EMPORIA STATE RESEARCH STUDIES Vol. 53, no. 1, p. 1 – 14 (2022) _____________________________________________________________________________________
Help Seeking Attitudes and Behavior in India, the United States, and China GEORGE B. YANCEYa, JAYASHREE GEORGEb, CHRISTINE K. JOOc, AND WEIWEI LIUd Southeast Missouri State University, b Southern Illinois University – Edwardsville, c Private Practice, d Korn Ferry; Corresponding Author: gyancey@semo.edu a
______________________________________________ Across cultures, there are differences in attitudes towards seeking help. This also corresponds with differences in the number of mental health care workers between countries. We inquired into the attitudes towards seeking help among participants in the United States, India, and China, gender differences in help seeking attitudes, and interactions between gender and country in help seeking attitudes and behavior. In a convenience sample of 1,412 participants (728 from India, 479 from the USA, and 205 from China), we found that participants from the United States sought help the most, followed by the Indians, and then the Chinese. The North Indians had the most positive help seeking attitudes, followed by the participants from the United States, China, and South India. While American women were more likely to have sought help than American men, in India and China, the men were more likely to have sought out help compared to their female counterparts. This study was done before the COVID-19 pandemic. Such a study is useful in providing comparison data with those done during the pandemic and in the years thereafter. Keywords: help seeking attitudes, mental health, cross-cultural, gender, help seeking behavior
INTRODUCTION What makes someone seek help as a way to find lifeenhancing change while another shuns help because they see it as a personal weakness or moral failure? What shapes such attitudes? These were some of the questions Fischer and Turner (1970) and Fischer and Cohen (1972) sought to answer in the early nineteen seventies. Fischer and Cohen (1972) debunked the common notion of the times that one’s socioeconomic status correlated with seeking help, the assumption that upper class persons would be more open to seeking help than lower class persons. These early ponderings formed the impetus for the current inquiry, with the idea that understanding people’s views toward mental health and seeking help from both the United States and non-Western cultures, such as India and China, might provide useful information to mental health providers in the United States and elsewhere. Cultural attitudes are important to reckon with in psychotherapy as they have an impact on alliance. Attitudes towards help seeking impact whether clients access help, and having accessed help, whether they continue without prematurely dropping out. College students were the majority of the participants in the early articles, similar to our current inquiry. The research for this article was based on pre-COVID-19 experiences. Within the current context of the pandemic, rates of
depression and anxiety and other correlated symptoms are on the rise globally (Zaidi et al., 2020). Many countries have responded by creating avenues for seeking help. What attitudes in the pre-pandemic context shape our understanding of help seeking behavior among participants in India, China, and the United States? This is the purpose of our inquiry. EAST VERSUS WEST According to the World Health Organization’s Global Health Workforce Statistics (2018), for every 100,000 people in the population, the United States had 10.5 psychiatrists, 4.3 nurses, 60.3 social workers, and 29.9 psychologists working in the mental health sector in 2016. In 2016, India had had .3 psychiatrists, .8 nurses, .1 social workers, and .1 psychologists per 100,000 citizens. In 2015, China had 2.2 psychiatrists, 5.4 nurses, and no numbers reported for social workers or psychologists for the number of people working in the mental health sector per 100,000 citizens. The relatively small number of mental health care workers in China and India, per capita, does not indicate that Chinese and Indian citizens have less need of mental health care. Fong and Li (2014) estimate that “in China, 173 million adults have a mental disorder, 91.3% of whom have never received professional help” (p. 868). In India, the Central