Patient management

The Asian population is considered as the fastest growing ethnic population in the United States. The influx of Asians into the mainland started several decades ago and the migration still continues to this date and the coming years. Aside from the simple settling down of Asians in a developed country such as the U. S. , these individuals are subjected to crisis between maintaining their culture in a foreign land and adopting Westernized attitudes and principles. In addition, these Asian migrants, just like any other human beings, are susceptible to develop mental health conditions and may need medical attention and therapeutic intervention.

They would request for this healthcare service and unfortunately, most of the physicians in the United States are trained within the country and may not be fully aware of the differences in cultures between Asians and Westerners. Since Asians comprise almost 60% of the total world population, it is thus important that the Asian perspective on mental health be studied and understood. One important aspect of the Asian culture that is of significance to the field of mental health is that this ethnic group maintains a strong hold on its culture, regardless of their current physical location of residing in the United States.

It is also important to understand that the same issues regarding mental health among Asians may also be applicable to other continents around the world. This paper will describe the Asian perspective with regards to mental health issues and its associated psychotherapeutic interventions. Caution will be exercised with regards to country-specific reports, such as descriptions that are only appropriate to Chinese or Japanese individuals. However, there will also be certain concepts that are homogeneously applicable to all Asian individuals. Selected conceptual framework

The term Asian refers to the large population that is composed of approximately 28 countries. Each subgroup can be characterized by its unique culture, as well as through its national language. In addition, there are also several religious backgrounds and dietary routines in every Asian subgroup. However, one unique feature that is common to all the Asian subgroups is the history of immigration from their home countries to the United States. The main driving force for the migration of Asians to the United States is to find better options for their families and thus this movement started almost one century ago and still continues to this date.

Similar to any other human being, Asians are subjected to stress and crisis and there may be times when these individuals would reach a point when there would be a need to seek medical attention. However, mental stress among Asians is often magnified because they are localized in a foreign country and there may be some principles that have already been included in their personality and values. It is thus common to find an Asian-American to present a mixture of both Western and Eastern values, depending on how this individual assesses the need to imbibe certain ideas to his own personal benefit.

This condition thus influences the manner as to how a psychotherapist should deal and approach an Asian client during sessions. The psychotherapist may find that the Asian client upholds a modification or distortion of the psychological norms and this is mostly due to the cultural background of the client. It is thus important that the psychotherapist understands and recognizes these differences and come up with approaches that are acceptable and ultimately, beneficial to the client’s mental health wellness.

Specific examples will be presented in this paper and further assessment will also be provided. Review of related literature It has been observed that the number of admissions of Asian patients into hospitals for mental health disorders is low. Similarly, out-patient consultations for mental health conditions are rare. The poor utilization by Asians could suggest that psychological disorders may be uncommon in this ethnic group, yet other reports have suggested other reasons.

Firstly, it may be possible that members of this ethnic group are more resilient than the average American and thus they are unperturbed by stress and other mental breakdowns (Lin and Cheung, 1999). However, sociologists indicate the Asian immigrants in the United States actually experience severe conditions than the rest of the local inhabitants and this is mostly due to the differences in their cultural background. Given this scenario, an Asian individual is thus only convinced to seek professional help when he has reached an extreme mental health condition and sadly, this stage is often too late or more complicated to address.

Another Asian attitude is that any mental health condition is often restricted within the family and the immediately community and thus the local health system is generally unaware of the problem until a severe incident has been performed by the person himself (Shin and Lukens, 2002). This attitude is the extreme opposite of Americans, wherein the individual is immediately submitted for testing and consultation in a mental health clinic once the slightest signs of atypical behavior are observed in an individual.

The idea of being immigrants also further suppresses Asians to admit that they are suffering from a mental health condition. Given these reasons, it is thus important that specialized institutions be created in order to entice Asians to receive mental health services at the earliest possible time. So far, there are mental health clinics that are custom-designed for Asians in the cities of Los Angeles, San Francisco and New York. The staff members of these clinics are required to be bilingual, in order to remove any language and cultural barriers that may interfere or inhibit the Asian patient.

Since the creation of such clinics, more Asians have submitted themselves for consultation and testing, and those patients positively diagnosed with mental health disorders appropriately treated and registered for psychotherapy. Another issue that is important to consider with regards to Asian individuals and mental health conditions is that their diagnosis may be approached through a modified criteria for screening. It is important to understand that the standards for diagnostics in mental health conditions are not straightforward if the patient is Asian.

