Help-Seeking Behaviors among Chinese Americans with Depressive Symptoms Patrick Leung, Monit Cheung, and Venus Tsui An exploratory survey indicated that the depression prevalence among Chinese Americans is 17.4 percent. Of 516 respondents, 34.9 percent preferred seeking advice from friends or relatives, followed by 30.2 percent not showing any preference when facing a mental health problem. Logistic regression results pointed to three contributing factors: anxiety problems, acculturation concerns, and domestic violence. Learning from these factors, the authors conducted additional analyses to connect depressive symptoms with demographics to explain the underutilization of mental health services. Significant results showed that male Chinese Americans were more likely than female Chinese Americans to seek help from physicians but less likely to seek help from friends. Those who were not employed were more likely than those who were employed to think that a family problem would take care of itself or to seek help from herbalists, from physicians, or from friends. Implications for social work practice are discussed and address risk factors and multicultural considerations. KEY WORDS: acculturation; anxiety disorder; Asian immigrants; domestic violence; help seeking D epression is a serious mental health issue that occurs in people of all ages, genders, and socioeconomic back- grounds; however, not all cultures view depres- sion as a mental illness. Chinese Americans seldom discuss their mental health problems (Hwang & Myers, 2007). Even if expressed, their “problems” are mainly tied to health care con- cerns, parental expectations, acculturation, or dis- crimination, as indicated in recent research (Grossman & Liang, 2008; Juang, Syed, & Takagi, 2007; S. Lee, Lee, Rankin, Weiss, & Alkon, 2007; Ying, 2007). In studies of Chinese Americans, help seeking has been found to be related to “en- vironmental or hereditary causes” and has seldom been reported as personal or psychological pro- blems (Chen & Mak, 2008). Chinese Americans seldom seek mental health services. According to the U.S. Census Bureau (2008), Chinese Americans made up more than 20 percent of the 11.9 million Asians living in the United States, representing the largest Asian group in this country. Research has shown that Asian Pacific Americans, including Chinese Americans, tend to underutilize mental health services (Abe-Kim, Hwang, & Takeuchi, 2002; Matsuoka, Breaux, & Ryujin, 1997). A study conducted by Loo, Tong, and True (1989) showed that only 5 percent of the 108 Chinese Americans sought mental health services when needed. Data from the Chinese American Psychiatric Epidemiology Study (CAPES) revealed that only 17 percent of 1,747 Chinese Americans sought help when dealing with major depression and other psychi- atric problems (Spencer & Chen, 2004). Among the help seekers in CAPES, only a small percent- age had received services from professionals, such as mental health professionals (6 percent) and medical doctors (4 percent), in the previous six months, whereas the majority (90 percent) received informal support from religious leaders or friends (Spencer & Chen, 2004). Although depression is widely underreported, research findings reveal that Chinese Americans are not free of mental health problems, and underutilization of mental health services is a great concern (Chen & Mak, 2008; S. Sue, Fujino, Hu, Takeuchi, & Zane, 1991). In addition, not all Chinese Americans are well-adjusted to their en- vironment, and many do not feel comfortable communicating their problems to others (Grossman & Liang, 2008; J. Lee, Lei, & Sue, 2001; Yick, 2000). Spencer and Chen (2004) found that the main reason Chinese Americans did not seek help was related to language-based discrimination. The data from 1,747 CAPES doi: 10.1093/sw/swr009 © 2012 National Association of Social Workers 1 Social Work Advance Access published May 22, 2012