How people from Chinese backgrounds make sense of and respond to the experiences of mental distress: Thematic analysis

Yeung, Echo Yuet Wah; Irvine, Fiona; Ng, Siu-Man; Tsang, Katherine

doi:10.1111/jpm.12406

Cited by 9 publications

(9 citation statements)

References 47 publications

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“…Formal help-seeking becomes synonymous with the acquisition of (additional) stigmatising and oppressive labels and diagnoses [ 48 , 81 , 88 , 89 , 102 , 103 ], particularly where faith and other communities and families encourage a view that (mental) illness is equated with weakness and moral failings [ 48 , 65 , 78 , 88 , 102 – 105 ]. A diagnosis of mental illness can therefore be seen as equivalent to a form of social death, which “ cuts short any types of aspirations and hope ” [ 103 ], particularly in the context of precarious minority identities, racist social exclusion, and strong interdependence in ethnic minority communities in response to that [ 49 , 69 , 75 , 78 , 81 , 88 , 89 , 91 , 102 , 103 , 106 , 107 ]. As such, for some families, the need for social survival in the context of social marginalisation results in emotional suppression and the censoring of conversations around mental illness [ 64 , 76 , 78 , 83 , 91 , 98 – 100 , 105 ].…”

Section: Resultsmentioning

confidence: 99%

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

et al. 2022

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Background Evidence regarding the presence and persistence of ethnic inequalities in mental healthcare is well established. The reasons for these inequalities and lack of progress in diminishing them are less understood. This meta-ethnography aims to provide a new conceptual understanding of how ethnic inequalities are created and sustained; this is essential to develop effective interventions. Specifically, we sought to understand why people from ethnic minority groups are underrepresented in primary care mental health service provision and overrepresented in crisis pathways and detention. Methods and findings Following eMERGe guidelines for meta-ethnographies, we searched OpenGrey, Kings Fund, CINAHL, Medline, PsycINFO, and Social Care Online databases for qualitative articles published from database inception until October 2, 2022, using broad categories of search terms relating to “ethnicity AND (mental illness/mental health/emotional distress) AND (help-seeking/service utilisation/experience/perception/view).” We included all conceptually rich articles that used qualitative methods of data collection and analysis and excluded non-UK studies and those that focused solely on causation of mental illness. Our patient, public, and practitioner lived experience advisory group provided feedback and input on key stages of the project including search terms, research questions, data analysis, and dissemination. A total of 14,142 articles were identified; 66 met the inclusion criteria. We used reciprocal, refutational, and line of argument analytical approaches to identify convergence and divergence between studies. The synthesis showed that current models of statutory mental healthcare are experienced as a major barrier to the delivery of person-centred care to those in ethnic minority groups due to the perceived dominance of monocultural and reductionist frameworks of assessment and treatment (described as “medical” and “Eurocentric”) and direct experiences of racist practice. The lack of socially oriented and holistic frameworks of knowledge and understanding in medical training and services is experienced as epistemic injustice, particularly among those who attribute their mental illness to experiences of migration, systemic racism, and complex trauma. Fear of harm, concerns about treatment suitability, and negative experiences with health providers such as racist care and medical neglect/injury contribute to avoidance of, and disengagement from, mainstream healthcare. The lack of progress in tackling ethnic inequalities is attributed to failures in coproduction and insufficient adoption of existing recommendations within services. Study limitations include insufficient recording of participant characteristics relating to generational status and social class in primary studies, which prevented exploration of these intersections. Conclusions In this study, we found that the delivery of safe and equitable person-centred care requires a model of mental health that is responsive to the lived experiences of people in ethnic minority groups. For the people considered in this review, this requires better alignment of mental health services with social and anti-racist models of care. Our findings suggest that intersections related to experiences of racism, migration, religion, and complex trauma might be more relevant than crude ethnic group classifications. Strategies to tackle ethnic inequalities in mental healthcare require an evaluation of individual, systemic, and structural obstacles to authentic and meaningful coproduction and implementation of existing community recommendations in services.

