Hirt, Rose

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					Hirt, Rose
Multicultural Counseling Issues: Ethnic Groups’ Attitudes Towards Mental Illness
Timothy B. Smith, PhD, Counseling Psychology and Special Education

In the world of counseling, there are many issues that arise due to differences between cultures.
These differences are particularly apparent in how different cultural groups view mental illness.
There have been studies done on this topic, but the literature must be compiled and compared in
order for any overall effect to be measured. My research set out to begin compiling this literature.
Specifically, this research consisted of articles and dissertations published since the year 1999. I
generated search terms with Dr Smith, which helped narrow the search for current research that
addressed the issue of attitudes and perceptions of mental illness within four major ethnic groups,
African American, Asian American, Native American and Hispanic American. As I compiled the
literature, I noticed that some of the articles were more specific in the cultural groups that they
included. Whereas I had originally intended to code articles under the 4 general ethnic groups, my
mentor and I determined that articles where ethnic groups were specified as Chinese Americans or
Asian Pacific Islanders or other ethnic groups should be represented in the data as they were in the
article that they came from.
I compiled the literature, reviewed it, and categorized the perceptions and attitudes that the different
cultural groups had. I paid special attention to the ideas that ethnic groups has for the causes of
mental illness, as well as any shame that was associated with mental illness. When I read the ethnic
groups’ beliefs about the causes of mental illness I put these causes into categories, and I also
included specific wording from the articles that helped me come to conclusions as to which category
to put the mental causes into.
With the information in the articles, I was able to identify 6 categories of causes that I believe are
separate. Biological causes were those that the subjects perceived as genetic, chemical imbalances, or
that had some sort of biological/medical explanation (Hampton, N.Z., Yeung, T., & Nguyen, C.H.
2007). Environmental causes were those that were byproducts of upbringing, the influence of
others, or which caused mental illness due to specific physical situation (Bernstein, K.S. 2008). These
environmental causes were often mentioned along with stress, so I put that under this category
(Cabassa, L.J., Lester, R., & Zayas, L.H. 2007). Other causes were perceived to be supernatural in
nature and included religious, spiritual, and mystical explanations for mental illness (Givens, J.L.,
Houston, T.K., Van Voorhees, B.W., Ford, D.E., & Cooper, L.A. 2007). Another cause that some
groups perceived was drugs and alcohol (Edman, J.L., & Johnson, R.C. 1999). Moral issues such as
going against one’s morals, when the subjects believed that they had been “immoral” by their own
or others’ standards, a differentiation between one’s thoughts or morals and one’s actions, and a lack
of moral “balance” in one’s life was also perceived as a cause or mental illness (Nunez, A. 2006).
The last category that I identified within the literature that I studied was a loss of control. In this
category, subjects believed that mental illness could be a result of losing control of one’s emotions
or mental state (Shellman, J., Mokel, M., & Wright, B. 2007). These subjects often saw mental illness
as a personal weakness as opposed to a medical condition (Sanchez, F., & Gaw, A. 2007).
Many, but not all of the articles that I coded referred to the shame that certain ethnic groups
associated with mental illness (Tabora, B.L., & Flaskerud, J.H. 1999). For these articles, I categorized
them as shame, no shame, or not discussed.
It is difficult to say whether my research is finished or not. This particular stage of the research,
categorizing the attitudes towards mental illness, will hopefully be the starting point for various
other research projects within the scope of psychology. My part in this stage of the research is
finished, but I hope that others such as myself will expound on it and have great success in better
understanding ethnic groups’ attitudes towards mental illness.
Akutsu, P.D. & Chu, J.P. (2006). Clinical problems that initiate professional help-seeking behaviors
                 from Asian Americans. Professional Psychology: Research and Practice, 37(4). 407-415.
Alvidrez, J. 1999. Ethnic variations in mental health attitudes and service use among low-income
                 African American, Latina, and European American young women. Community Mental
                 Health Journal, 35(6). 515-530.
Bernstein, K.S. (2008). Mental health issues among urban Korean American immigrants. Journal
                 Transcultural Nursing, 18(2). 175-180.
Cabassa, L.J., Lester, R., & Zayas, L.H. (2007). "I's like being in a labyrinth:" Hispanic immigrants'
                 perceptions of depression and attitudes toward treatments. Journal of Immigrant Health,
                 9. 1-16.
Chen, S.X., & Mak, W.W. (2008). Seeking professional help: etiology beliefs about mental illness
                 across cultures. Journal of Counseling Psychology, 55(4). 442-450.
Dow, H.D. (2006). Mental health perceptions among Albanian immigrants and their families in
                 Southern California: an exploratory study. Unpublished doctoral dissertation. Alliant
                 International University, San Diego, CA.
Edman, J.L., & Johnson, R.C. (1999). Filipino American and Caucasian American beliefs about the
                 causes and treatment of mental problems. Cultural Diversity and Ethnic Minority
                 Psychology, 5(4). 380-386.
Garcia, C.M., & Saewyc, E.M. (2007). Perceptions of mental health among recently immigrated
                 Mexican adolescents. Issues in Mental Health Nursing, 28. 27-54.
Givens, J.L., Houston, T.K., Van Voorhees, B.W., Ford, D.E., & Cooper, L.A. (2007). Ethnicity and
                 preferences for depression treatment. General Hospital Psychiatry, 29. 182-191.
Hampton, N.Z., Yeung, T., & Nguyen, C.H. (2007). Perceptions of mental illness and rehavilitation
                 services in Chinese and Viatmese Americans. Journal of Applied Rehabilitation Counseling.
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Kendrick, L.K., Anderson, N.L.A., & Moore, B. (2007). Perceptions of depression among young
                 African American men. Family Community Health, 30 (1). 63-73.
Morrison, E.F., & Thornton, K.A. (1999). Influence of Southern spiritual beliefs on perceptions of
                 mental illness. Issues in Mental Health Nursing, 20. 444-458.
Nunez, A. (2006). Perception of mental health and treatment of low income latinas. Unpublished
                 doctoral dissertation. Chicago School of Professional Psychology. Chicago, IL.
Pollack, L.E., & Aponte, M. (2001). Patients perceptions of their bipolar illness in a public hospital
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Roberts, J.S., Connell, C.M., Cisewski, D., Hipps, Y.G., Demissie, S., & Green, R.C. (2003).
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Sanchez, F., & Gaw, A. (2007). Mental health care for Filipino Americans. Psychiatric Services, 58(6).
Schnittker, J., Freese, J., & Powell, B. (2000). Nature, nurture, neither, nor: Black-White differences
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Shellman, J., Mokel, M., & Wright, B. (2007). "Keeping the bully out": Understanding older African
               Americans' beliefs and attitudes toward depression. Journal of the American Psychiatric
               Nurses Association, 13(4). 230-236
Tabora, B.L., & Flaskerud, J.H. (1999). Mental health beliefs, practices, and knowledge of Chinese
               American immigrant women. Issues in Mental Health Nursing, 18. 172-189.
Vera, E.M., & Conner. W. (2007). Latina mothers' perceptions of mental health and mental health
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