Using Intersectionality As an Analytic Framework to Understand the Experiences of Mental Health Stigma for Racialized Men

Background: Much of the research in mental health concerning immigrant, refugee, ethnocultural and racialized populations has treated these populations as homogeneous and has uncritically posited culture as one of the key barriers to accessing mental health services and supports (McKenzie, et al., 2016; Morrow, Smith, Lai, Jaswal, 2008). This obscures the many inter- and intra- group differences among populations with respect to how mental health is experienced, understood and how systems respond to these populations (McKenzie, et al., 2016). Few studies have fully explored the complex ways in which gender, socio-economic status, ethnicity, ability, time of and experience of migration, sexual orientation, and age interconnect to influence the experiences of Asian populations. In this presentation, we offer an intersectional analysis of focus group data collected in Vancouver, British Columbia as part of a multiyear, multisite intervention study that tested the efficacy of two workshop-based interventions (Acceptance & Commitment Training and Contact Based Empowerment Education) to reduce internalized and social stigma around mental illness amongst Asian men (n=761).

Methods: Researchers conducted 12 pre-intervention focus groups and 12 post-intervention focus groups, which were audio recorded, transcribed, and coded by two independent researchers using NVIVO. A code book was developed which identified ‘parent’ nodes (e.g., gender) and ‘child’ nodes (e.g., hegemonic masculinity, transgender masculinities). This code book was used to analyze all transcripts. The research team held collective data analysis meetings to identify and clarify emerging themes. Intersectionality was used as the guiding theoretical framework for all analyses. Hill Collins & Bilge (2016) describe intersectionality as a “…way of understanding and analyzing the complexity in the world, in people, and in human experiences…” (2).

Results: Four themes emerged from focus group analysis: 1) performing and re-forming masculinities; 2)  migrations, masculinities, and labor; 3) the “Triple Whammy” of multiple marginalization; and 4) reducing stigma in action. Broadly, men in the SIU study negotiated and re-negotiated hegemonic masculinity with regard to strength, weakness, needs, and emotions. Study participants almost universally expressed distress around breadwinner expectations and the challenges imposed on them via racialization processes and newcomer status. Men in the study sample who identified as visible minorities, sexual minorities, and people with lived mental health experience talked about the compounding self and community effect of multiple marginalization. Finally, pre- and post-intervention focus groups revealed that participants came to understand mental health and illness on a continuum and to challenge self and social stigma in their families and communities.

Implications: Study implications suggest: 1) the utility of complexifying rather than simplifying identity in population-based mental health and public health initiatives and interventions; 2) the importance of creating relationally safe spaces, in the context of mental healthcare, for Asian men to discuss racism and migration; and 3) the need to attend to the post-migration needs and struggles of Asian men in North America.