Sociocultural determinants of the help-seeking behavior of patients with mental illness.

This descriptive study employed semistructured interviewing and questionnaire administration to delineate the sociocultural determinants of the help-seeking process in 48 psychiatric patients. The help-seeking process is considered in two stages. The first stage starts from the recognition of initial symptoms and ends in the first contact with a mental health professional. The second stage is defined as that time between the first contact and actual participation in a planned treatment program. In both stages, patients typically go through phases of lay consultation, nonpsychiatric professional consultation, and referral. The multiple steps which are usually involved in help seeking often result in significant delay of both mental health contact and treatment. The help-seeking process was found to correlate strongly with ethnicity. Both Asians and Blacks showed more extended family involvement, and the involvement of key family members tended to be persistent and intensive in Asians. Ethnicity was also associated with the length of delay, with Asians showing the longest delay and Caucasians the least. These ethnic differences were also reflected in help-seeking pathway assignment using Lin's criteria. Although modernity and parochialism, as measured by the level of modernization and the cohesiveness of the social network system of the subjects, were also found to be correlated with delay, they appeared to exert an influence independent from that of ethnicity.