Introduction: This paper uses fi ndings from a larger study to present a nuanced depiction of the interplay of informal and formal help-seeking processes of a sample of Chinese immigrants in their mental healthcare in New York City.
Method: Thirty one participants who were receiving mental health treatment were interviewed with regard to their experiences preceding their suicide attempt. Their narratives were coded for thematic analysis.
Findings: Acculturation difficulties, inaccessibility to services and stigma associated with mental illness were major obstacles in the participants’ help-seeking process, which was consistent with other studies of immigrants of ethnic minority groups in the USA. In addition, the findings showed how changes in this sample of Chinese immigrants’ socio-cultural reality disrupted familiar help-seeking pathways, and perpetuated and amplified the aforementioned stressors. Issues of human connection, immigrants’ resiliency and missed opportunities were also identified as potential resources to modify cultural stigmas and help-seeking behaviour.
Conclusion: There are varied socio-cultural factors that need to be considered in mental health outreach services in immigrant communities.
Abe-Kim, J., Takeuchi, D. & Hwang, W.C. ( 2002) Predictors of help seeking for emotional distress among Chinese Americans: Family matters. Journal of Consulting and Clinical Psychology, 70(5), 1186-1190.
2.
Akutsu, P.D. & Chu, J.P. ( 2006) Clinical problems that initiate professional help-seeking behaviours from Asian Americans. Professional Psychology: Research and Practice, 37(4), 407-415.
3.
Andersen, R.M. ( 1995) Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior , 36, 1-10.
4.
Bhugra, D. ( 2004a). Migration and mental health. Acta Psychiatrica Scandinavia, 109, 243-258.
5.
Bhugra, D. ( 2004b) Migration, distress and cultural identity. British Medical Bulletin, 69, 129-141.
6.
Chen, A.W., Kazanjian, A. & Wong, H. ( 2008) Determinants of mental health consultations among recent Chinese immigrants in British Columbia, Canada: Implications for mental health risk and access to services. Journal of Immigrants and Minority Health, online first. http://www.springerlink.com/content/8165jp261432895h/fulltext.pdf
7.
Fung, K. & Wong, Y.R. ( 2007) Factors influencing attitudes towards seeking professional help among East and Southeast Asian immigrant and refugee women. International Journal of Social Psychiatry, 53(3), 216-231.
8.
Hsiao, F.H., Klimidis, S., Minas, H. & Tan, E.S. ( 2006) Cultural attribution of mental health suffering in Chinese societies: The views of Chinese patients with mental illness and their caregivers . Journal of Clinical Nursing, 15, 998-1006.
9.
Hwang, W., Myers, H., Abe-Kim, J. & Ting, J. ( 2008) A conceptual paradigm for understanding culture’s impact on mental health: The cultural influences on mental health (CIMH) model . Clinical Psychology Review, 28, 211-227.
10.
Kleinman, A. ( 2004) Culture and depression. New England Journal of Medicine, 351, 951-953.
11.
Kleinman, A. ( 1988) The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books, Inc.
12.
Koss-Chioino, J.D. ( 2000) Traditional and folk approaches among ethnic minorities . In Psychological Intervention and Cultural Diversity (eds. J.F. Aponte & J. Wohl). Needham Heights, MA: Allyn & Bacon.
13.
Leong, F.T.L., Wagner, N.S. & Tata, S.P. ( 1995) Racial and ethnic variations in help-seeking attitudes . In Handbook of Multicultural Counseling (eds. J.G. Pontervotto, J. Manual Casas, L.A. Suzuki & C.M. Alexander), pp. 415-438. Thousand Oaks, CA: Sage.
14.
Mo, P., Mak, W. & Kwan, C. ( 2006) Culture change and Chinese immigrants’ distress and help-seeking in Hong Kong. Journal of Ethnic & Cultural Diversity in Social Work, 15(3/4), 129-150.
15.
Ng, C.H. ( 1997) The stigma of mental illness in Asian cultures. Australian and New Zealand Journal of Psychiatry, 32, 382-390.
16.
Padmavati, R., Thara, R. & Corin, E. ( 2005) A qualitative study of religious practices by chronic mentally ill and their caregivers in south India. International Journal of Social Psychiatry, 51(2), 139-149.
17.
Parker, G., Gladstone, G. & Chee, K.T. ( 2001) Depression in the planet’s largest ethnic group: The Chinese. American Journal of Psychiatry, 158(6), 857-864.
18.
Potocky-Tripodi, M. ( 2002) Best Practices for Social Work with Refugees and Immigrants . New York: Columbia University Press.
19.
Razali, S.M. & Najib, M.A. ( 2000) Help-seeking pathways among Malay psychiatric patients . International Journal of Social Psychiatry, 46(4), 281-289.
20.
Segal, U.A. ( 2002) A Framework for Immigration: Asians in the United States . New York: Columbia University Press.
21.
Shin, J.K. ( 2002) Help-seeking behaviours by Korean immigrants for depression . Issues in Mental Health Nursing, 23, 461-476.
22.
Sue, S. & Sue, D.W. ( 2003) Counseling Asian Americans. In Counseling and Therapy with Racial/Ethnic Minority Populations, 4th Edition (S. Sue & D.W. Sue), pp. 327-342. New York: John Wiley & Sons, Inc.
23.
Takeuchi, D.T. & Kim, K.F. ( 2000) Enhancing mental health services delivery for diverse populations. Contemporary Sociology, 29(1), 74-83.
24.
Winnicott, D.W. ( 1961) Varieties of Psychotherapy. In Home is Where We Start From (D.W. Winnicott), pp. 101-111. New York: W.W. Norton.
25.
Yamashiro, G. & Matsuoka, J.K. ( 1997) Help-seeking among Asian and Pacific Americans: A multi-perspective analysis. Social Work, 42(2), 176-186.
26.
Zhang, A.Y., Snowden, I.R. & sue, S. ( 1998) Differences between Asian and White Americans’ help-seeking and utilization patterns in the Los Angeles area. Journal of Community Psychology, 26(4), 317-326.
