Mental Health Wellness of South Asian Students of Minnesota: A Mixed-method Study of Determinants, Attitudes, and Barriers Open Access

Bhatia, Ayesha (Spring 2019)

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Objectives: There is a dearth of research on factors influencing a South Asian student’s mental health wellness in the Midwest. The objective of this study was to understand: (1) the mental health issues and what factors influence them, (2) associations between mental health status and social, environmental, and personal factors, and (3) barriers to mental health services and supports in South Asian students of Minnesota. The study was conducted in order to improve upon AshaUSA’s current programs and develop new programs towards mental health wellness. AshaUSA is a nonprofit organization located in Minnesota.

Methods: This study utilized a mixed-methods approach consisting of an online survey administered to 133 South Asian Minnesotan students and 17 in-depth interviews. The study was conducted between May 2018 and August 2018. ANOVA and chi-square (X2) tests were conducted to identify social, environmental, and personal characteristics associated with mental health status. Qualitative data were recorded, transcribed verbatim, and analyzed for common themes using thematic analysis.

Results: 22.66% of students had a negative perceived mental health wellness status and 32.76% of students had a diagnosed mental illness. Perceived mental health status was significantly associated with sources of stress including school, GPA, clubs and organizations, finances, the level of parent and peer supportiveness, and the level of mental health awareness of surrounding adults. The qualitative interview themes supported findings from the survey. Themes included the definition of mental health wellness, support, coping strategies, accessing and barriers to accessing mental health resources, and major factors of stress including family, time, future, school work, stigma, and pressure from self, family, peers, and community. The main barriers to accessing resources were stigma and lack of knowledge about resources.

Discussion: Mental health in South Asian American students is affected by factors related to stigma, sources of stress in life including family, thoughts of the future, academics, and pressure from self, family, peers, and community. The analyses also provided support that factors such as stigma in the community and family, a busy schedule, lack of information, and finances act as barriers to accessing mental health services and supports. New programs should address self-pressure, family pressure, and de-stigmatizing mental health in society. Recommendations fall under the broader branches of education, social marketing and media engagement, community engagement, social leadership, and evaluation.

Table of Contents


Introduction and rationale. 1

Problem statement 3

Purpose statement 4

Objectives. 4

Significance statement 4

Definition of terms. 5


Mental health wellness worldwide. 7

Definition. 7

Prevalence. 8

Historical context of South Asians in the United States. 9

History. 9

Stereotypes. 11

South Asians in Minnesota. 12

Challenges. 13

South Asian and mental health wellness. 14

Acculturation. 15

South Asian student mental health wellness. 17

Barriers to seeking mental health wellness programs and support 19

Finance and Culture. 19

Stigma. 20

Overview of cultural mental health wellness organizations and programs. 21


Student Contribution. 25

Manuscript Title Page. 26

Abstract 27

Objectives. 27

Methods. 27

Results. 27

Conclusions. 27

Introduction. 28

Methods. 31

Population and Sample. 31

Data Collection Procedure. 32

Recruitment 32

Research Instruments. 33

Data Analysis. 34

Ethical Considerations. 36

Results. 37

Quantitative Results. 37

Qualitative Results. 39

Summary. 44

Discussion. 45

Summary of findings. 45

Limitations. 50

Research Implications and Recommendations. 52

Conclusion. 55

Manuscript References. 57

Tables and Figures. 60

Table 1: Descriptive characteristics of survey participants. 60

Table 2: Descriptive characteristics of in-depth interview participants. 62

Table 3: Questions Chosen for Analysis. 63

Table 4: ANOVA summary for perceived mental health. 66

Table 5: Χ2 summary for perceived mental health. 67

Table 6: ANOVA summary for diagnosed mental illness. 68

Table 7: Χ2 summary for diagnosed mental illness. 69

Table 8: Summary of themes from qualitative interviews. 70


Education. 73

Social Marketing and Media Engagement 74

Community Engagement 75

Social Leadership. 77

Research and Evaluation. 77

Conclusion. 78



Appendix A. Recruitment letter 92

Appendix B. Parental survey consent for under 18. 93

Appendix C. Survey consent over 18. 98

Appendix D. Survey instrument 102

Appendix E. Post-survey consent to contact for in-depth interview.. 116

Appendix F. Parental in-depth interview consent for under 18. 118

Appendix G. In-depth interview consent over 18. 120

Appendix H. In-depth interview guide. 122

Appendix I. Resources provided to participants. 124

Appendix J. IRB Letter 127

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