1.Mental Health Experiences of Filipino Americans: Considerations for Cardiovascular Disease
Kevin L. Nadal, Ph.D.
John Jay College of Criminal Justice- City University of New York
2.Overview
Introduction
Multicultural Competence
Filipino American Cultural Values and Processes
Filipino Americans and Mental Health
Filipino Americans’ Experience with Mental Health Treatment
Discussion
3.Multicultural Competence
Knowledge
attaining of information about various cultural groups, including cultural values, traditions, histories, beliefs, and behaviors.
Awareness
insight of one’s own attitudes, biases, and beliefs that may impact one’s work with clients; awareness also includes relational dynamics that may occur between both parties.
Skills
techniques one can utilize to provide effective treatment with culturally diverse populations.
4.Knowledge of Cultural Values
Indigenous Filipino Values
kapwa: fellow being
utang ng loob: debt of reciprocity
hiya: shame
pakikasama: togetherness and social acceptance
bayanihan: community spirit
5.Knowledge of Cultural Values
Spanish Influences
Catholicism
Gender Roles
Indigenous Philippines was viewed as matriarchical or gender neutral
Spanish gender roles emerged
marianismo: female submissiveness
machismo: male dominance
Bahala na: fatalism (“leave it up to God”)
6.Knowledge of American Cultural Values
Individualism: The moral stance, political philosophy, or social outlook that stresses independence and self-reliance.
Conflicts with bayanihan (community spirit) which promotes collectivism: the moral stance, political philosophy, or social outlook that stresses human interdependence and cooperative action.
May lead to “Crab Mentality”: desire to outdo, outshine, or surpass another (often of one’s same ethnic group) at the other's expense
“The American Dream” was introduced
Filipinos may develop colonial mentality and/or an indebtedness to the US
7.Knowledge of Cultural Processes
Assimilation: A process in which members of one cultural group abandon their beliefs, values, and behaviors and fully adopt those of a new host group.
Acculturation: A process in which members of one cultural group adopt the beliefs, values, and behaviors of another group.
8.Knowledge of Colonial Mentality
Colonial Mentality: The concept that the colonizer’s values and beliefs are accepted by the colonized as a belief and truth of their own; that the mores of the colonizer are superior to that of the colonized.
Many Filipinos and Filipino Americans may develop colonial mentality and adhere to both Spanish and American values.
9.Filipino Americans and Mental Health
Some studies have found depression to be higher in Filipino Americans than in the general American population
Some studies have found suicide ideation higher in Filipino American youth, particularly Filipina adolescent girls
Some studies have found that substance abuse is more prevalent in Filipino American communities, suggesting that substance abuse disorders are prevalent as well.
10.Filipino Americans’ Mental Health Help-Seeking Behaviors
Asian Americans utilize mental health services less than any other racial/ethnic group, including Whites and other people of color
Moreover, when Asian Americans do attend mental health services, they prematurely terminate
Filipino Americans tend to underutilize health and mental health services more than other Asian American groups
Filipino Americans who do seek treatment had more severe or dysfunctional psychological disorders
11.Cultural Stigma and Psychotherapy
Cultural stigma is cited as a main reason why there is an underutilization of mental health services for Filipino Americans
Bahala na (fatalism or “Leave it up to God”) prohibits Filipino Americans from seeking help
Many Filipino Americans may turn to religious leaders or clergy for assistance with their mental health problems
Filipino Americans may foster a cultural mistrust or patient suspiciousness against mental health services in the same way other racial/ethnic minority groups might, which may then impact their inability to seek mental health services
12.Filipino Americans’ Experiences in Psychotherapy
Filipino Americans are more likely to admit to discussing personal and emotional problems in counseling than other Asian American groups, who were more likely to admit to educational and vocational concerns
This trend may be due to the emotional expressiveness that may be more prevalent in Filipino American communities
This trend aligns with research with Latinos and the need for emotionally closer psychotherapeutic relationships
13.Cultural Considerations
Some Filipino Americans may suffer from a “Smiling Depression” in which they do not exhibit external symptoms (e.g., difficulty eating, sleeping, functioning) but repress or hide internal symptoms (e.g., sadness, worthlessness)
Filipino Americans are sometimes diagnosed with schizophrenia; however, oftentimes it may be a normal coping method of dealing with death (e.g., a widow may claim her deceased husband “visits” her)
14.Impacts of Mental Health on CVD
Cultural-related stressors
Acculturative stress
Family pressures/ expectations
Faulty coping mechanisms
Inability to seek mental health services
Gender influences
Additional factors
Immigration status
Colonial mentality
Socioeconomic status
15.For more information
Kevin L. Nadal, Ph.D.
Assistant Professor
John Jay College of Criminal Justice
City University of New York
knadal@gmail.com