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Section: Resultsmentioning

confidence: 99%

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

et al. 2022

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“…Two studies focused on meaning making about MHP in migrant communities and highlighted the relevance of culturally held meanings about mental health not only in individuals’ understanding, but also their behaviour. In studies with Egyptian families in Australia (Endrawes, O'Brien, & Wilkes, 2007) and Chinese families in England (Yeung, Irvine, Ng, & Tsang, 2017), cultural stigma was found to hamper relatives’ understanding because of the belief that MHP should not be discussed outside the family. In combination with religious traditions and language barriers, family obligations were found to perpetuate silence (Endrawes et al, 2007).…”

Section: Resultsmentioning

confidence: 99%

“…Endrawes et al (2007) found that older, first‐generation immigrants tended to be more sceptical of medication and hospital treatment. Yeung et al (2017) reported that male relatives in Chinese families took longer than women to label their partner's unusual behaviours as “mental health” rather than “personality.” In both studies, relatives drew upon both medical and religious conceptualizations to support their sense making.…”

Section: Resultsmentioning

confidence: 99%

Family understanding and communication about an adult relative’s mental health problem: A systematic narrative review

Gammage

Nolte

2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Adults who support an adult family member with a severe and enduring mental health problem often experience carer burden. Over time, this often negatively affects their mental and physical health and social well‐being. Understanding and communicating about mental health problems in families can help to improve resilience and coping among both adults and children. What does this paper add to existing knowledge? We conducted a review of studies looking at how adult relatives understand and communicate about an adult family member's mental health problem. The findings highlight that how relatives make sense of MHP is related to historical family relationships, their mental health literacy and whether they see themselves as a “carer” or not. The findings also show that little research to date has explored how adult relatives talk with children about their parent's difficulties, and how the adults’ understanding might affect what children learn about the MHP. What are the implications for practice? There is a research gap to be addressed regarding family communication with children about parental mental health problems. This knowledge gap likely impacts family‐focused mental health nursing and therapy provision. Mental health nursing, therapeutic and support workers and advocates are ideally positioned to assist relatives with improving their mental health literacy and confidence communicating about mental health, and to promote inclusion of relatives and children in interventions. Abstract IntroductionRelatives are profoundly affected by an adult family member's severe and enduring mental health problem (MHP). The burdens of caring impact on adult relatives’ emotional, physical and social well‐being. How relatives make meaning and communicate about the MHP is thought to affect family talk about mental health, and this can impact family coping and well‐being. AimNo review has yet drawn together research about how adult relatives of people with severe and enduring MHP make meaning and communicate about their relatives’ difficulties. We aimed to address this gap. MethodWe conducted a systematic review of peer‐reviewed primary research. SCOPUS, PubMed, Psychnet, SCIE, Cochrane and CINAHL+ databases were searched. ResultsNineteen papers qualified for inclusion. Findings are organized under four themes: making meaning about the MHP and affected individual; conceptualizing the self in the presence of the MHP; meaning‐making processes underlying relatives’ well‐being outcomes; and relatives’ perspectives on family talk about the MHP. DiscussionHistorical relationships, caregiver identity and mental health literacy moderate relatives’ understanding and talk about the MHP. Implications for practicePsychoeducation and communication support for relatives should be provided by mental health practitioners. Future research should address familial communication about MHP, including with children.

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“…A review also described that migrants tend to prefer seeking help from their social network, rather than to seek help from mental health services [ 18 ]. Another study in the UK described that the use of mental health services of Chinese migrants with mental illness was delayed because their social networks lacked the knowledge of mental health services [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study

Schoenmakers

Lamkaddem

Suurmond

2017

IJERPH

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Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems.

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How people from Chinese backgrounds make sense of and respond to the experiences of mental distress: Thematic analysis

Cited by 9 publications

References 47 publications

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

Family understanding and communication about an adult relative’s mental health problem: A systematic narrative review

The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study

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