(Withdrawn) Stigma & Shame: The Mental Health Help-Seeking Behaviors of Second-Generation Chinese American Women

Background and Purpose: Asian Americans reportedly underutilize mental health services due to mental health stigma. However, there have been limited studies focusing on the mechanisms that prevent formal help-seeking behaviors. The cultural and structural barriers can be telling in terms of why Chinese American individuals are not accessing mental health resources. There is also a need to disaggregate the experiences of the larger Asian American community as they are not a monolith, and their experiences are diverse. This paper helps to fill this gap by exploring the factors that motivate mental health help-seeking behaviors and experiences accessing mental health care among second-generation Chinese American women. Furthermore, this paper studies a specific subgroup within the Asian American population.

Methods: Four focus groups consisting of four to five members and five follow-up individual interviews were conducted with second-generation (American-born children to immigrant Chinese parents) Chinese American women between the ages of 18-25 about mental health stigma and help-seeking behaviors. Participants were recruited via social media posts (Instagram, Facebook, and LinkedIn) and in lower division Asian American Studies courses at (UCLA). Interview questions consisted mental health attitudes and beliefs, help-seeking behaviors/experiences, impacts of anti-Asian violence, and ways to address mental health stigma amongst the Chinese/Asian American community. Interviews were recorded on Zoom, which produced transcripts that were cleaned up. The coding process was informed by grounded theory.

Findings: Chinese American women experience mental health stigma on three levels: self, familial, and stigma, which informs their mental health attitudes and beliefs. This in turn impacts their mental health help-seeking behaviors. Structural barriers such as health insurance and cost, complicated intake processes, and long wait times are factors that prevent help-seeking. There is a lack of mental health conversations in their immigrant households further impacting help-seeking. Chinese American women engage with informal help-seeking behaviors such as reaching out to their peers or seeking out mental health information on social media. Findings suggest that Chinese American women are interested in seeking out mental health services, but some do not know where to begin.

Several participants who were currently engaged with mental health services extensively shared their experiences. Participants who were insured under their parents’ health insurance expressed internalized conflict when wanting to access services. For participants who were insured through their employers, they expressed the ease of accessing therapy without the need to be transparent with their parents. Participants suggested that more bilingual therapists are needed to promote mental health utilization within the larger Asian American population.

Conclusion & Implications: Findings highlight the intersectional experience of second-generation Chinese American women who operate under the guise of “saving face” and “filial piety”, while navigating systems and expectations to prioritize their own mental health needs. Chinese American women are not comfortable seeking out services due to the lack of mental health conversation and knowledge within their immigrant families. Additional support and psychoeducation addressing mental health stigma amongst Asian American communities.