Psychological distress, mental health services, and forgone health care use among lesbian and bisexual Asian-American women

Background: Lesbian and bisexual women have higher rates of mental disorders and suffer from greater psychological distress than their heterosexual counterparts. However, little is known about the mental health status and health care utilization of Asian-American lesbian and bisexual women. Methods: We surveyed 701 non-married Chinese, Korean, and Vietnamese women, who are children of immigrants and residents of Greater Boston. Our dependent variables are perceived mental health status, depression score based on CES-D, psychiatric diagnosis by psychiatrists or psychologists, inpatient mental health hospitalization, adequate outpatient mental health use, and forgone health care. To compare Asian-American women on mental health status measures by sexual orientation, we estimated logistic regression models adjusting for socio-demographic covariates. For mental health service utilization, we estimated logistic regression adjusting for health status and socio-demographic characteristics. Results: In our sample, 18.4 % identified themselves as lesbian/bisexual. Lesbian/bisexual women had significantly higher odds of reporting fair or poor health, severe depression, and any mental health diagnosis after controlling for covariates compared to their heterosexual counterparts. Lesbian/bisexual women were more likely to be treated in inpatient mental hospitals and to report forgone health care, even after adjustment for health status and sociodemographics. No differences were identified in adequate outpatient mental health care. Conclusion: This study suggests an imbalance among lesbian/bisexual Asian-American women in that they have both higher rates of mental illness and greater unmet need for mental health services. Our study calls for improving the provision of mental and medical health services for this vulnerable group.