Community Ment Health J (2012) 48:84–90 DOI 10.1007/s10597-011-9398-5
BRIEF REPORT
Racial Differences in Satisfaction with Mental Health Services Among Victims of Intimate Partner Violence Hyunkag Cho • Woo Jong Kim
Received: 7 June 2010 / Accepted: 28 February 2011 / Published online: 6 March 2011 Ó Springer Science+Business Media, LLC 2011
Abstract Research on mental health among victims of intimate partner violence (IPV) has often ignored racial minorities. As the US population has become more racially diverse, the dearth of research on racial minorities’ experience with current mental health systems makes it challenging for service providers and practitioners to serve them adequately. This study hypothesized that satisfaction with mental health services would be different across race in both the general population and among IPV victims. This study used the Collaborative Psychiatric Epidemiology Surveys. Logistic regression analyses were conducted. The study results revealed racial differences in satisfaction only in the IPV group. Race had effects on perceived helpfulness among IPV victims. Asian victims of IPV were more likely to perceive mental health services as helpful than any other race groups. Financial security had a positive effect both on subjective satisfaction and perceived helpfulness among IPV victims. Keywords Intimate partner violence Domestic violence Mental health Satisfaction Racial minorities
Introduction For decades, intimate partner violence (IPV) has been recognized as a major social problem. While IPV occurs
H. Cho (&) W. J. Kim School of Social Work, Michigan State University, East Lansing, MI 48824, USA e-mail:
[email protected] W. J. Kim e-mail:
[email protected]
123
both for men and women, the majority of victims are women (Catalano 2008; Tjaden and Thoennes 2000). IPV has numerous negative effects on victims’ mental health, not to mention their physical health. They suffer from depression, anxiety, suicidal tendencies, and post traumatic stress disorder, among other mental health problems (Bargai et al. 2007; Campbell 2002; Leiner et al. 2008). Not surprisingly, victims of IPV use the health care system more often and amass higher health care costs than nonvictims (Bergman and Brismar 1991; Wisner et al. 1999). In response to victims’ needs for mental health services, mental health systems have strengthened efforts to prevent and intervene in IPV, which includes assisting them with making changes in social and behavioral factors that may lead to IPV and providing appropriate health care to victims (Saltzman et al. 2000). One of the important elements in developing the mental health care response to IPV is to help mental health service providers and practitioners— such as doctors, counselors, and social workers—understand and meet the varying needs of victims. It is well documented that the nature of, and responses to, IPV will vary for different racial groups (e.g., Tjaden and Thoennes 2000; Yoshioka et al. 2003). However, research has been limited in dealing with mental health services for racial minorities. As the US population has become more racially diverse (US Census Bureau 2008), the dearth of research on Asian victims’ experiences with the current mental health systems makes it challenging for service providers and practitioners to serve them adequately. Knowledge of service satisfaction is particularly important in meeting their needs, given that most services have been developed for racial majorities and may not be well prepared to serve minorities. This study uses nationally representative data to examine racial differences in satisfaction with mental health services among victims of IPV.
Community Ment Health J (2012) 48:84–90
IPV and Help Seeking While IPV victims, in general, tend to utilize informal networks of kin and friends for as long as possible, before seeking formal help (Coker et al. 2000), victims’ varying needs, resources, and cultures also have influences on their help-seeking. Racial minorities, in particular, seem to rely more on informal help and less on formal services than White victims. One study compared differences in disclosure of IPV between racial groups and found that Asian victims were most likely to disclose their IPV experiences to friends, and least likely to seek help from counselors and police (Yoshioka et al. 2003). Informal networks may provide victims with emotional, instrumental support and assistance that are often not available from formal sources of help (Yoshioka et al. 2003). However, it may be a greater danger to victims if they rely heavily on informal help and delay seeking formal help until the violence reaches a severe level (Hutchison and Hirschel 1998). It is well known that early intervention, before IPV escalates in severity, is more effective than later interventions (Saltzman et al. 2000). However, there may be various barriers that keep service providers from detecting IPV early, or that keep victims from reporting and seeking formal help at the earlier stages of IPV. Victims may think that seeking formal help would increase dangers, like retaliatory violence or damaged social relations that would affect them and their children (Wolf et al. 2003). Victims from low-income neighborhoods may have limited access to formal services because of their economic constraints or a scarcity of service agencies in their communities (Pinn and Chunko 1997). Victims from oppressed groups may interpret their IPV experiences in terms of racial oppression and consider formal services as an institutionalized agent of the oppression (Brice-Baker 1994). In addition, victims from immigrant families may be also influenced by sociocultural factors that limit their access to formal sources of help. These may include traditional family and community values (Rimonte 1989; Vasquez 1998), fear of deportation (Bauer et al. 2000), a lack of knowledge of formal sources of services (Krishnan et al. 1998), linguistic limitations, and culturally insensitive services (Leong and Lau 2001; Sue et al. 1991). Culturally sensitive services are believed to be effective in serving IPV victims from immigrant families. They can provide victims with effective help in addressing their multiple needs and guide them through other resources in the community (Goodman et al. 2005; Sokoloff and Dupont 2005). On the other hand, the sociocultural factors may have different effects on different ethnic groups. One group may be influenced by family values more than others, while another group may be influenced by economic limitations more than others. Service providers may find this information helpful in
85
identifying different barriers for different groups and developing better services that recognize ethnic differences. However, little is known about racial differences and the effects of sociocultural factors on seeking help.
