Mental Health Help-Seeking Intentions and Perceived Barriers Among Filipino American Older Adults: An Exploratory COM-B-Informed Cross-Sectional Study

Abstract

Highlights What are the main findings? Filipino American older adults reported high health insurance coverage and social support, but only moderate intentions to seek professional mental health care. Stigma/interpersonal concerns were the most prominent perceived barriers to help-seeking for mental health problems and were associated with higher symptoms of depression and anxiety. What are the implications of the main findings? Improving access to healthcare alone may be insufficient to increase mental health service utilization among Filipino American older adults. Culturally responsive interventions addressing stigma, mental health literacy, and community-based support may improve engagement with mental health services. Abstract Background/Objectives: Filipino Americans are one of the least likely Asian American subgroups to use formal mental health services, even when mental health needs are present. This study used the Capability–Opportunity–Motivation–Behavior (COM-B) framework to examine mental health symptomatology, perceived social support, help-seeking intentions, and perceived barriers to mental health treatment among Filipino American older adults residing in the United States. Methods: We used a cross-sectional descriptive correlational design. A sample of 100 Filipino American older adults completed the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, an 8-item subset of the Multidimensional Scale of Perceived Social Support, the Mental Health Seeking Intention Scale, and the Perceived Barriers to Psychological Treatment scale. We performed descriptive statistics and correlation analyses using Pearson’s and Spearman’s coefficients. Results: Participants experienced low levels of depressive symptoms (M = 2.73, SD = 4.80) and anxiety symptoms (M = 2.56, SD = 4.11), high perceived social support (M = 5.32, SD = 1.83), moderate help-seeking intentions (M = 4.90, SD = 2.18), low overall perceived barriers to care (M = 1.67, SD = 0.90), and nearly universal health insurance coverage. Of the barrier domains, stigma/interpersonal barriers had the highest mean scores. Greater depressive and anxiety symptom severity was associated with higher overall perceived barriers to mental health care (r = 0.45–0.47) and with higher structural, motivational, and stigma/interpersonal barriers (r = 0.41–0.46). Conclusions: Despite high healthcare access and strong perceived social support, Filipino American older adults expressed only moderate intentions to seek professional mental health care. Culturally mediated factors may shape mental health help-seeking beyond structural barriers to access. The COM-B framework offers a useful lens for understanding help-seeking behavior and guiding culturally responsive interventions with Filipino American older adults.