Date of Award

2025

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Teresa Van Winkle

Readers

Kumhee Ro

Abstract

Background: Asian Americans are understudied in the field of mental healthcare. Barriers to care include stigma, acculturative stress, and community expectations, coupled with structural limitations such as culturally insensitive care and knowledge gaps, which contribute to decreased rates of mental health access and utilization for this population.

Objective: Identify gaps in the diagnosis, and treatment pathways for Asian Americans receiving mental health services in the primary care setting.

Methods: A retrospective chart review was conducted through a group of community health clinics in Seattle, Washington. Race, preferred language, English-proficiency, age, income, insurance-type, and ethnic subgroups were identified and compared to screening, diagnosis, and treatment outcomes: The following variables were used as outcome measures: positive (score >10) PHQ-9 and GAD-7 screening scores, the presence of a depression or anxiety diagnosis, the presence of antidepressant use, and the presence of behavioral health encounters.

Results: Asian American (AA) patients and white patients are diagnosed with depression at the same rates, while AAs are less likely than white patients to be diagnosed with anxiety. For insurance type and income level, there is little variability in treatment type. More adults under 65 years of age are being diagnosed with both depression and anxiety than adults greater than 65 years of age; however, both groups are equally likely to receive treatment. Lastly, English-proficient patients are being diagnosed with depression and anxiety at a greater rate than patients requiring an interpreter, but there is little variability with treatment.3

Conclusion: There is still much to overcome regarding mental health stigma and cultural nuances in the realm of improving help-seeking and service utilization amongst the Asian American population. However, it is apparent that culturally specific strategies are beneficial and must be continued through trusted access points like community health centers to improve the current nature of mental health for Asian Americans.

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