ABSTRACT
Introduction and background Korean Americans are the fourth largest Asian American group in the United States, at 0.4 per - cent of the population; Chinese Americans make up the largest Asian group at 0.9 percent, followed by Filipino Americans at 0.7 percent, Asian Indians at 0.6 percent, and Japanese Americans at 0.3 percent (Kalibatseva & Leong, 2011). Korean Americans are also one of the fastest growing ethnic minorities in the United States (Hoeffel, Rastogi, Kim, & Shahid, 2012). In addition, a recent analysis by the Pew Research Center found that 78 percent of Korean Americans ages 18 years and older were born outside of the United States (Pew Research Center, 2012). One study of Korean Americans (N = 304) found that they had higher depression scores than the general population (Bernstein, Park, Shin, Cho, & Park, 2011), and another found that 23 percent reported having depressive symptoms but only 8.5 percent used mental health services (most did not perceive the need for psychological help, even when they had depressive symptoms) (Park, Cho, Park, Bernstein, & Shin, 2013). Another study of 860 Korean immigrants found that they reported higher levels of depressive symptoms and of psychological distress than other Asian ethnic groups (Noh, Avison, & Kaspar, 1992). Korean Americans who abandoned their Korean identity, traditions, and values scored higher for depression than did those who maintained their traditional values and identity (Oh, Koeske, & Sales, 2002). Depression was often under diagnosed in another study and therefore not treated due to barriers that included limited access to services and lack of culturally appropriate therapies (Lee, Hanner, Cho, Han, & Kim, 2008). A study of 230 older Korean American immigrants reported that the women scored higher on depressive symptoms than the men did and that their cultural background and values deeply influenced, and thus limited, their help-seeking behaviors and attitudes toward mental health services (Jang, Kim, & Chiriboga, 2011). The Korean word for depression, “wooul-jeung,” translates as “a state of being out-of-balance,” reflecting a culture in which health and well-being are seen as a balance between body and mind (Shin, 2002). Korean culture is informed by Confucianism and its emphasis on family integrity, group conformity, and traditio - nal gender roles, influencing how people of Korean descent conceptualize depression, express depressive symptoms, and seek help (Park & Bernstein, 2008). The Korean cultural norm is to suppress personal emotions, avoid confrontation, and emphasize harmony within groups
and in relationships (Park & Bernstein, 2008). Furthermore, the ideal Korean woman has been traditionally viewed as self-sacrificing, discreet, soft-spoken, and submissive (Kim, 1998). The “wise mother and good wife” concept has been influential in modern Korean life (Ku˘m, 2003; Pak, 2006), and its influence is apparent in Korean American women’s mental health-related behaviors and attitudes toward treatment (Bemak & Chung, 2000).
