires on their demographic and social characteristics. The ethnically diverse sample featured mostly foreign-born individuals with long-standing schizophrenia. Findings highlighted participants’ differential experience of social adversities and stressful events, but also revealed salient cultural resources that shielded some from the social sequelae of schizophrenia. Recovery-oriented mental health programs staffed by culturally and linguistically compatible providers remain key to engaging this marginalized population in service. Findings also uphold a holistic management of schizophrenia spectrum disorder among racial and ethnic minorities, taking into account the complex social needs of afflicted individuals.

Keywords

Asian Americans Schizophrenia Sociodemographic profile Community mental health centers 

Notes

Acknowledgement

This research was supported by the Okura Mental Health Scholarship awarded to Caroline Lim by the Asian Pacific Islander Social Work Educator Association. Funding from the University of Southern California Suzanne Dworak-Peck School of Social Work supported the article preparation. The authors gratefully acknowledge the contributions of mental health providers and study participants. The authors declare no potential conflicts of interest with respect to the research, authorship, or publication of this article.

References

  1. Alegría, M., Takeuchi, D., Canino, G., Duan, N., Shrout, P., Meng, X.-L., et al. (2004). Considering context, place, and culture: The National Latino and Asian American Study. Internal Journal of Methods and Psychiatric Research, 13, 208–220.  https://doi.org/10.1002/mpr.178.CrossRefGoogle Scholar
  2. Barreto, R. M., & Segal, S. P. (2005). Use of mental health services by Asian Americans. Psychiatric Services, 56, 746–748.  https://doi.org/10.1176/appi.ps.56.6.746.CrossRefGoogle Scholar
  3. Brekke, J. S., Prindle, C., Bae, S. W., & Long, J. D. (2001). Risks for individuals with schizophrenia who are living in the community. Psychiatric Services, 52, 1358–1366.  https://doi.org/10.1176/appi.ps.52.10.1358.CrossRefGoogle Scholar
  4. Brislin, R. W. (1980). Translation and content analysis of oral and written materials. In H. C. Triandis & J. W. Berry (Eds.), Handbook of cross-cultural psychology: Methodology (pp. 389–444). Boston, MA: Allyn & Bacon.Google Scholar
  5. Cervantes, R. C., Padilla, A. M., Napper, L. E., & Golbach, J. T. (2013). Acculturation-related stress and mental health outcome among three generations of Hispanic adolescents. Hispanic Journal of Behavioral Sciences, 35, 451–468.  https://doi.org/10.1177/0739986313500924.CrossRefGoogle Scholar
  6. Charlson, F. J., Ferrari, A. J., Santomauro, D. F., Diminic, S., Stockings, E., Scott, J. G., et al. (2018). Global epidemiology and burden of schizophrenia: Findings from the Global Burden Disease Study 2016. Schizophrenia Bulletin, 44, 1195–1203.  https://doi.org/10.1093/schbul/sby058.CrossRefGoogle Scholar
  7. Chuang, H. T., Williams, R., & Dalby, J. T. (1987). Criminal behavior among schizophrenics. Canadian Journal of Psychiatry, 32, 255–258.  https://doi.org/10.1177/070674378703200401.CrossRefGoogle Scholar
  8. Cohen, S., Tyrrell, D. A., & Smith, A. P. (1993). Negative life events, perceived stress, negative affect, and susceptibility to the common cold. Journal of Personality and Social Psychology, 64, 131–140.  https://doi.org/10.1037/0022-3514-64-1-131.CrossRefGoogle Scholar
  9. Colby, S. L., & Ortman, J. M. (2015). Projections of the size and composition of the U.S. population: 2014 to 2060. Washington, DC: U.S. Census Bureau.Google Scholar
  10. Durvasula, R., & Sue, S. (1996). Severity of disturbance among Asian American outpatients. Cultural Diversity and Mental Health, 2, 43–51.  https://doi.org/10.1037/1099-9809.2.1.43.CrossRefGoogle Scholar
  11. Gong, F., Xu, J., Fujishiro, K., & Takeuchi, D. T. (2011). A life course perspective on migration and mental health among Asian immigrants: The role of human agency. Social Science and Medicine, 73, 1618–1626.  https://doi.org/10.1016/j.socscimed.2011.09.014.CrossRefGoogle Scholar
