Family social networks and mental health service use among Vietnamese-Americans in multigenerational families.

摘要

While there is a large body of research demonstrating that Asian-Americans underutilize mental health services compared to other ethnic groups, little is known about how Vietnamese-Americans use formal mental health services. The traumatic war, post-war and refugee journey contributed to incidences of PTSD and other mental disorders. This mixed-method study aims to understand how multigenerational Vietnamese-Americans view their serious mental illness and how past experiences, family structure, and social networks influence mental health and use of mental health services. The theories that guided the research were the Network-Episode Model and Social Network Orientation Theory.;Quantitative analyses using data from the National Latino and Asian-American Study (NLAAS) examined the relationship of variables assessing acculturation, social support, cultural identity, and health/mental health status with formal mental health service use for the Vietnamese-American subsample (N=520). The qualitative study explored how Vietnamese-Americans in multigenerational households experience severe mental illness and the reasons that influenced their mental health help-seeking and service use. Semi-structured interviews with 17 members of six multigenerational Vietnamese families from the greater Boston and Los Angeles area were conducted in English, transcribed, and analyzed using thematic analysis.;Findings from the study highlight the differences between 1st and 2nd generation Vietnamese respondents and provide insight into how generational culture -- the prevailing attitudes, values, and beliefs of each generation -- influences the social network support of Vietnamese-Americans and affects their mental health help-seeking behavior. The forced migration severed social networks, restricting 1st generation respondents to rely on small family networks for information and support. The traditional matriarchal hierarchy limited access to treatment as younger 2nd generation Vietnamese-Americans were unable to convince their parents to seek help for serious mental health problems or to get their approval to seek treatment. Cultural values such as belief in spiritual healers and self-reliance also insulated families from seeking professional help. The study found that the types of interactions respondents had with their social networks---whether positive or negative in orientation---shaped their beliefs about who and where they could go to for help with serious mental health problems and was instrumental in creating pathways to mental health service use.