IPV and Mental Health Services Racial minorities are shown to be less likely to use mental health services than Whites. National data collected on those seeking mental health services in the 1980s showed that racial minorities used these services less frequently than Whites (Zhang, Snowden, and Sue 1998). Another study found that only 17% of Asian Americans with mental disorders in Los Angeles sought mental health services (Young 1998). Recent national data, collected in 2002, reported that racial minorities with mental health problems used mental health services less than the general population (Abe-Kim et al. 2007). In addition to the differences between racial groups in mental health service use, there may also be racial differences in satisfaction with services among IPV victims. Satisfaction with services is a particularly important element in addressing services for victims of IPV, given a long history of victim suffering where they have been ignored, blamed, and ill treated by service providers (Hamberger et al. 1998; Rodriguez et al. 1996). It is well established that satisfaction with mental health services has a strong effect on a client’s quality of life (Blenkiron and Hammill 2003). While a few studies have been conducted on racial differences in mental health service satisfaction, the results are not conclusive. Some studies, utilizing a small clinical sample, found no racial differences in satisfaction with counseling services (Fuertes and Brobst 2002). One study analyzed national survey data and found that Hispanics and African Americans were less satisfied with most components of mental health care than Whites (Wells et al. 2001). Another study utilizing national survey data from veterans found the opposite results: racial minorities were more satisfied with mental health services than Whites (Greenberg and Rosenheck 2004). Greater satisfaction with services among minorities has been shown to be linked with the empathy of service providers, culturally competent services, and positive attitudes toward helpseeking (Diala et al. 2000; Mitchell 1998; Takeuchi et al. 1995). Some racial groups are also more likely to be satisfied with specific types of care, while other groups are not. For instance, one recent national study found that African Americans reported more satisfaction with psychiatrists and social workers, while Hispanics reported more satisfaction with psychologists (Redmond et al. 2009). However, other studies showed rather mixed results (Abe-Kim et al. 2007; Jackson et al. 2007). Further
123
86
research is clearly required to disentangle racial disparities in mental health services, with relation to the types of services.
Study Hypotheses An increasing number of studies over the last decade have examined racial differences in use of, and satisfaction with, mental health services. However, to the authors’ knowledge, there is no study to date that utilizes national data with regard to racial differences in satisfaction with mental health services among victims of IPV. This study attempts to fill this gap by analyzing the recent nationally representative data to examine differences in satisfaction with mental health services between racial groups. This study has two research hypotheses. The first hypothesis is that satisfaction with mental health services will be different across race in the general population. The second hypothesis is that satisfaction with mental health services will be different across race among victims of IPV.