  12. Harry, B., & Steadman, H. J. (1989). Arrest rates of patients treated at a community mental health center. Psychiatric Services, 39, 862–866.  https://doi.org/10.1176/ps.39.8.862.CrossRefGoogle Scholar
  13. Hiday, W. A., Swartz, M. S., Swanson, J. W., Borum, R., & Wagner, H. R. (1999). Criminal victimization of persons with severe mental illness. Psychiatric Services, 50, 62–68.  https://doi.org/10.1176/ps.50.1.62.CrossRefGoogle Scholar
  14. Jeste, D. V., Palmer, B. W., Appelbaum, P. S., Golshan, S., Gloriosa, D., Dunn, L. B., et al. (2007). A new brief instrument for assessing decisional capacity for clinical research. Archives of General Psychiatry, 64, 966–974.  https://doi.org/10.1001/archpsyc.64.8.966.CrossRefGoogle Scholar
  15. Kane, J. M., Leucht, S., Carpenter, D., & Docherty, J. P. (2003). Expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: Methods, commentary, and summary. Journal of Clinical Psychiatry, 64(Suppl. 12), 5–19.Google Scholar
  16. Kim, B. S. K., & Omizo, M. M. (2003). Asian cultural values, attitudes toward seeking professional psychological help and willingness to see a counselor. Counseling Psychologists, 31, 343–361.  https://doi.org/10.1177/0011000003031003008.CrossRefGoogle Scholar
  17. Kinzie, J. D., & Tseng, W.-S. (1978). Cultural aspects of psychiatric clinical utilization: A cross-cultural study in Hawaii. International Journal of Social Psychiatry, 24, 177–188.  https://doi.org/10.1177/002076407802400305.CrossRefGoogle Scholar
  18. Koenig, H. G., & Büssing, A. (2010). The Duke University Religion Index (DUREL): A five-item measure for use in epidemiological studies. Religions, 1, 78–85.  https://doi.org/10.3390/rel1010078.CrossRefGoogle Scholar
  19. Kung, W. (2003). The illness, stigma, culture, or immigration? Burdens on Chinese American caregivers of patients with schizophrenia. Families in Society, 84, 547–557.  https://doi.org/10.1606/1044-3894.140.CrossRefGoogle Scholar
  20. Lafayette, J. M., Frankie, W. G., Pollock, A., Dyer, A., & Goff, D. C. (2003). Clinical characteristics, cognitive functioning, and criminal histories of outpatients with schizophrenia. Psychiatric Services, 54, 1635–1640.  https://doi.org/10.1176/appi.ps.54.12.1635.CrossRefGoogle Scholar
  21. Levkoff, S. E., Levy, B. R., & Weitzman, P. F. (2000). The matching model of recruitment. Journal of Mental Health & Aging, 6, 29–38.Google Scholar
  22. Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M., Rosenheck, R. A., Perkins, D. O., et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 1209–1223.  https://doi.org/10.1056/NEJMoa051688.CrossRefGoogle Scholar
  23. Lueck, K., & Wilson, M. (2010). Acculturative stress in Asian immigrants: The impact of social and linguistic factors. International Journal of Intercultural Relations, 34, 47–57.  https://doi.org/10.1016/j.ijintrel.2009.10.004.CrossRefGoogle Scholar
  24. McEvoy, J. P. (2007). The costs of schizophrenia. Journal of Clinical Psychiatry, 68, 4–7.CrossRefGoogle Scholar
  25. Mohr, S., Borras, L., Nolan, J., Gillieron, C., Brandt, P.-Y., Eytan, A., et al. (2012). Spirituality and religion in outpatients with schizophrenia: A multi-site comparative study of Switzerland, Canada, and the United States. International Journal of Psychiatry in Medicine, 44, 29–52.  https://doi.org/10.2190/PM.44.1.c.CrossRefGoogle Scholar
  26. National Institute of Mental Health. (2009). Schizophrenia (NIH Publication No. 09-3517). Retrieved from http://www.nimh.nih.gov/health/publications/schizophrenia/nimh-schizophrenia-booklet.pdf.
  27. Newport, F. (2016, Dec 23). Five key findings on religion in the U.S. Retrieved from http://www.gallup.com/poll/200186/five-key-findings-religion.aspx.
  28. Nuechterlein, K. H., Subotnik, K. L., Turner, L. R., Ventura, J., Becker, D. R., & Drake, R. E. (2008). Individual placement and support for individuals with recent-onset schizophrenia: Integrating supported education and supported employment. Psychiatric Rehabilitation Journal, 31, 340–349.  https://doi.org/10.2975/31.4.2008.340.349.CrossRefGoogle Scholar
