Loma Linda University TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works Loma Linda University Electronic Theses, Dissertations & Projects 8-2018 A Cross-sectional Study on Korean American Mental Health Challenges and Help-seeking Behavior Kelly Eunjung Baek Follow this and additional works at: http://scholarsrepository.llu.edu/etd Part of the Social Psychology and Interaction Commons, and the Social Work Commons Recommended Citation Baek, Kelly Eunjung, "A Cross-sectional Study on Korean American Mental Health Challenges and Help-seeking Behavior" (2018). Loma Linda University Electronic Theses, Dissertations & Projects. 524. http://scholarsrepository.llu.edu/etd/524 This Dissertation is brought to you for free and open access by TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. 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LOMA LINDA UNIVERSITY School of Behavioral Health in conjunction with the Faculty of Graduate Studies ____________________ A Cross-sectional Study on Korean American Mental Health Challenges and Help-seeking Behavior by Kelly Eunjung Baek ____________________ A Dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Social Policy & Social Research ____________________ August 2018 © 2018 Kelly Eunjung Baek All Rights Reserved Each person whose signature appears below certifies that this dissertation in his/her opinion is adequate, in scope and quality, as a dissertation for the degree Doctor of Philosophy. , Chairperson Larry Ortiz, Professor of Social Work Qais Alemi, Assistant Professor of Social Work and Social Ecology Susanne Montgomery, Professor of Social Work and Social Ecology iii ACKNOWLEDGEMENTS Pursuing this degree has been an incredible journey and would not have been possible with my committee, the Los Angeles Korean American Christian community, and my family. Firstly, I would like to thank the community leaders, service providers, pastors, and churches in the greater Los Angeles area for making this study possible. Dr. Alemi, your feedback and suggestions on how I can improve professionally has a huge impact on my work. I learned and gained so much just observing due to the quality of your work and willingness to help and provide support. Dr. Montgomery, the excitement that I felt when developing the first study and paper with you still drives me today. Your guidance was critical in my understanding of research and I hope that I am able to share that same joy and excitement with my students. Dr. Ortiz, your support and guidance went so much further than helping me develop professionally and prepare myself as an expert in my field and am so very grateful that I had the privilege of working with you throughout my time here. Thank you for empowering me to speak up and to understand the value of my voice. Mario, thank you for patiently listening and supporting me. Sandra and Sunny, thank you for the encouragement and confidence in me. Most of all, thank you mom and dad, for all the sacrifices that you made so I could have a happy and fulfilling life. It takes a tremendous amount of strength, resilience, and persistence to come to another country with literally nothing and find the means to overcome the obstacles and barriers to support us so that we could thrive. My success and accomplishments are just as much, if not more, yours. I will never be able to express the depth of my gratitude for everything that you’ve done for me. iv CONTENT Approval Page .................................................................................................................... iii Acknowledgements ............................................................................................................ iv List of Tables ..................................................................................................................... xi List of Abbreviations ........................................................................................................ xii Abstract ............................................................................................................................ xiii Chapter 1. Introduction ................................................................................................................ Theoretical/Conceptual Framework ...................................................................3 Critical Race Theory ....................................................................................3 Anderson Healthcare Utilization Model ......................................................5 Nature and Statement of the Problem ................................................................6 Significance of the Issue ....................................................................................8 Study Aims ........................................................................................................9 2. Literature Review and Theoretical/Conceptual Framework Theoretical Underpinnings ...............................................................................11 Summary of Critical Race Theory ...................................................................11 Critical Race Theory Tenet: Anti-Essentialism ...............................................14 Mental Health Care Policy .........................................................................15 Critical Race Theory Tenet: Intersectionality ..................................................19 Women’s Mental Health Challenges .........................................................20 Barriers to Care for Korean American Religious Leaders .........................23 Mental Distress in the Korean American Community .....................................23 Hwa-byung .................................................................................................23 Depression ..................................................................................................25 Anxiety .......................................................................................................26 Anderson Healthcare Utilization Model ..........................................................26 v Predisposing Factors ..................................................................................27 Enabling Factors ........................................................................................30 Need ...........................................................................................................32 Significance of the Issue ..................................................................................32 Conclusion .......................................................................................................33 3. Preliminary Research Abstract ............................................................................................................36 Background ......................................................................................................37 Mental Health of Korean Americans ...............................................................38 Korean American Concepts of Mental Health .................................................39 Theoretical Framework ....................................................................................40 Methods............................................................................................................41 Sampling & Recruitment ...........................................................................41 Interview Procedures .................................................................................42 Qualitative Data Analysis ..........................................................................43 Establishing Trustworthiness and Rigor ....................................................44 Results ..............................................................................................................44 Sample Characteristics ...............................................................................44 Theme 1: Factors Influencing Mental Health Perceptions and Help-seeking Behavior ...............................................................................45 Theme 2: Barriers to Accessing or Receiving Mental Health Services .....48 Theme 3: Participants Recommendations for Addressing Mental Health Challenges ......................................................................................49 Discussion ........................................................................................................50 Strengths, Limitations, and Future Study Directives .......................................54 Conclusion .......................................................................................................55 References ........................................................................................................56 4. Methodology Rationale and Research Questions ...................................................................59 Participants and Procedures .............................................................................61 Measures ..........................................................................................................63 Dependent Variables ..................................................................................63