Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1099-1114 |
| Number of pages | 16 |
| Journal | Journal of Community & Applied Social Psychology |
| Volume | 32 |
| Issue number | 6 |
| Early online date | 25 May 2022 |
| DOIs | |
| Publication status | Published - Nov 2022 |
Keywords
- acculturation
- help seeking
- immigration
- mental illness
- stigma
- SOCIAL SUPPORT
- ILLNESS
- IMMIGRANTS
- SCHIZOPHRENIA
- EXPERIENCES
- DEPRESSION
- BELIEFS
Access to Document
- 10.1002/casp.2620Licence: CC BY-NC-ND
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In: Journal of Community & Applied Social Psychology, Vol. 32, No. 6, 11.2022, p. 1099-1114.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Perspectives on mental health difficulties amongst second-generation Chinese individuals in Germany
T2 - Stigma, acculturation, and help seeking
AU - Shu, J.L.
AU - Alleva, Jessica M.
AU - Stutterheim, S.E.
N1 - Funding Information: In this preregistered study (https://osf.io/bfhe4/), we took a general inductive, problem-driven approach (Guest, MacQueen, & Namey, 2012). The aim was to improve our understanding of mental illness stigma in second-generation Chinese individuals, paying particular attention to the role of acculturation, with the explicit intention of using the findings to support mental health care service provision. COREQ criteria were used to design the study (Tong, Sainsbury, & Craig, 2007). Ethical approval was provided by the Maastricht University's Ethics Review Committee at the Faculty of Psychology and Neuroscience. In this preregistered study (https://osf.io/bfhe4/), we took a general inductive, problem-driven approach (Guest, MacQueen, & Namey, 2012). The aim was to improve our understanding of mental illness stigma in second-generation Chinese individuals, paying particular attention to the role of acculturation, with the explicit intention of using the findings to support mental health care service provision. COREQ criteria were used to design the study (Tong, Sainsbury, & Craig, 2007). Ethical approval was provided by the Maastricht University's Ethics Review Committee at the Faculty of Psychology and Neuroscience. German-born Chinese individuals living in Germany, either with or without a self-reported previous history of mental health difficulties or mental illness (e.g. depression, anxiety, eating disorder, and schizophrenia) were recruited via purposive and snowball sampling. Inclusion criteria were that participants had been born and raised in Germany, were at least 17 years of age, and that both parents were Chinese immigrants. An advertisement was sent to Chinese Language Schools and Chinese Associations and distributed on Facebook. Also, participants were recruited directly by the first author, who is a second-generation Chinese individual living in Germany. Once screened for eligibility, participants received verbal and written information about the study purpose and procedure, and digital informed consent was obtained. Participation was voluntary and no monetary compensation was provided. In total, we recruited and included 23 second-generation Chinese individuals born and raised in Germany. Ages ranged from 17 to 40 years (mean = 24.74; SD = 6.34). Most were university students (n = 15), six were employed, and three were in high school. Eleven self-reported a history of mental health difficulties and/or mental illness, and 12 reported no previous mental health difficulties, which enabled triangulation across data sources. Seventeen participants self-identified as being integrated (74%), four assimilated (17%), and one marginalised. Ten identified as German (43%), seven as Chinese (30%), four as both (17%), and two as none (9%). Parents mostly originated from Zhejiang (61%), followed by Hong Kong (9%), Jiangxi (9%), Shanghai (9%), Jilin (4%), Guangdong (4%), and Beijing (4%). Reasons for parents’ migration were economic (74%) and academic opportunities (22%). Participant characteristics are reported in Table 1. The 23 semi-structured interviews were held in German between March and June 2020, of which three were conducted face to face before Germany issued social distancing regulations for COVID-19. The remaining interviews were conducted via Skype and FaceTime. Interviews were guided by a structured protocol of open-ended questions with follow-up probes, with participants’ self-identifying acculturation level according to Berry's (1997) acculturation model beforehand. The protocol was pre-tested. Details on the content of the interviews are reported in Table 2. All interviews were recorded and transcribed verbatim. Personal information was removed from the transcripts and audio recordings were deleted once coding was complete. Participants received a pseudonym and their mental health status is not disclosed to protect participants’ confidentiality. Data were coded and analysed thematically (Braun, Clarke, & Terry, 2015) using Atlas.ti whilst listening to the recordings. Meaningful units were grouped and underlying themes were identified to develop a coding structure. All emerging code groups, including those that were not maintained, were documented via annotations. Peer review within the research team was employed to enhance rigour. After coding and analysis, preliminary findings were checked with participants to ensure congruence with their experiences. Selected quotes were translated to English and reviewed for the originality of meaning by the first author, who is bilingual. Publisher Copyright: © 2022 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd.
PY - 2022/11
Y1 - 2022/11
N2 - Migration demands may put Chinese people living abroad at higher risk for mental health difficulties. However, mental illness is stigmatised and often neglected. The aim of this study was to investigate mental illness stigma endorsement amongst second-generation Chinese individuals in Germany and explore the role of acculturation and stigma on mental health service-seeking behaviours. In semi-structured interviews with 23 second-generation Chinese individuals, half of whom had a history of mental illness and half did not, we explored beliefs contributing to mental illness stigma, manifestations of stigma, the influence of acculturation, experience with mental health difficulties, and barriers to help seeking. Findings indicate that, within Chinese immigrant communities, people with mental illness are perceived as crazy, abnormal, weak, of poor character, having poor genes, or coming from a 'bad' family. Manifestations of mental illness stigma were avoidance, social exclusion, labelling, blame, and gossip. Stigma by association of family members was also reported. Acculturation appeared to attenuate stigma endorsement with most participants expressing considerate attitudes towards people with mental illness. However, acculturation also contributed to mental health difficulties through intergenerational differences in view on mental illness and help seeking. Findings highlight the importance of considering family dynamics when providing mental health services to second-generation Chinese individuals.
AB - Migration demands may put Chinese people living abroad at higher risk for mental health difficulties. However, mental illness is stigmatised and often neglected. The aim of this study was to investigate mental illness stigma endorsement amongst second-generation Chinese individuals in Germany and explore the role of acculturation and stigma on mental health service-seeking behaviours. In semi-structured interviews with 23 second-generation Chinese individuals, half of whom had a history of mental illness and half did not, we explored beliefs contributing to mental illness stigma, manifestations of stigma, the influence of acculturation, experience with mental health difficulties, and barriers to help seeking. Findings indicate that, within Chinese immigrant communities, people with mental illness are perceived as crazy, abnormal, weak, of poor character, having poor genes, or coming from a 'bad' family. Manifestations of mental illness stigma were avoidance, social exclusion, labelling, blame, and gossip. Stigma by association of family members was also reported. Acculturation appeared to attenuate stigma endorsement with most participants expressing considerate attitudes towards people with mental illness. However, acculturation also contributed to mental health difficulties through intergenerational differences in view on mental illness and help seeking. Findings highlight the importance of considering family dynamics when providing mental health services to second-generation Chinese individuals.
KW - acculturation
KW - help seeking
KW - immigration
KW - mental illness
KW - stigma
KW - SOCIAL SUPPORT
KW - ILLNESS
KW - IMMIGRANTS
KW - SCHIZOPHRENIA
KW - EXPERIENCES
KW - DEPRESSION
KW - BELIEFS
U2 - 10.1002/casp.2620
DO - 10.1002/casp.2620
M3 - Article
SN - 1052-9284
VL - 32
SP - 1099
EP - 1114
JO - Journal of Community & Applied Social Psychology
JF - Journal of Community & Applied Social Psychology
IS - 6
ER -