Kin and Nonkin Social Supports in a Community Sample of Vietnamese Immigrants

Over the past three decades, large influxes of immigrants and refugees from Southeast Asia have reconfigured the multicultural mosaic in North America (U.S. Bureau of the Census, 1999). In 1970 Asian and Pacific Islander Americans accounted for only 1.5 million people in the United States. However, by 1980 they dramatically increased in population and in 1999 numbered around 10.1 million (3.8 percent of the population). The Vietnamese are the fourth largest ethnic group in the Asian and Pacific Islander category, one of over 30 distinct cultural groups. Each Asian ethnic group has its own cultural background and history that affects how it views mental health and help seeking (Center for Mental Health Services, 1998). Estimates of the number of Vietnamese in the United States hover around 768,000, an increase of 53 percent since the late 1980s (U.S. Bureau of the Census). This article reports on a two-wave longitudinal prospective panel study examining the relationship between social support and depression am ong a sample of Vietnamese immigrants. There are several reasons for examining social support and mental health factors of Vietnamese immigrants. First, few empirical studies examining kin (ethnic) and nonkin (nonethnic) social supports among Vietnamese can be found. Earlier research has shown mixed results for the role of social support on psychological distress. One line of research has indicated that individuals with a strong social network tend to function better in crisis situations than those with a weak support system (Brown, Andrews, Harris, Adler, & Bridge, 1986; Fawzy, Fawzy, Arndt, & Pasnau, 1995; Kessler, Kendler, Heath, Neale, & Eaves, 1994; Terry, Rawle, & Callan-Victor, 1995). In contrast, other researchers found that immigrants with close ties to their ethnic group tend to have more psychological distress compared with those with additional nonethnic social supports (Boehnlein et al., 1995; Brugha, 1995; Hurh & Kim, 1988). Second, there has also been little attention in the literature to the significant role that culture plays in the expression and experience of psychological distress. Nguyen, Messe, and Stollack (1999) suggested that illness is shaped by cultural factors governing perception, labeling, explanation, and evaluation of the distressing phenomenon. Third, mental health services research for ethnic minority groups is now attracting wider attention in social work. The Vietnamese immigrant experience has been a focus of interest, and studies have examined the experiences of refugees (Nicholson, 1997), family functioning (DuongTran & Richey, 1997), adolescent and adult depression (DuongTran, 1996; Tran, 1993), and well-being (Tran & Wright, 1986). Fourth, there is some evidence that Asian American immigrants have particularly high levels of mental health problems (Takeuchi & Adair, 1992). Research suggests that Asian immigrants are at higher risk of depression than white people but at somewhat less risk than African Americans and Hispanic Americans (Gary, Brown, Milburn, Ahmed, & Booth, 1989; Mui, 1996; Nguyen & Peterson, 1993). The most common risk factors of depression for the Asian group include poverty, low educational attainment, poor physical health, and higher rates of family disruption. Stressors of immigration and acculturation to the new country are additional factors contributing to depressive symptoms, often when family supports are weak or unavailable. Finally, the social science literature suggests that the mental health needs of ethnic minority groups are largely unmet and that services are culturally flawed and misguided (Takeuchi & Uehara, 1996). It is well known that Asian Americans tend to make less use of mental health services than the general population. Reasons for underutilization of services include a variety of factors--ethnocentric beliefs about mental illness, stigma and shame, limited English proficiency, and lack of culturally sensitive services (Neighbors, Bashshur, & Price, 1992; Takeuchi & Uehara). …