Method Study Sample This study used the Collaborative Psychiatric Epidemiology Surveys (CPES), which collected nationally representative data from adults aged 18 or older in the U.S. regarding the prevalence of mental disorders and their treatment patterns (Heeringa et al. 2004; Pennell et al. 2004). Use of mental health services was measured by asking respondents if they had ever seen any mental health professionals for problems with their mental health problems in the past 12 months. Those who answered to have seen at least one professional were identified as mental health service users for this study. A total of 1,812 service users were included: 1,120 Whites, 149 Blacks, 394 Latinos, and 149 Asians. Variables Sociodemographic variables included age, race, gender, education, financial security and employment. Race consisted of four categories: Whites, Blacks, Asians and Latinos. Education was measured by asking respondents’ years of education: 0–12, 13–15, and 16 years or more. Financial security was assessed by asking ‘‘In general, would you say you have more money than you need, just enough for your needs, or not enough to meet your needs?’’ Respondents who answered as having either ‘more than you need’ or ‘just enough for your needs’ were coded as
123
Community Ment Health J (2012) 48:84–90
being ‘financially secure’ and others being ‘financially not secure’. Employment was measured by three categories in the original survey question: employed, unemployed, not in labor force. The values were recoded dichotomously: ‘employed’ as being employed, and ‘unemployed’ and ‘not in labor market’ as being unemployed. Intimate partner violence (IPV) was measured by asking respondents how often the partner/spouse had perpetrated IPV to respondents over the course of their relationship. Included in IPV incidents were pushing, grabbing or shoving, throwing something, slapping, hitting or spanking, kicking, biting or hitting with a fist, beating up, choking, burning or scalding, and threatening with a knife or gun (Straus 1979). Those who have experienced any of IPV incidents were coded as ‘having experienced IPV’ and others as ‘not having experienced IPV.’ Satisfaction with mental health services was measured by two items: subjective satisfaction and perceived helpfulness. Subjective satisfaction was measured by asking ‘‘How satisfied are you with the treatments and services you received from the [service provider] in the past 12 months?’’ Original five responses were reduced to two categories: ‘satisfied’ and ‘not satisfied.’ Perceived helpfulness of mental health services was assessed with the question ‘‘Did the [service provider] help?’’ Respondents who answered as being helped ‘‘a lot’’ were coded as ‘helpful,’ and others ‘not helpful.’ Analysis The CPES data collections used a multistage area probability sample design, which requires researchers to compute unbiased estimates of population statistics and relationships by using weights and complex survey sample design measures (Heeringa et al. 2004). We conducted all analyses with SPSS version 13.0 using Taylor series linearization method. Descriptive statistics were first obtained to examine racial differences in demographic characteristics, IPV experience, and satisfaction with mental health services. Weighted estimates are reported, along with unweighted sample sizes and associated P-values. Two separate logistic regression analyses were conducted to test for associations between two dependent variables (subjective satisfaction and perceived helpfulness) and independent variables in the general population (N = 1,812). Complex-design-adjusted population-weighted estimates are reported. Two additional logistic regression analyses were conducted to measure the associations between independent and dependent variables among IPV victims. Only those who reported IPV experience were included in the analyses (N = 124). The Institutional Review Boards at the university the authors currently work with approved this study.
Community Ment Health J (2012) 48:84–90
Results Sample characteristics of mental health service users showed that more females (64%) were included in the sample than males (36%) for all race groups. The majority (55%) were employed except for Asians (47%). There were significant gaps in financial security among race groups. More than two-thirds of Whites (70.3%) and Asians (70.6%) felt themselves as being financially secure, which is greater than Latinos (60%) and Blacks (54.6%). There were significant differences in education among race groups. Asians attained the highest education among all race groups. The average age of Whites was highest, 42.45, with Latinos being the lowest, 39.56. Satisfaction with mental health services was not different across race. About three quarters of services users (77%) were satisfied with services; more than half of service users (58%) perceived the services as helpful. Lastly, Latinos experienced IPV the most (10%) among service users, followed by Asians (5.9%) and Blacks and Whites (5.4%, P = .010). Logistic regression analyses were conducted to examine factors that affected satisfaction with services in the general population. Both subjective satisfaction and perceived helpfulness were not significantly different across race. Aging had a small positive effect on perceived helpfulness (Odds ratio, or OR = 1.013), but not on subjective satisfaction. Gender, education, employment, financial security, and IPV experience did not affect satisfaction. Another logistic regression analysis was conducted to examine factors affecting service satisfaction among IPV victims. IPV victims’ patterns of satisfaction were significantly different from the general population. Latino, Black, and White victims were less likely to perceive the service as helpful than Asians (OR = 0.134, 0.180, and 0.089, respectively). There was, however, no difference in subjective satisfaction across race. Financial security increased greatly the odds of being satisfied with the service. Financially secure victims were more likely to be satisfied with the service and perceive the service as helpful than victims who were financially not secure (OR = 4.643 and 3.294, respectively). Employed victims were more likely to perceive the service as helpful than unemployed ones (OR = 2.070).
