The Influence of Family and Social Support on the Experience of Depression in Asian American Communities

Background and Purpose: Substantial literature suggest that mental illness is more stigmatizing compared to physical health concerns among Asian communities. Such culture-based stigma tends to instigate a number of negative consequences, such as reduced help-seeking behavior, longer durations of untreated mental illness, increased social distance due to lack of perceived support, and other barriers to receiving effective treatment. Given that major depression is a leading mental health concern worldwide, affecting more than 350 million individuals globally, Asian communities are particularly at risk for delaying or denying care for this mental illness.

Family members and peers are two prominent sources of stigmatization among Asian individuals, particularly due to cultural values of family honor and social belonging. Given this, few studies have evaluated the influence of both familial and peer relationships on the experience of depression within Asian communities. The present study thus aimed to investigate the relationships between family loyalty, comfort level disclosing mental health challenges with friends, and depression among a sample of Asian Americans.  

Methods: Cross-sectional data were analyzed from the National Latino and Asian American Study (NLAAS), a national epidemiological survey of Asian Americans using a probability sample of household resident adults in the United States. The sample was narrowed to include only Asian Americans (N=2,095) given the scope of the study. Categories included were Vietnamese, Chinese, Filipino, and all other Asian. The family and friend variables were each a single item within the NLAAS survey, and depression was measured by the DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Data were analyzed using linear regression in SPSS24.

Results: Within the narrowed sample of only Asian Americans (N=2,095), 52.22% of participants identified as female, and the average age was 41.12 (SD=14.64). The majority of participants identified as Chinese (N=600, %=28.6), followed by Vietnamese (N=520, %=24.8).

The linear regression model revealed that both the disclosure to friend variable and the family variable significantly related to depression. For every one-unit increase in embarrassment when telling friends about receiving mental health care, there was an average associated increase in depression (b= .262, SE = .130, p < .05). In addition, for every one-unit increase in family loyalty, there was an average associated increase in depression (b= .415, SE = .179, p < .05).

Conclusions and Implications: Among Asian American communities, stigma towards depression may be heavily linked to the influence of familial and social relationships. Experiences of depressive symptoms may be exacerbated by the influence of an individual’s family and friends. As such, mental health practitioners should be mindful of clients’ cultural backgrounds and social support networks, so as to evaluate the influence of close relationships on potentially stigmatizing experiences and ensuing barriers to effective treatment. Given the influence of these relationships, it is thus important for practitioners to address and aim to strengthen social networks and supports. Future research should also further evaluate the relationships between family, friends, and other mental illnesses among Asian communities.