Background and aims: It has been recognized that Asian immigrants in North America have lower rates of mental health service utilization. From the perspective of cross-cultural psychiatry, one of the most important cultural factors may be differences in the explanatory model of illness. This article examines the relationship of causal beliefs, perceived service accessibility and attitudes towards seeking mental health care. Method: The sample consisted of 1000 immigrant and refugee women from five ethnic minority communities in Toronto, including three Chinese Canadian communities (Hong Kong, mainland China and Taiwan), Korean Canadians and Vietnamese Canadians. Data were acquired by a self-administered structured questionnaire. Quantitative data were analysed using MANOVA, ANOVA and stepwise multiple regression. Results: The five ethnic minority groups of women differed in their explanatory models about mental illness and distress. In the full model where other variables were controlled for, the most significant factor predicting attitudes towards seeking professional help was perceived access for all groups except the Hong Kong Chinese. In the last group, those subscribing more to a Western stress model of illness had a more positive attitude towards seeking professional help, while those subscribing more to supernatural beliefs had a more negative attitude. Age and education were not significant predictors. Conclusion: Perceived access is one of the main factors that influence attitudes toward seeking professional help. Explanatory models may predict help-seeking behaviours if perceived access to such services is available. © SAGE Publications, Inc. 2007.

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education China immigrant Chinese Asian refugee mental health service step wise multiple regression attitude to mental illness human Refugees middle aged Self Report ethnic group mental stress controlled study Far East Taiwan health personnel attitude multivariate analysis of variance Humans attitude Canada female Viet Nam prediction Article Ontario help seeking behavior Questionnaires adult major clinical study health care access age distress syndrome Hong Kong Emigration and Immigration Patient Acceptance of Health Care Analysis of Variance quantitative analysis structured questionnaire Asia, Southeastern Korea