Discussion Our findings indicate that the majority of individuals in the general population who used mental health services are satisfied with the services they received. However, ratings of perceived helpfulness are lower than subjective measures of satisfaction. The discrepancy between the two ratings may result from the study’s methodology. First,
87
previous studies found that subjective satisfaction ratings were more likely to be skewed than perceived helpfulness (Abe-Kim et al. 2007). Another possibility is that subjective satisfaction may be more about patients’ feeling about the effectiveness of the services they received than their judgment regarding overall quality of the service provider that was measured by perceived helpfulness. For example, a minority patient may be satisfied with a specific service that addresses its specific needs but may not necessarily think that the service provider is culturally sensitive. Finally, satisfaction may not be a simple phenomenon that can be measured by only two questions as the study did; discrepancies between ratings of subjective satisfaction and perceived helpfulness may be an artifact of multiple aspects of satisfaction. It is encouraging, however, for this study to find that the majority of mental health service users were satisfied with the services. The authors hypothesized that satisfaction with mental health services in the general population would be different across race. The results did not support the hypothesis. Race had no effect on both subjective satisfaction and perceived helpfulness, controlling for age, gender, education, financial security, employment, and IPV experience. There may be variation within a race that was not measured in this study. Ratings of satisfaction, however, do not seem to vary significantly across ethnicity. Two studies used the different sub-datasets of the CPES from this study to examine Asians and black Caribbean immigrants separately (Abe-Kim et al. 2007; Jackson et al. 2007). They found that satisfaction with most components of mental health services did not differ significantly across ethnic groups. Besides ethnicity, cultural and linguistic diversity in the immigrant population might also constitute withinrace variation. The two studies cited above also found significant effects of immigration-related factors on perceived helpfulness of the mental health services. While these findings suggest some relations between the immigration status and perceived helpfulness, it is hard to find any consistent direction and strength of those relations across various immigrant groups. It may be that immigrantrelated factors (e.g., nativity status, language, knowledge of services) interact with other cultural factors (e.g., traditional norms, stigma) to influence immigrants’ perceptions of satisfaction and helpfulness, which might confound the relationship between race and satisfaction. We cannot examine further this possibility for the current data collected information regarding these factors from Asians, Latinos, and black Caribbean immigrants, but not from African Americans and Whites. It is recommended that future research examine the relations between immigrantrelated factors and service satisfaction among immigrant populations and use that information to better understand factors affecting satisfaction with mental health services.
123
88
As financial security and employment had also no effect on subjective satisfaction and perceived helpfulness, socioeconomic status does not seem to be a meaningful factor that affects satisfaction. While IPV experience was not found to affect ratings of satisfaction across race as well, there may be variation within those who experienced IPV. This study hypothesized that ratings of satisfaction would be different across race among IPV victims. The results are rather mixed. Race had no effect on subjective satisfaction with services, but did affect perceived helpfulness; financial security had a positive effect both on subjective satisfaction and perceived helpfulness; and employment affected positively perceived helpfulness but had no effect on subjective satisfaction. Based on the data, there is no decisive information why race and other factors differentially affected subjective satisfaction and perceived helpfulness. Moreover, we cannot tell which one would be better to detect relations between race and service satisfaction. Nevertheless, the results suggest that perceived helpfulness seems to be a greater factor than subjective satisfaction. Future research is apparently needed to examine further these relations. It is surprising that Asian victims of IPV were more likely to perceive mental health services as helpful than any other race groups, given that there was no racial difference in the general population. Literature on service experiences of racial minorities suggests the positive relationship between culturally sensitive services and clients’ satisfaction (Diala et al. 2000; Mitchell 1998; Takeuchi et al. 1995). Asian victims of IPV might have used culturally sensitive services and been satisfied with the services more than other race groups do, although the current data did not allow further examination of this possibility. Another explanation for the differences we observed might be that racial preferences for specific