Who Gets to 'tell' Mental Health Perspectives? Exploring the Epistemic Perspectives on Conceptualizing Mental Health While Accounting for Power across Asian American and Latinx Immigrant Family Generations

Background: Guided by an epistemology of resistance framework, critical race theory, and acculturation theory, this study examines the experiences of knowledge production, meaning-making, and epistemic resistance as “knowers” by Asian American and Latinx young adults and their immigrant families associated with mental health epistemologies, including folkways of knowing. Power dynamics are embedded in epistemic interactions pertaining to mental health, as some mental health conceptualizations are hermeneutically ignored, while others are foregrounded. Western notions of mental health knowledge have centered a biomedical model of illness and disordering. Across the familial life course development, younger generations have been introduced with formal epistemologies of mental health via school that cater to a biomedical model whereas many older generations have not had structural access to a privileged system of education that cater to diagnoses. There is an imbalance of power in racialized mental health systems that privilege certain individuals as “knowers” while others are silenced.

Method: Qualitative in-depth semi-structured interviews were conducted with 12 Asian American and Latinx children of immigrants. Six interviews were conducted with Asian American young adults and six interviews were conducted with Latinx young adults. This study analyzes qualitative data from a larger study that examines mental health beliefs and help-seeking among immigrant families. Open coding which included line by line, focused, and axial coding was conducted with a diverse team ranging from 6-8 coders to identify recurrent themes. Thematic analysis was used to conduct the analysis.

Results: Themes that emerged from the transcripts illustrate the imbalance of power in the U.S. via the stratification of a medicalized mental health knowledge production. An epistemic gap in knowledge has created friction, resistance, and knowledge sharing amongst Asian American and Latinx immigrant families across generations. The following themes were shared amongst Asian American and Latinx family’s mental health epistemologies: racialized knowing (structural stratification in knowledge production and access to knowledge in comparison to White counterparts), intergenerational cultural dissonance associated to mental health literacy (not talking about mental health amongst older familial generations); epistemic privilege via U.S. schools (children of immigrants learning about mental health conditions in school), multidimensional perspectives of mental health (knowledge-making and sharing as fluid amongst families), and epistemic resistance as folkways of healing (reclaiming heritage history; using art and music; and defining self and collective as “survivors”). Even though Asian and Latinx immigrant parents shared their culturally ingrained idioms of distress that counter biomedical vocabulary, differences were also noted— Latinx parents used emotions to describe distress whereas Asian parents used, “stress” to describe mental health challenges.

Conclusion/Implications: The findings call for epistemic justice and epistemic resistance to debunk dominant epistemologies that have catered to White logics, that have willfully ignored folkways of knowing and knowers. Practitioners serving immigrant families should develop mental health interventions that account for power dynamics and explore folklore conceptualizations of mental health and wellness. At a policy level, funding should be granted to mental health organizations that do not operate solely on a Western biomedical model. Researchers should incorporate critical feminist epistemologies and indigenous methodologies.