Transmission of Mental Health Knowledge in the Family: Parental Mental Health Socialization Among Asian American Families

Purpose: Asian Americans are the least likely, of all racial and ethnic groups, to seek mental health care. While low mental health literacy is associated with negative attitudes towards mental health service and delayed help seeking, research suggests that racially and ethnically diverse populations also engage in alternate approaches to addressing mental health. These “folklore” understandings and approaches to mental health are often embedded in knowledge that is passed down within families, and collectively from generation to generation. The family is identified as the primary influence that shapes children’s understandings of illness and health. Yet little is known how culturally construed forms of mental health knowledge and practices are transmitted from parent to child. To address this gap, a new measure of parental socialization of mental health knowledge was developed and tested with a sample of 486 Asian American young adults. The measure specifically assesses what messages of mental health parents pass down to their children, be it explicit discussions or nonverbal responses to distress.

Method: This study examines cross-sectional data on a newly developed survey on parent mental health socialization from a sample of 486 Asian American young adults (Mean Age 23.1, Female 54.1%). The sample was randomly split into two subsamples for factor analyses. Exploratory factor analyses were conducted with Sample 1 (n=243) Asian Americans). Confirmatory factor analyses were then conducted with Sample 2 (n=243) on the 7 factor model that was derived from the EFA.

Results: Results from the EFA with Sample 1 (n=241) indicated that 7 factor solution demonstrated an adequate fit. The 7 factors identified are: parental stigma message to youth, parental minimization of young adult distress, parental fear of courtesy stigma, keeping mental distress private, lack of understanding of young adult distress, success will solve distress, and parental support of youth mental distress. Using Sample 2 (n=241), the CFA confirms that the seven-factor model fits the data well. All seven scales have good internal consistency reliability, convergent validity, and discriminant validity. Hierarchical regressions revealed that parental stigma, parental minimization and fear of courtesy stigma was positive associated with stigma attitudes towards mental health. Five of the seven scales were negatively associated with positive attitudes towards mental health services. All scales except for parental support of youth distress were positively associated with symptoms of young adult depression and somatic symptoms.

Conclusion and Implications: The current findings suggest that our new measure of parental socialization of mental health knowledge is a valid and reliable measure of assessing the socialization process involved in passing down mental health knowledge from parents to their children. Moreover, the positive associations with young adult mental health (depression, somatic symptoms) suggest that our findings have significant implications for intervention, particularly the need to consider how folklore mental health knowledge are transmitted from generation to generation.