types of services are likely to affect satisfaction. Numerous recent studies suggest that racial minorities are more likely to be satisfied with specialty services than general services (Abe-Kim et al. 2007; Alegrı´a et al. 2007; Jackson et al. 2007; Redmond et al. 2009). Given that Asian victims of IPV are less likely to seek help outside, formal help than other race groups (Coker et al. 2000; Yoshioka et al. 2003), they may have serious mental health problems when they decide to seek formal help. Accordingly, they may want to visit specialty mental health services that can address their specific health concerns. We could not examine this possibility because of the small sample sizes for some subgroups (e.g., 12 Asian and 9 Black victims). Another interesting finding of this study is that economic factors, such as financial security and employment, affected perceived helpfulness of services among IPV victims, but not in the general population. Economic factors, such as income and employment, have been reported to have positive effects on physical and mental well-being, regardless of race and
123
Community Ment Health J (2012) 48:84–90
ethnicity (Lantz et al. 1998; Ojeda and McGuire 2006; Sorlie et al. 1995). It is, however, also speculated that economic factors can be confounded by other unmeasured factors affecting health (Alegria et al. 2002). Victims with better economic means may use service providers who deliver good quality, high price services, which is likely to affect satisfaction positively, but unlikely to be available to victims without those means. On the other hand, service needs of IPV victims are quite broad, including shelter services, legal services, health care, economic assistance and counseling services. Better economic means may allow victims to utilize other services in addition to mental health services. For instance, income was shown to be positively associated with victims’ use of legal services (Macy et al. 2004). Utilization of multiple services is likely to help victims meet their needs effectively, leading to better satisfaction. Another possible explanation for positive effects of economic resources on satisfaction is that treatment effects of mental health services among IPV victims may be confounded by life stress faced by victims. IPV victims who seek help tend to have a myriad of difficulties and stressful life events, either resulting from or influencing IPV (Riger et al. 2002). Financially secure and employed victims are, however, less likely to be exposed to stressful life events associated with limited economic resources than victims who are financially unsecure or unemployed. Victims with limited economic resources may be satisfied with mental health services, but their satisfaction can be quickly eroded by stressful life events that they have to face at home. This study had several limitations. The number of IPV victims included in the analysis was relatively small for some subgroups, weakening individual factors’ predictive accuracy, as well as disallowing for further examination of within group differences. While sampling weights were applied to all analyses for better estimation, the power of the analyses may be limited by the original sample size. A larger sample, especially for Asians and Blacks, is clearly needed to disentangle complicated relations among socioeconomic factors, race, and satisfaction with services among IPV victims. Another limitation is that the study findings regarding the association between IPV experience and satisfaction with services are correlational. We could not determine from the study data any temporal order between IPV experience and service use. Respondents might have used mental health services after experiencing IPV; they might have experienced IPV after using mental health services. Longitudinal studies are clearly needed.
Conclusion The results of this study reveal limited racial differences in satisfaction with mental health services among IPV
Community Ment Health J (2012) 48:84–90
victims, along with effects of socioeconomic factors. While Asian victims’ higher satisfaction with services is encouraging, further examination should be done regarding why satisfaction of victims from other race groups is lower than Asian victims. Given the positive relationship between economic resources and satisfaction with services, it is critical to further examine potential disadvantages of IPV victims with limited socioeconomic resources in meeting their mental health needs. It is also critical for mental health service providers to screen their clients for IPV and connect the identified IPV victims with a range of services to address their multiple, co-occurring needs effectively. While various service settings have moved, if slowly, toward better screening for IPV, much work still needs to be done (Levine and Greene 2000). In addition, service providers need to incorporate more information about racial and ethnic minority victims of IPV in their service delivery. Minority victims have long been underrepresented by various services related to IPV; mental health services are not exception. Minority victims may not be significantly different from White victims in basic needs for protection and safety against IPV, but seem to be unique in use of, and satisfaction with, mental health services.
