Kim Min Kyung, Su Grace S, Chan Angel N Y, Fu Yuxin, Huang Yanqing, Huang Chien-Chi, Hires Ben, Chu MyDzung T
Tufts Clinical and Translational Science Institute, Boston, MA, USA.
Boston Chinatown Neighborhood Center (BCNC), Boston, MA, USA.
BMC Psychiatry. 2024 Jul 16;24(1):506. doi: 10.1186/s12888-024-05894-x.
Asians and Asian Americans have the lowest rate of mental health service utilization (25%) in the US compared to other racial/ethnic groups (39 - 52%), despite high rates of depression, anxiety, and suicidal ideation. The lack of culturally-responsive mental health trainings hinders access to mental health services for these populations. We assessed the mental health priorities of Asian communities in Greater Boston and evaluated cultural responsiveness of the Mental Health First Aid (MHFA), a first-responder training teaching participants skills to recognize signs of mental health and substance use challenges, and how to appropriately respond.
This is community-based participatory research with the Boston Chinatown Neighborhood Center (BCNC), Asian Women For Health (AWFH), and the Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition. We conducted focus groups with community-based organization staff and community members to assess mental health priorities of Asian populations in Boston, MA. We then evaluated the utility and cultural-responsiveness of the English-language MHFA for Asian populations through pre- and post-training questionnaires and focus groups with community participants. Paired t-tests were used to evaluate questionnaire responses. Thematic analysis was used to analyze interviews.
In total, ten staff and eight community members participated in focus groups, and 24 community members completed the MHFA and pre- and post-training questionnaires. Common mental health challenges in the Asian communities reported by participants were loneliness, high stigma around mental illnesses, academic pressure, and acculturation stress. Compared to pre-training, MHFA participants demonstrated lower personal mental health stigma (p < 0.001) and higher mental health literacy (p = 0.04) post-training. Participants also noted the lack of data statistics and case studies relevant to Asian populations in the training, and desired the training be offered in languages spoken by Asian ethnic subgroups (e.g., Chinese, Vietnamese).
Cultural-responsiveness of the MHFA for Asian populations could be improved with the inclusion of data and case studies that capture common mental health challenges in the Asian communities and with translation of the MHFA to non-English languages predominant in Asian communities. Increasing the cultural relevance and language accessibility of the MHFA could facilitate wider adoption of these trainings across communities and help to reduce mental health stigma and gaps in literacy and service utilization.
在美国，与其他种族/族裔群体（39%-52%）相比，亚裔和亚裔美国人的心理健康服务利用率最低（25%），尽管他们的抑郁症、焦虑症和自杀意念发生率很高。缺乏具有文化适应性的心理健康培训阻碍了这些人群获得心理健康服务。我们评估了大波士顿地区亚裔社区的心理健康优先事项，并评估了心理健康急救（MHFA）培训的文化适应性，这是一种急救人员培训，教导参与者识别心理健康和物质使用问题迹象的技能，以及如何做出适当反应。
这是一项与波士顿华埠邻里中心（BCNC）、亚洲女性健康组织（AWFH）以及通过转化研究解决亚裔人群差异联盟（ADAPT）合作开展的基于社区的参与性研究。我们与社区组织工作人员和社区成员进行了焦点小组讨论，以评估马萨诸塞州波士顿亚裔人群的心理健康优先事项。然后，我们通过培训前和培训后的问卷调查以及与社区参与者的焦点小组讨论，评估了英语版MHFA对亚裔人群的实用性和文化适应性。配对t检验用于评估问卷回复。主题分析用于分析访谈内容。
共有10名工作人员和8名社区成员参加了焦点小组讨论，24名社区成员完成了MHFA培训以及培训前和培训后的问卷调查。参与者报告的亚裔社区常见心理健康挑战包括孤独感、对精神疾病的高度污名化、学业压力和文化适应压力。与培训前相比，MHFA参与者在培训后表现出更低的个人心理健康污名感（p<0.001）和更高的心理健康素养（p=0.04）。参与者还指出培训中缺乏与亚裔人群相关的数据统计和案例研究，并希望以亚裔族裔亚群体使用的语言（如中文、越南语）提供培训。
通过纳入反映亚裔社区常见心理健康挑战的数据和案例研究，并将MHFA翻译成亚裔社区中占主导地位的非英语语言，可以提高MHFA对亚裔人群的文化适应性。提高MHFA的文化相关性和语言可及性可以促进这些培训在各社区的更广泛采用，并有助于减少心理健康污名以及素养和服务利用方面的差距。
