This study is a structured review summarizing findings of the existing literature on mental health service use among Asian and Pacific Islanders (API) youth. The project aims to answer the following questions: (1) What type of services do API youths access to address their mental health needs? (2) To what extent are API youths utilizing these mental health services to address their needs? (3) What type of methodological approach is used to evaluate API youth’s needs and utilization of mental health? (4) How can findings from this literature review contribute to clinical practice and future research? The methodological approach includes evaluating peer-reviewed articles from 1990 to 2012, which identified Asian and/or Pacific Islanders who are 19 years old and younger, and examined mental health services use as an outcome within a variety of specialty and/or non-specialty mental health service settings. Findings were broadly organized by level of restrictiveness and mental health service type. Studies were reviewed with regard to their study design, sample characteristics, measures used and key findings. Results showed that there were a limited number of studies evaluating API youth mental health services utilization. The studies that evaluated API youth mental health utilization demonstrated that they often accessed mental health services at a lower rate than other racial/ethnic groups. Types of services included: school-based mental health services, xi community-based mental health services, group home/residential treatment, psychiatric care, 24-hr crisis care, and non-specialty mental health care (i.e. self-help groups). When API youth accessed mental health services, they were often school- and community-service based. The majority of studies reported a relationship between mental health service use and race/ethnicity. Those studies also confirmed disparities between mental health need and actual service use among API youth. Methods varied widely, using both cross-sectional and longitudinal designs and a range of standardized measures to evaluate needs and types of service accessed by API youths. Characteristics of the samples varied on clinical and non-clinical demographics. As noted by the way API groups were categorized across studies when looking at racial grouping, gender, age, number of participants, etc. Findings further showed that cultural factors such as stigma and beliefs about the etiology of mental health problems may not be directly influencing API youth access and utilization of mental health services, but are impacting caregiver’s perception of need. This, consequently, affected the youth mental health service utilization. There was also some evidence that ethnic specific services seem to be more effective in facilitating access for API youths. A significant methodological limitation of reviewed studies involved the aggregation of various API groups or the aggregation of API youth with other racial/ethnic groups. Aggregation impacts understanding of within-group differences. Existing disparities between need and use underscore the need for further research in this area. Clinical implications include a need for more culturally appropriate psycho-education for gatekeepers to identify API youths who are in need and facilitate access to services.

LLU Discipline





School of Behavioral Health

First Advisor

James, Sigrid

Second Advisor

Vermeersch, David A.

Degree Name

Doctor of Psychology (PsyD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Mental Health Services; Delivery of Health Care - Ethnology; Ethnic Groups - Psychology; Asian Continental Ancestry Group - Psychology; Oceanic Ancestry Group - Psychology

Subject - Local

Literature Reviews; Pacific Islanders; Youth; Mental Health Utilization; School-based Mental Health Services


Doctoral Project

Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives