Mental distress in the Korean American community remains chronically high yet professional service utilization is amongst the lowest of any ethnic group in the United States. With high rates of co-morbidity in this community, it is critical to utilize a multilevel approach to understand the scope of distress of distress by simultaneously analyzing the occurrences of anxiety, depression, and hwa-byung (a Korean cultural illness), in addition to studying factors that impact help-seeking behavior. To contextualize the unique circumstances and factors that impact mental health challenges and resource utilization in the community, Critical Race Theory and Anderson’s Healthcare Utilization Model was utilized to frame the diverse experiences and perspectives. Separate hierarchal linear regressions for anxiety, depression, and hwa-byung, were run, controlling for socio-demographic variables in the first step and potential protective factors in the second step. Two logistic regressions were run to analyze formal and informal resource utilization. Results showed that the language they took the survey in, income, church role, and generational status significantly predicted distress scores. Perceived better physical health status, higher perceived resiliency, positive views of God and/or religion appeared to serve as potential protective factors for distress. Level of education, employment status, and religious affiliation significantly predicted formal service utilization. Factors that predicted informal resource utilization were gender, attitudes toward professional mental health services, acculturation, and views of God and religion. It is suggested that future studies be conducted to further explore which types of interventions would be most effective in not only decreasing mental distress but also in identifying interventions or resources people are most likely to use based on intersections of roles and experiences.

LLU Discipline

Social Policy and Social Research


Social Work and Social Ecology


School of Behavioral Health

First Advisor

Ortiz, Larry

Second Advisor

Alemi, Qais

Third Advisor

Montgomery, Susanne

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Depression; Health Behavior -- Korean-Americans; Mental health; Korean Americans; Spirituality;

Subject - Local

Mental Distress; Co-morbidity; Education; Employment status; Religious affiliation



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