References Abe-Kim, J., Takeuchi, D. T., Hong, S., Zane, N., Sue, S., Spencer, M. S., et al. (2007). Use of mental health related services among immigrants and US born Asian Americans: Results from the National Latino and Asian American Study. American Journal of Public Health, 97(1), 91–98. Alegria, M., Canino, G., Rios, R., Vera, M., Calderon, J., Rusch, D., et al. (2002). Inequalities in use of specialty mental health services among Latino, African Americans, and non-Latino Whites. Psychiatric Services, 53, 1547–1555. Alegrı´a, M., Mulvaney-Day, N., Woo, M., Torres, M., Gao, S., & Oddo, V. (2007). Correlates of past-year mental health service use among Latinos: Results from the National Latino and Asian American Study. American Journal of Public Health, 97(1), 76–83. Bargai, N., Ben-Shakhar, G., & Shalev, A. Y. (2007). Posttraumatic stress disorder and depression in battered women: The mediating role of learned helplessness. Journal of Family Violence, 22, 267–275. Bauer, H. M., Rodriguez, M. A., Szkupinski-Quiroga, S., & FloresOrtiz, I. G. (2000). Barriers to health care for abused Latina and Asian immigrant women. Journal of Health Care for the Poor and Underserved, 11(1), 33–44. Bergman, B., & Brismar, B. (1991). A 5-year follow-up study of 117 battered women. American Journal of Public Health, 81, 1486–1488. Blenkiron, P., & Hammill, C. A. (2003). What determines patient’s satisfaction with their mental health and quality of life? Postgraduate Medical Journal, 79, 337–340. Brice-Baker, J. R. (1994). Domestic violence in African-American and African-Caribbean families. Journal of Social Distress and the Homeless, 3(1), 23–38.
89 Campbell, J. C. (2002). Health consequences of intimate partner violence. Lancet, 359, 1331–1336. Catalano, S. (2008). Intimate partner violence in the United States. Washington, DC: US Department of Justice. Coker, A. L., Derrick, C., Lumpkin, J. L., Aldrich, T. E., & Oldendick, R. (2000). Help-seeking for intimate partner violence and forced sex in South Carolina. American Journal of Preventive Medicine, 19, 316–320. Diala, C. C., Muntaner, C., Walrath, C., Nickerson, K., LaVeist, T., & Leaf, P. (2000). Racial differences in attitudes toward professional mental health care and in the use of services. The American Journal of Orthopsychiatry, 70, 455–464. Fuertes, J., & Brobst, K. (2002). Clients’ ratings of counselor multicultural competency. Cultural Diversity and Ethnic Minority Psychology, 8, 214–223. Goodman, L. A., Dutton, M. A., Vankos, N., & Weinfurt, W. (2005). Women’s resources and use of strategies as risk and protective factors for re-abuse over time. Violence Against Women, 11(3), 311–336. Greenberg, G. A., & Rosenheck, R. A. (2004). Changes in satisfaction with mental health services among blacks, whites, and Hispanics in the Department of Veterans Affairs. Psychiatric Quarterly, 75(4), 375–389. Hamberger, L. K., Ambuel, B., Marbella, A., & Donze, J. (1998). Physician interaction with battered women: The women’s perspective. Archives of Family Medicine, 7, 575–582. Heeringa, S., Wagner, J., Torres, M., Duan, N., Adams, T., & Berglund, P. (2004). Sample designs and sampling methods for the collaborative psychiatric epidemiology studies (CPES). International Journal of Methods in Psychiatric Research, 13(4), 221–240. Hutchison, I. W., & Hirschel, J. D. (1998). Abused women: Helpseeking strategies and police utilization. Violence Against Women, 4, 436–456. Jackson, J. S., Neighbors, H. W., Torres, M., Martin, L. A., Williams, D. R., & Baser, R. E. (2007). Use of mental health services and subjective satisfaction with treatment among Black Caribbean immigrants: Results from the national survey of American life. American Journal of Public Health, 97(1), 60–67. Krishnan, S., Baig-Amin, M., Gilbert, L., El-Bassel, N., & Waters, A. (1998). Lifting the veil of secrecy: Domestic violence against South Asian women in the United States. In S. Das Dasgupta (Ed.), A patchwork shawl: Chronicles of South Asian womanhood in America (pp. 145–159). New Brunswick, NJ: Rutgers University Press. Lantz, P. M., House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., & Chen, J. (1998). Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults. Journal of the American Medical Association, 279(21), 1703–1708. Leiner, A. S., Compton, M. T., Houry, D., & Kaslow, N. J. (2008). Intimate partner violence, psychological distress, and suicidality: A path model using data from African American women seeking care in an urban emergency department. Journal of Family Violence, 23, 473–481. Leong, F. T. L., & Lau, A. S. L. (2001). Barriers to providing effective mental health services to Asian Americans. Mental Health Services Research, 3(4), 201–214. Levine, S. A., & Greene, J. A. (2000). Linking substance abuse treatment and domestic violence services: A guide for administrators (No. SMA00–3391). Rockville, MD: Substance Abuse and Mental Health Services Administration. Macy, R. J., Nurius, P. S., & Kernic, M. (2004). Profiles of battered women’s needs and strength: A person-centered profile analysis. In: Paper presented at the Society for Social Work and Research, New Orleans.
