Measuring stigmatized mental health issues in an Asian community: Preliminary results from Chicago's Chinatown Community Heath Survey

Objectives: Little information exists on the mental health needs of Asian Americans. Response rates to depression inventories tend to be low, and few measures have been validated in Asian American communities. Surveys that use a list of depressive symptoms have been effective in other communities, and were used in this study to identify both individual and community level mental health needs in Chicago's Chinatown community. Methods: Random Census block sampling was used to identify eligible households and individuals. Participants were eligible if they were18 years and older, self-identified as Asian, and consented to the study. Bi-lingual interviewers completed face-to-face questionnaires at participants' residences in Cantonese, Mandarin or English. A 10-item short form of the CES-D (Center for Epidemiological Study-Depression) was used to screen for depression. Results: Almost all participants (97%) answered at least 6 of the 12 depression questions. Participants with a score of 4 or more were considered “depressed”; 11% of participants were depressed, with more females (70%) than males (30%) reporting depressive symptoms. More participants reported knowing a depressed Chinatown resident (14%) or a family member (7%) than self-identifying as depressed. Mid-project interviewer evaluations identified the mental health questions as uncomfortable for participants, and that a dichotomous response choice of yes/no might have reduced responses. Conclusions: Measuring mental health needs in the Asian American is complicated by the stigma associated with depression. Participants may be unwilling to identify individual or family mental health needs. Additionally, question structure may influence response rate.