Category: Cultural Diversity / Vulnerable Populations
Research has consistently documented mental healthcare disparities affecting Asian Americans, such as delayed help-seeking, poor treatment outcomes, and underutilization of mental health services. Some of these disparities have been attributed to cultural barriers like stigma that negatively affect help-seeking and treatment of mental illness. These barriers to help-seeking and treatment among Asian Americans may be particularly detrimental for managing psychotic illnesses which are often accompanied by considerable losses in social/role functioning, educational functioning, as well as significant hardships for the individual and his/her family. Early intervention is crucial during the focal period prior to the onset of psychosis, a period known as “clinical high-risk for psychosis” (CHR), when positive symptoms and functional impairments are less entrenched and more responsive to treatment.
The current study seeks to examine in the general Chinese and Taiwanese U.S. population the relationships among CHR stigma, illness perception, and beliefs towards traditional Chinese and Western medicine. As a part of a larger online study, participants (N=237) read a vignette about a Chinese American student experiencing symptoms of CHR and then completed a number of questionnaires, including the Stigma and Beliefs of Efficacy towards Traditional Chinese Medicine and Western Psychiatric Treatment scale, the Brief Illness Perception Questionnaire (Brief-IPQ), and the Devaluation and Discrimination Stigma (DDS) scale. Participants’ average age was 31.45 (SD=14.68); 65.4% (n=155) of the sample was female. Approximately half of participants (51.1%, n=121) were born abroad; of these, 61.2% (n=74) were first-generation U.S. immigrants.
Regression analyses revealed that stigma was positively associated with the belief that it would be shameful to see a mental health professional for a problem similar to that of the vignette character, ß = .369, p < .001, but not with the belief that it would be shameful to see a practitioner of Chinese traditional medicine for a similar problem. Further, participants with higher levels of stigma were more likely to view the vignette character’s illness as more threatening and severe, ß = .174, p < .05.
These findings highlight the importance of understanding and addressing stigma of mental illness in Western mental health settings for Chinese/Taiwanese clients with CHR and their families. Stigma reduction efforts that are incorporated into interventions may bolster the therapeutic relationship and protect against premature treatment termination.