Mental health and barriers to help-seeking among South Asians in Hong Kong at the end of the COVID-19 pandemic: a cross-sectional study

Abstract

Objectives: This study aimed to determine the mental health status and help-seeking barriers and to identify predictors of help-seeking barriers among South Asians in Hong Kong at the end of the COVID-19 pandemic. Methods: This cross-sectional study was conducted between January and August 2023. Using convenience sampling, South and Southeast Asian Hong Kong residents aged ≥18 years were invited to complete an online questionnaire in English. Anxiety in the prior 2 weeks was assessed using the Generalised Anxiety Disorder-7. Depression in the prior 2 weeks was assessed using the Patient Health Questionnaire-9. Insomnia in the prior 2 weeks was assessed using the Insomnia Severity Index. Perceived barriers to help-seeking were measured using eight statements; responses were either ‘agree’ or ‘disagree’. Additionally, quality of life and quality of health were assessed using a visual analogue scale ranging from 0 to 100. Results: Of 474 respondents, 273 were verified to be South or Southeast Asians and were included in the analysis. Of these, 13.6%, 22.8%, and 12.1% were at risk of developing anxiety, depression, and insomnia, respectively. Self-report quality of life and quality of health scores were 70.3 and 67.9, respectively. Compared with those not at risk, those at risk of developing mental health disorders (anxiety, depression, or insomnia) were younger (34.0 vs 29.6 years, p = 0.003), not married (27.7% vs 43.6%, p = 0.02), and had lower quality of life score (77.3 vs 52.6, p < 0.001) and quality of health score (75.4 vs 49.1, p < 0.001). They also more frequently reported having cultural/language barriers (50.2% vs 70.5%, p = 0.004), having cost concerns (64.1% vs 80.8%, p = 0.011), being too busy to seek help (41.5% vs 66.7%, p < 0.001), and that their family considered having mental health disorders to be shameful (25.1% vs 51.3%, p < 0.001). The predictors of perceived barriers to help-seeking were full-time employment (p = 0.02), having a lower education level (p = 0.02), and being at risk of developing mental health disorders (p = 0.02). Conclusion: Among South Asians in Hong Kong, those who were younger and not married were more likely to be at risk of developing mental health disorders, whereas males, full-time workers, those with a lower education level, and those at risk of developing mental health disorders were more likely to report having help-seeking barriers. The predictors of perceived barriers to help-seeking were full-time employment, a lower education level, and being at risk of developing mental health disorders.