123
90 Mitchell, C. G. (1998). Perceptions of empathy and client satisfaction with managed behavioral health care. Social Work, 43(5), 404–411. Ojeda, V. D., & McGuire, T. G. (2006). Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults. Psychiatric Quarterly, 77(3), 211–222. Pennell, B., Bowers, A., Carr, D., Chardoul, S., Cheung, G., Dinkelmann, K., et al. (2004). The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. International Journal of Methods in Psychiatric Research, 13(4), 241–269. Pinn, V. W., & Chunko, M. T. (1997). The diverse face of violence: Minority women and domestic abuse. Academic Medicine, 72(1), S65–S71. Redmond, M. L., Galea, S., & Delva, J. (2009). Examining racial/ ethnic minority treatment experiences with specialty behavioral health service providers. Community Mental Health Journal, 45(2), 85–96. Riger, S., Raja, S., & Camacho, J. (2002). The radiating impact of intimate partner violence. Journal of Interpersonal Violence, 17, 184–205. Rimonte, N. (1989). Domestic violence among Pacific Asians. In A. W. U. o. California (Ed.), Making waves: An anthology of writings by and about Asian American women (pp. 327–337). Boston: Beacon Press. Rodriguez, M. A., Quiroga, S. S., & Bauer, H. M. (1996). Breaking the silence: Battered women’s perspectives on medical care. Archives of Family Medicine, 5, 153–158. Saltzman, L. E., Green, Y. T., Marks, J. S., & Thacker, S. B. (2000). Violence against women as a public health issue: Comments from the CDC. American Journal of Preventive Medicine, 19(4), 325–329. Sokoloff, N. J., & Dupont, I. (2005). Domestic violence at the intersections of race, class, and gender: Challenges and contributions to understanding violence against marginalized women in diverse communities. Violence Against Women, 11(1), 38–64. Sorlie, P. D., Backlund, E., & Keller, J. B. (1995). US mortality by economic, demographic and social characteristics: The National Longitudinal Mortality Study. American Journal of Public Health, 85, 949–956.
123
Community Ment Health J (2012) 48:84–90 Straus, M. A. (1979). Measuring intrafamily conflict and violence: The conflict tactics scale. Journal of Marriage and the Family, 41, 75–87. Sue, S., Fujino, D. C., Hu, L. T., Takeuchi, D. T., & Zane, N. W. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59(4), 533–540. Takeuchi, D. T., Sue, S., & Yeh, M. (1995). Return rates and outcomes from ethnicity-specific mental health programs in Los Angeles. American Journal of Public Health, 85(5), 638–643. Tjaden, P., & Thoennes, N. (2000). Extent, nature, and consequences of intimate partner violence: Research report. Washington DC: National Institute of Justice and the Centers for Disease Control and Prevention. US Census Bureau (2008). American Community Survey. Retrieved November 28, 2008, from http://factfinder.census.gov. Vasquez, M. T. (1998). Latinos and violence: Mental health implications and strategies for clinicians. Cultural Diversity and Mental Health, 4, 319–334. Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. The American Journal of Psychiatry, 158(12), 2027–2032. Wisner, C. L., Gilmer, T. P., Saltzman, L. E., & Zink, T. M. (1999). Intimate partner violence against women. Do victims cost health plans more? The Journal of Family Practice, 48, 439–443. Wolf, M. E., Ly, U., Hobart, M. A., & Kernic, M. A. (2003). Barriers to seeking police help for intimate partner violence. Journal of Family Violence, 18(2), 121–129. Yoshioka, M. R., Gilbert, L., El-Bassel, N., & Baig-Amin, M. (2003). Social support and disclosure of abuse: Comparing South Asian, African American, and Hispanic battered women. Journal of Family Violence, 18(3), 171–180. Young, K. (1998). Help seeking for emotional/psychological problems among Chinese Americans in the Los Angeles area: An examination of the effects of acculturation. Unpublished doctoral dissertation, University of California, Los Angeles. Zhang, A. Y., Snowden, L. R., & Sue, S. (1998). Differences between Asian- and White-Americans’ help-seeking and utilization patterns in the Los Angeles area. Journal of Community Psychology, 26, 317–326.
