Understanding and addressing the underutilization of school-based mental health services among Korean immigrant adolescents

This ethnographic case study investigates the underutilization of school-based mental health services among Korean immigrant adolescents in the United States. Drawing on the Mental Health Belief Model, the study examines how Korean immigrant adolescents and their parents perceive school-based mental health services and identifies factors that could enhance their utilization. Data were collected through semi-structured interviews and informal conversations and analyzed using thematic analysis. Findings indicate that while Korean immigrant parents value their children’s happiness, they hold cultural beliefs, stigma, and concerns about family honor regarding seeking mental health services. The adolescents also questioned the necessity of professional mental health services compared to informal support. Additionally, participants identified several factors that could enhance engagement with these services, which can be categorized into three themes. First, the importance of using alternative terminology to reduce stigma and encourage engagement with mental health services was emphasized. Confidentiality and privacy emerged as crucial factors, with participants expressing a willingness to engage in school-based mental health services if these aspects are assured. Finally, effective communication with parents was recognized as key to fostering service utilization. Implications for educators and school psychologists include using less stigmatizing terminology, ensuring confidentiality, and establishing effective communication with parents to improve access to and utilization of mental health services among immigrant adolescents.