title: Mental health service use from a religious or spiritual advisor among Asian Americans.
abstract: BACKGROUND
  Asian Americans experience significant underuse of mental health treatment. Religious clergy and spiritual advisors play a critical role in delivering mental health care in the United States. Limited knowledge exists about their use among Asian Americans.
  
  
  OBJECTIVE
  We describe mental health service use from a religious/spiritual advisor among Asian Americans.
  
  
  METHODS
  We analyzed data from 2095 respondents in the 2002-2003 National Latino and Asian American Study.
  
  
  RESULTS
  Lifetime and 12-month prevalence of mental health service use from a religious/spiritual advisor (5.5% and 1% overall, respectively) was generally higher among U.S.-born Asians and those with a 12-month mental disorder (23.6% and 7.5%, respectively). Religious/spiritual advisors were seen by 35% of treatment-seeking Asian Americans with a lifetime mental disorder. They were seen as commonly as psychiatrists but less commonly than a mental health specialist or general medical provider. Approximately 70% of those seeking treatment had a mental disorder, significant proportions of whom sought treatment in the absence of a psychiatrist, a mental health specialist or even a healthcare provider. A significant majority with 12-month use perceived the care as helpful, felt accepted/understood and satisfied (71-86%). However, only 31% rated the care as excellent, 28% quit completing care, and referral rates for specialty mental health treatment were low, even among those with a mental disorder (9.5%).
  
  
  CONCLUSIONS
  Religious/spiritual advisors are a key source of treatment-seeking for Asian Americans with a mental disorder. Quality of care and low referral rates for specialty mental health treatment warrant further attention and need for increased collaboration with the mental health system.
authors: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA. Electronic address: djohn@hsph.harvard.edu.
authors: Dolly A
authors: DA
authors: John
authors: David R
authors: DR
authors: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012069:Religion and Psychology; D014481:United States
keywords: Asian Americans; Ethnicity; Mental disorder; Mental health service use; Nativity; Religious and spiritual advisor