This interview sample survey of adult residents of San Francisco's Chinatown was conducted in an effort to understand the phenomenon of underutilization of mental health services by Chinese Americans and the reasons underlying this phenomenon. Findings revealed that the use rate of mental health services was extremely low, with only 5% of respondents having sought mental health services, suggesting that this ethnic community has not yet seen the gains promised by the community mental health movement. At the same time, reported psychological disorders in the community were quite prevalent; a sizable number of respondents admitted to symptoms of emotional tension, depression, loneliness, and psychological-physiological symptoms. Thus, need is high, but demand is small. Findings suggested that underutilization is not due to unwillingness to admit to symptoms nor to use of alternative cultural sources of help; rather, lack of knowledge of existing services seems to be a major contributor to low use rates. Other contributing factors include the belief among some respondents that mental disorders cannot be prevented, lack of awareness of how psychological problems can be treated, and a low priority attached to seeking professional help for depression. Compared to other low-income Americans, Chinatown residents demonstrated more determination than resignation in handling personal problems. Moreover, approaches to handling problems were varied and often multiple in nature. The survey confirmed some existing notions about mental health among Asian Americans, while disconfirming other assumptions.
Statistical data on the mental illnesses of Asian Americans have been scanty (Kung, 1962). There has been little direct study of the mental health service needs or problemsolving strategies of this population. With so few empirical studies having been conducted on Asian Americans, particularly on non-college student populations, mental health planners and service providers have had to rely on personal experiences, historical observation, demographic material, or limited available data. Consequently, planning for the delivery of social services often must be made on the basis of the "best guess" approach (Kim, 1978). Moreover, because studies of treated groups "usually fall short