The Cultural Beliefs and Mental Health Help-Seeking Behaviors of People with Schizophrenia in Taiwan
The purpose of this study was to explore the help-seeking behaviors of persons with schizophrenia in Taiwan. As the literature indicates, this illness has both biological and social cuases and is one of the most misunderstood, stigmatized, and untreated diseases. Cheng (2003) estimated that of the 64,908 individuals with chronic mental illness in Taiwan, 60% were dysfunctional and required long-term continuous and rehabilitative care. Wynaden (2005) found that religion was an important factor influencing individual and family health beliefs and that in the Taiwanese culture, many people turned to Buddhism and Taoism for folk healing. He recommended that mental health professionals need to develop stronger linkages with religious groups in the community. This study utilized the Behavioral Model of Health Service Use (Andersen, 1968) to test the combined influence of Predisposing Factors (family composition, social structure, and health beliefs), Enabling Factors (family and community resources), and Need Factors (including the severity of illness and the patient/family response). It was hypothesized that: 1) each of these characteristics would have a direct impact on the utilization of mental health services; and 2) cultural factors would have a moderating effect on the interrelationship of these Factors. The study included a radom stratified sample of 125 persons diagnosed with schizophrenia from the four major geographic regions of Taiwan, including urban, suburban, and rural regions. The study hypotheses were partially supported in that Predisposing Factors had a direct influence on informal service utilization, and Enabling Factors had a direct influence on utilization of formal services. Further, one Need Factor, level of distress, showed a direct influence on informal service utilization. As predicted, cultural factors, insight and stigmatization, had an indirect effect on the inter-relationships among the study factors. These findings support the usefulness of the Anersen Behavioral Health Model as a tool for understanding mental health service utilization. They also highlight the importance of cultural sensitivity, particularly sensitivity to religious factors in mental health service planning and delivery in Taiwan.
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