ASIAN HUMAN SERVICES (AHS) Chicago Illinois

Asian Human Services is a large own-Asian social service agency providing a wide range of community health, employment, youth programs, legal literacy, and mental health services to many Asian communities in Chicago. The SHARE Innovation Award allowed AHS to develop ethnic and language specific groups to address the depression, loneliness and isolation among elders from Cambodian, Vietnamese, Chinese, and Korean backgrounds that have been observed by the staff.

Components of the program included:

• Recruitment of older adults with mental health issues in the four Asian target communities for groups using bilingual, bicultural mental health providers.
• Conducting 10-session groups for each of the target older adult populations recruited with the goal of increasing their physical/mental health and decreasing depression.
• Linking participants to needed services that are culturally appropriate.

Outcomes Included:

• Staff designed a curriculum that addressed issues common to elderly immigrants and refugees such as the immigration experience, Inter-generational conflicts, and growing old in a new land.
• Intakes for the program numbered150.115 joined the groups. Multiple groups were held for Vietnamese and Cambodian clients because of the number wishing to join. Consistent attendance in the groups varied considerably by ethnicity and were influenced by the weather and lack of transportation.
• A majority of clients improved on measures of health and depression. On a self-rating scale of physical and mental health, overall 73% of participants showed improvement after ten weeks.. Those reporting improvements included 100% of Cambodians, 67% of Chinese, 38% of Koreans the first year and 75% the second year, 37% of the Vietnamese the first year and 63% the second year. On specific measures of depression, the Geriatric Depression Scale, very high rates of scores in the range signifying depression were noted at the beginning of the groups. Scores 5 and over are considered likely to be depressed,; the average Time1 scores for the Koreans was 6, for Vietnamese 11 and for Cambodians 15, which was considered extremely high. All of the Vietnamese and Cambodian participants in the first year of the grant scored in the depressed range. At the end of ten sessions 100% of Cambodian elders had lower depression scores as did 50% Chinese, 94% of Vietnamese the first year and 59% the second year, and 35% of the Koreans the first year and 75% the second year.
• Overall, 80% of the participants wer4e linked to other services in the second year and 63 % in the first year. The linkage occurred primarily in the Cambodian and Vietnamese groups. Chinese participants were already linked to services, and some Korean participants felt that their needs were being met. Staff felt that the time commitment to meet the needs for the participants' ancillary services were much greater than anticipated.
• Staff found that it was necessary to make the design of the intervention more flexible than originally planned to meet the needs of the elders. Many of the Cambodian and Vietnamese elders found that the groups were extremely meaningful and did not want to quit coming after the ten weeks were over, so they were allowed to continue.

Staff reported that the Vietnamese groups became very cohesive by sharing personal stories especially related to the Vietnam War. The seniors expressed more comfort in answering questions from their children and grandchildren because their pain was lessened by sharing it with their peers. For the first time some have developed a sense of future with the support of the group.

In the Cambodian group, which was all women, they spoke constantly of the pain and torture of the horrific years under the Khmer Rouge, and many were surprised to find others had similar experiences. Because many were isolated in their homes and immediate neighborhoods, coming to the group was a major event. Some of the women who learned to use public transportation tautht other members of the group, which helped them to conquer the fear associated with not being able to speak or write English.

The Korean groups were much more responsive to an educational format than a more traditional mental health support process. In response to their need to feel they were learning something at each meeting, outside speakers were brought in on various topics. They also chose to meet in the early morning at Lake Michigan to do gentle exercises.

Return to: Mental Health and Aging: October 6, 2004 Conference, Introductory page