Stigma vs. Support: Factors that Affect Mental Health Treatment-Seeking Behaviors in Middle-Aged Immigrant South Asian American Women Open Access
Shemontee, Mirza (Spring 2022)
Abstract
Introduction: South Asian Americans are a growing demographic, rising from 3.5 million in 2010 to 5.7 million in 2019. Although often viewed as part of the “model minority,” this community experiences significant unique stressors, such as acculturative stress, that indicate the possibility of high rates of mental distress. However, data on the prevalence of mental health disorders in this population is outdated and often only available as disaggregated data for all Asian Americans. Studies on the South Asian diaspora in other countries suggest that middle aged women, in particular, are especially at risk for mental health distress. Yet, mental health service use among South Asian American middle aged women is extremely low. Currently, there are limited studies exploring this specific demographic and their attitudes towards mental health. This qualitative study seeks to close this gap by examining the factors that influence mental health treatment-seeking behaviors among immigrant South Asian American women between the ages of 45 and 65.
Methods: This study used thematic analysis of semi-structured interviews to yield findings about mental health treatment-seeking behaviors. South Asian American women between the ages of 45 and 65 were recruited to participate in hour-long in-depth interviews discussing their experiences and opinions to better understand their viewpoint of mental health. These interviews were then analyzed via MAXQDA software to find commonalities in participants’ mental health experiences. Feminist theory was used as a major philosophical foundation of analysis to generate themes. These themes were then used to modify the Theory of Planned Behavior to apply to mental health treatment-seeking behaviors in South Asian American women.
Results: A total of fifteen interviews were conducted with South Asian American women ranged in age from 45 to 65 years of age, with the average age of participants being 57 years old. Participants immigrated to America between the years of 1974 and 2006, from eleven different South Asian cities. Four main themes emerged: mental health understanding, positive support systems, negative influence of cultural values, and structural barriers. These themes all contribute to institutional and attitudinal barriers that may be related to low mental health service use. Modification of the Theory of Planned Behavior shows that subjective norms are a powerful predictor of mental health treatment-seeking behavior within this general population.
Conclusions: Interventions that emphasize positive social support to counteract negative cultural influence, as well as interventions to reduce structural barriers, would both be particularly effective to increase mental health treatment-seeking behavior. Future directions for research should include examining the effect of migration year on acculturative stress experiences, as well as gathering more accurate prevalence data for this demographic.
Table of Contents
Chapter I: Introduction and Statement of the Problem and Purpose 1
Chapter II: Review of the Literature 5
South Asian American Immigrants 5
Asian American Mental Health 7
Acculturative Stress 9
Prevalence of Stigma 10
Theoretical Framework - Feminist Theory 11
Theoretical Framework - Theory of Planned Behavior 12
Figure 1: The Theory of Planned Behavior Conceptual Model 13
Chapter III: Methodology 15
Introduction 15
Population and Sample 15
Recruitment and Eligibility 16
Procedures and Privacy Measures 17
Data Analysis Methodology 18
Chapter IV: Results 20
Theme 1: Mental Health Understanding 20
Experiences with Mental Health 21
Knowledge Acquisition 25
Theme 2: Positive Support Systems 27
Individual Mental Health Management 28
Seeking Professional Treatment 30
Theme 3: The Negative Influence of Cultural Values 31
Stigma Against Mental Health 32
Treatment of Women 34
Stigma Against Divorce 35
Image-Consciousness 36
Theme 4: Structural Barriers 37
Financial Barriers 37
Logistical Barriers 38
Chapter V: Conclusions, Implications and Recommendations 41
Figure 2: TPB Conceptual Model Modified for South Asian American Women’s Mental Health 41
Discussion of Key Results 41
Recommendations 47
Create Interventions Using Support Systems 47
Recruit Volunteers to Act as Mental Health Treatment Guides 48
Increase Telehealth Service Options 48
Research Cultural Freezing 49
Examine Effect of Migration Year on Acculturative Stress Experiences 49
Update Prevalence Data 49
Repeat Study with More Representative Sample 50
Strength and Limitations 50
Conclusion 52
References 53
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