  29. Okazaki, S. (2000). Treatment delay among Asian-American patients with severe mental illness. American Journal of Orthopsychiatry, 70, 58–64.  https://doi.org/10.1037/h0087751.CrossRefGoogle Scholar
  30. Pew Research Center (2013, April 4). The rise of Asian Americans. Retrieved from http://www.pewsocialtrends.org/2012/06/19/the-rise-of-asian-americans/.
  31. Robertson, G., Pearson, R., & Gibb, R. (1996). The entry of mentally disordered people to the criminal justice system. British Journal of Psychiatry, 169, 172–180.  https://doi.org/10.1192/bjp.169.2.172.CrossRefGoogle Scholar
  32. Rumbaut, R. G. (2004). Ages, life stages, and generational cohorts: Decomposing the immigrant first and second generations in the United States. International Migration Review, 38, 1160–1205. .CrossRefGoogle Scholar
  33. Shin, C.-N., Dirksen, S. R., & Suh, B. (2017). Acculturative stress in Korean Americans. Applied Nursing Research, 38, 70–75.  https://doi.org/10.1016/j.apnr.2017.09.010.CrossRefGoogle Scholar
  34. Stueve, A., Vine, P., & Struening, E. L. (1997). Perceived burden among caregivers of adults with serious mental illness: Comparison of Black, Hispanic, and White families. American Journal of Orthopsychiatry, 67, 199–209.  https://doi.org/10.1037/h0080223.CrossRefGoogle Scholar
  35. Sue, S., Fujino, D. C., Hu, L.-T., Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–540.  https://doi.org/10.1037/0022-006x.59.4.533.CrossRefGoogle Scholar
  36. Takeuchi, D. T., Hong, S., Gile, K., & Alegría, M. (2007). Developmental contexts and mental disorders among Asian Americans. Research in Human Development, 4, 49–69.  https://doi.org/10.1080/15427600701480998.CrossRefGoogle Scholar
  37. Tepper, L., Rogers, S. A., Coleman, E. M., & Malony, H. N. (2001). The prevalence of religious coping among persons with persistent mental illness. Psychiatric Services, 52, 660–665.  https://doi.org/10.1176/appi.ps.52.5.660.CrossRefGoogle Scholar
  38. Tsai, J., Stroup, T. S., & Rosenheck, R. A. (2011). Housing arrangements among a national sample of adults with chronic schizophrenia living in the United States: A descriptive study. Journal of Community Psychology, 39, 76–88.  https://doi.org/10.1002/jcop.20418.CrossRefGoogle Scholar
  39. Turner, R. J., & Lloyd, D. A. (1995). Lifetime traumas and mental health: The significance of cumulative adversity. Journal of Health and Social Behavior, 36, 360–376.  https://doi.org/10.2307/2137325.CrossRefGoogle Scholar
  40. U.S. Census Bureau. (2016). Asian/Pacific American heritage month: May 2016 (Report No. CB16-FF.07). Retrieved from https://www.census.gov/newsroom/facts-for-features/2016/cb16-ff07.html.
  41. U.S. Census Bureau. (2017). American Community Survey 1-year estimates. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk.
  42. Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E., Catalano, R., & Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771–778.  https://doi.org/10.1001/archpsyc.55.9.771.CrossRefGoogle Scholar
  43. Weisman, A. G., Nuechterlein, K. H., Goldstein, M. J., & Snyder, K. S. (1998). Expressed emotion, attributions, and schizophrenia symptom dimensions. Journal of Abnormal Psychology, 107, 355–359.  https://doi.org/10.1037/0021-843X.107.2.355.CrossRefGoogle Scholar
  44. Wheaton, B. (1994). Sampling the stress universe. In W. Avison & I. Gotlib (Eds.), Stress and mental health: Contemporary issues and prospects for the future (pp. 77–114). New York: Plenum Press.CrossRefGoogle Scholar
  45. White, M. C., Chafetz, L., Collins-Bridge, G., & Nickens, J. (2006). History of arrest, incarceration and victimization in community-based severely mentally ill. Journal of Community Health, 31, 123–135.  https://doi.org/10.1007/s10900-005-9005-1.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Suzanne Dworak-Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Steve Hicks School of Social WorkUniversity of Texas at AustinAustinUSA
  3. 3.Department of Social Work, Faculty of Arts and Social SciencesNational University of SingaporeSingaporeSingapore
  4. 4.Mount Saint Mary’s UniversityLos AngelesUSA

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