Comparison of illness representation models of mental illness in Asian Indian and Caucasian samples

Background: Illness representations (IRs) can play an important role in determining how one responds and copes with an illness (e.g., mental illness). Cultural differences between IRs of immigrant and host communities may explain under-use of mental health services by the immigrant group. Recent study findings suggest that Asian Indians do not seek mental health treatment at the same rate (Cooper et al., 2006) and are less likely to use psychotropic medication than a comparative Caucasian sample (Han & Liu, 2005).

Purpose: To determine how Asian Indians may differ from Caucasians in their illness representation of mental illness.

Methods: The study employed vignettes of depressed, schizophrenic and "troubled" persons. Asian Indians (N=149) attending health fairs (blind to condition) were randomly presented one of the three vignettes and were asked questions to elicit attributions regarding the seriousness, cause, expectation for recovery, and labels for symptoms presented in the vignette. Responses were compared to a nationally representative Caucasian sample (N=607) using data from the General Social Survey-1996.

Results: Regression analyses (controlling for years of education, sex, & age) suggest that Asian Indians rated schizophrenia and depression as less serious problems than Caucasians. They were also less likely to identify depression and schizophrenia as mental illnesses, were less likely to label them as biological illnesses, and believed the symptoms would improve on their own.

Discussion: These preliminary findings suggest that increasing utilization of mental health treatment by Asian Indians may require health literacy efforts aimed at improving identification of mental illnesses by this group.