April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: “神經病”: Exploring Self-Disclosure About Mental Health Among Chinese Young Adults and Their Parents
U.S. Asian/Asian American adults are less likely to receive mental health services compared to non-Hispanic White adults.1 Cultural barriers influence seeking professional help.2,3 In Asian cultures, mental illness is a family matter, not an individual problem.4 Because mental health is perceived as a weakness and a Western concept, talking openly about sadness, disappointment, and/or depression is rarely encouraged. Therefore, this intense stigma influences disparities in mental health prevention and utilization.5
Relying on frameworks, like the disclosure decision-making model, can assist in describing individuals’ decision-making about sharing non-visible, health-relevant information with others.6 When the personal information is stigmatized, like mental health, disclosure can be challenging.7 Asian/Asian Americans may encounter additional disclosure issues due to cultural norms.
Acknowledging these complexities, this study examined how Chinese young adults disclosed their mental health challenges to their Chinese parents. Two research questions (RQs) were posed: What are the barriers to disclosing about mental health?; and, What are the implications of disclosing about mental health? To answer the RQs, participants were recruited via social media and semi-structured interviews were conducted, which were recorded and transcribed. A thematic analysis8 was conducted to identify emerging themes. Themes were determined by Owen’s (1984) criteria: recurrence, repetition, and forcefulness.9
Six Chinese young adults (average age=25.6; SD=2.8) participated. All were Asian (specifically Chinese), Non-Hispanic/Latinx, single/not married, and had some college experience. The majority (66%) identified as male.
For RQ1, participants reported three barriers to wanting or being able to disclose their mental health challenges to their parents: stigma, fear of parent’s reaction, and parent’s lack of understanding about mental health. Participants discussed how mental health stigma limits family conversations about mental health. Further, participants expressed that with their parents’ limited knowledge of mental health information there were no open conversations; thus, they had to navigate their challenges alone. Lastly, with mental health’s stigma, participants feared disclosing, because they did not want to upset their parents. This communicative behavior upholds the Chinese values.
For RQ2, participants mentioned four implications of disclosing about mental health: manifesting toxicity within relationships, establishing distance, receiving no emotional support, and regretting the disclosure. Participants did not feel supported after disclosing to a parent; therefore, they regretted their decision. Regret stemmed from receiving negative responses (e.g., yelling, complaining) and no emotional support from parents, which created relationship challenges. To address the interpersonal issues, participants created distance (e.g., moving out, limiting interactions) and sought out social support resources elsewhere (e.g., friends, professional therapy). The participants’ initial disclosure was not positive; thus, it continued to perpetuate stigma, silence, and conflict.
This study provides a realistic, yet troubling, perspective about how Chinese young adults struggle to communicate their mental health challenges to their parents. This is significant as prior research shows that parents play an essential role in helping adolescents seek assistance with mental health challenges.10 Future research should examine Chinese parents’ perspectives about mental health disclosure with children; then, interventions should be created to address these communication barriers in order to improve mental health care for Asian/Asian Americans.
Relying on frameworks, like the disclosure decision-making model, can assist in describing individuals’ decision-making about sharing non-visible, health-relevant information with others.6 When the personal information is stigmatized, like mental health, disclosure can be challenging.7 Asian/Asian Americans may encounter additional disclosure issues due to cultural norms.
Acknowledging these complexities, this study examined how Chinese young adults disclosed their mental health challenges to their Chinese parents. Two research questions (RQs) were posed: What are the barriers to disclosing about mental health?; and, What are the implications of disclosing about mental health? To answer the RQs, participants were recruited via social media and semi-structured interviews were conducted, which were recorded and transcribed. A thematic analysis8 was conducted to identify emerging themes. Themes were determined by Owen’s (1984) criteria: recurrence, repetition, and forcefulness.9
Six Chinese young adults (average age=25.6; SD=2.8) participated. All were Asian (specifically Chinese), Non-Hispanic/Latinx, single/not married, and had some college experience. The majority (66%) identified as male.
For RQ1, participants reported three barriers to wanting or being able to disclose their mental health challenges to their parents: stigma, fear of parent’s reaction, and parent’s lack of understanding about mental health. Participants discussed how mental health stigma limits family conversations about mental health. Further, participants expressed that with their parents’ limited knowledge of mental health information there were no open conversations; thus, they had to navigate their challenges alone. Lastly, with mental health’s stigma, participants feared disclosing, because they did not want to upset their parents. This communicative behavior upholds the Chinese values.
For RQ2, participants mentioned four implications of disclosing about mental health: manifesting toxicity within relationships, establishing distance, receiving no emotional support, and regretting the disclosure. Participants did not feel supported after disclosing to a parent; therefore, they regretted their decision. Regret stemmed from receiving negative responses (e.g., yelling, complaining) and no emotional support from parents, which created relationship challenges. To address the interpersonal issues, participants created distance (e.g., moving out, limiting interactions) and sought out social support resources elsewhere (e.g., friends, professional therapy). The participants’ initial disclosure was not positive; thus, it continued to perpetuate stigma, silence, and conflict.
This study provides a realistic, yet troubling, perspective about how Chinese young adults struggle to communicate their mental health challenges to their parents. This is significant as prior research shows that parents play an essential role in helping adolescents seek assistance with mental health challenges.10 Future research should examine Chinese parents’ perspectives about mental health disclosure with children; then, interventions should be created to address these communication barriers in order to improve mental health care for Asian/Asian Americans.