This is mainly due to the cultural background, principles and attitudes that Asians maintain, regardless of their length of stay in the United States. More importantly, caution should be exercised when a patient is of Asian descent, because the Caucasian psychiatrist may misdiagnose the patient because he simply was not aware of the Asian cultural foundations. One of the most common Asian attitudes that complicate psychoanalytical screening is somatization. This process involves experiencing physical pain when an individual is in distress (Holt et al. , 2003).

Moreover, the Asian patient may actively ignore the impending mental burden and focus his attention on the physical impact that his emotions are influencing. It may be possible that Asians have an insufficiency of recognizing that the mind is such as strong organ that the rest of the body may follow suit if the mind is not at peace. Another discrepancy between Asian and Western psychological approaches is the concept of family. To the Asians, the ties of this social unit is so strong that when one member of the individual is diagnosed as ill, then the entire family feels that the illness has also affected them.

Hence in the case of a mental health condition, the entire family tries to contain the symptoms in order to prevent the entire family from being diagnosed to have the same condition. To the Westerner, this stance may be perceived as intrusive, yet this is the normal expression of unity and caring to the Asians. It is thus important that the Western psychologist understands how an Asian family unit works, in order to better understand and suggest actions that are acceptable to the patient and his family (Chien and Chan, 2004).

Psychotherapeutic interventions for Asian patients are often more creative because their cultural background should always be considered. One of the most successful psychotherapeutic approaches for Asian mental health patients is to commence a treatment with the establishment of trust (Chen et al. , 2007). This approach may be similar to Western patients, but the details of approach are quite modified. For example, psychological sessions with Asian patients are often more effective when the entire family are present in every session.

This setting instills trust, as well as hope in both the patient and his relatives. In addition, the psychotherapist should be always aware of providing the Asian patient with examples that involve identification of members of the patient’s family because familiarity is always an effective approach to these minorities. Asian give high regard to elderly members of the family and thus any examples that portray family members will make a strong impact on the Asian patient.

Implications for advanced nursing practice and other healthcare disciplines Psychotherapeutic interventions conducted on Asians are multi-dimensional because these require a good understanding of the culture and the values of this ethnic group. Several cultural principles are strongly regarded by Asian patients and thus it is important that healthcare professionals, especially nurses and psychotherapists, are aware of such differences and instill modifications that could be recognized by the patients and the members of their immediate family.

Asian patients treat mental health conditions in a different light and thus healthcare professionals should be aware that they may not approach the health condition in a straightforward manner unless they fully explain their actions to the patient. It is also important that the healthcare professional wins the patient’s trust so that the patient will comply with their healthcare advices.

The immigration history of the Asian patient should also be collected because it may be possible that the current mental health condition of the patient may be strongly correlated with their length of stay in the United States. It may be possible that new immigrants experience more stress than those immigrants who have already stayed in the country for a couple of years. The language barrier can also influence the success of interaction between the healthcare professional and the patient, thus the bilingual capability of the professional may alleviate this problem.

Healthcare implications for our nation The United States will continue to receive immigrants from almost all countries of the world. Asians comprise the highest number of immigrants and thus their integration into the society will impact the healthcare conditions of the country. It will be helpful for most healthcare professionals to understand the values and attitudes of the Asian population, in order to serve these minorities better in the healthcare institutions.

Their comprehension may also save the healthcare system from unnecessary treatments and misdiagnoses that are most probably due to the misunderstanding or unawareness of the values and cultural backgrounds of this ethnic group. Reform in the healthcare system may include the requirement of having bilingual hospital staff members that could interpret and interact with Asian patients that have difficulty in describing their conditions to the healthcare professionals.

Trust will also be instilled in the patient, possibly speeding up the recovery process of the patient. References Chen, J. , Nakano, Y. ,. Ietzugu, T. , Ogawa, S. , Funayama, T. , Watanabe, T. , Noda, Y. and Furukawa, Y. A. (2007). Group cognitive behavior therapy for Japanese patients with social anxiety disorder: Preliminary outcomes and their predictors. BMC Psychiatry, 7, 69-78, Chien, W. T. and Chan, S. W. (2004). One-year follow-up of a multiple-family-group intervention for Chinese families of patients with schizophrenia.

Psychiatric Services, 55, 1276-1284. Holt, D. J. , Phillips, K. A. , Shapiro, E. R. and Becker, A. E. (2003). “My face is my fate”: Biological and psychosocial approaches to the treatment of a woman with obsessions and delusions. Harvard Reviews in Psychiatry, 11, 142–154. Lin, K. M. and Cheung, F. (1999). Mental health issues for Asian Americans. Psychiatric Services, 50, 774-780. Shin, S. K. and Lukens, E. P. (2002). Effects of psychoeducation for Korean Americans with chronic mental illness. Psychiatric Services, 53, 1126-1131.

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