Asian Americans and cultural values : encountering and overcoming sociocultural barriers to community mental health services : a project based upon an independent investigation

This qualitative study explored the narrative experience of Asian American/Pacific Islanders (AA/PIs), who have received or are currently receiving community mental health services. This study was an attempt to illuminate their experience of encountering and overcoming socio-cultural barriers to these services. Historic underutilization of mental health services among AA/PI communities motivated the need to explore what cultural and/or institutional factors reduce barriers to services. Four AA/PIs, with an average length of 7.25 years in treatment, were recruited from a community mental health agency in San Francisco, CA. They participated in 45- minute to one hour semi-structured interviews discussing their experience in seeking and accessing mental health services. Thematic analysis was used to identify prominent themes in the narrative data. The study identified that individuals encountered specific socio-cultural barriers to services and utilized both personal and institutional factors in order to manage these barriers. Participants managed stigma with positive emotional and resource support that came mainly from their parents. Participants overcame lack of mental health services knowledge by complying with referrals, and trusting in clinician and agency outreach to manage personal and family issues. Findings also underscore the significant collective role of institutional factors of language services, cultural competency, location and Medi- Cal (California Medicaid) payment acceptance in outreaching and engaging AA/PIs. Support from immediate family members (with the exception of extended families) and friends was crucial in retaining participants in treatment