title: Mental illness disclosure in Chinese immigrant communities.
abstract: Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed.
authors: Columbia University School of Social Work, New York, NY 10027, USA. fc2208@columbia.edu
authors: Fang-Pei
authors: FP
authors: Chen
authors: Grace Ying-Chi
authors: GY
authors: Lai
authors: Lawrence
authors: L
authors: Yang
mesh_terms: D000328:Adult; D001213:Asian / Q000523:psychology* / Q000706:statistics & numerical data; D001294:Attitude to Health; D003469:Culture; D030881:Disclosure / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D057545:Social Stigma; D012944:Social Support; D013240:Stereotyping; D011795:Surveys and Questionnaires
references: Int J Behav Med. 2012 Jun;19(2):174-85
references: 21472482
references: Can J Psychiatry. 2012 Aug;57(8):464-9
references: 22854028
references: Br J Psychiatry. 2005 Feb;186:153-7
references: 15684240
references: Qual Health Res. 2005 Nov;15(9):1277-88
references: 16204405
references: Br J Psychiatry. 2002 Dec;181:488-93
references: 12456518
references: Contemp Nurse. 2012 Feb;40(2):194-209
references: 22554213
references: J Nerv Ment Dis. 1996 Aug;184(8):505-7
references: 8752081
references: J Consult Clin Psychol. 2002 Oct;70(5):1186-90
references: 12362969
references: Lancet. 2009 Jun 13;373(9680):2041-53
references: 19524780
references: Soc Sci Med. 2003 May;56(10):2191-200
references: 12697207
references: Health Soc Work. 2000 Feb;25(1):9-22
references: 10689599
references: Psychol Med. 2011 May;41(5):897-910
references: 20663257
references: Health Commun. 2012;27(4):356-68
references: 21992531
references: Can J Psychiatry. 2003 Nov;48(10):663-8
references: 14674048
references: Br J Clin Psychol. 2010 Mar;49(Pt 1):31-41
references: 19298685
references: J Community Psychol. 2010 Apr 1;38(3):259-275
references: 23970807
references: Psychol Bull. 2010 Mar;136(2):236-56
references: 20192562
references: Community Ment Health J. 2004 Dec;40(6):513-23
references: 15672690
references: Dev Psychopathol. 2000 Autumn;12(4):555-98
references: 11202034
references: Curr Opin Psychiatry. 2007 Mar;20(2):111-5
references: 17278906
references: Soc Sci Med. 2007 Apr;64(7):1524-35
references: 17188411
references: Eur Psychiatry. 2005 Dec;20(8):529-39
references: 16171984
references: Psychiatr Rehabil J. 2011 Fall;35(2):145-7
references: 22020846
references: Int J Soc Psychiatry. 2005 Sep;51(3):211-27
references: 16252790
references: J Abnorm Psychol. 1971 Feb;77(1):1-5
references: 5100122
references: Res Hum Dev. 2007 Jun 1;4(1 &AMP):49
references: 20150976
references: Transcult Psychiatry. 2014 Apr;51(2):139-57
references: 24318864
references: Community Ment Health J. 2011 Dec;47(6):613-21
references: 20703941
references: Arch Gen Psychiatry. 1992 Aug;49(8):624-9
references: 1637252
references: J Health Soc Behav. 2011 Dec;52(4):460-77
references: 22144733
references: BMC Psychiatry. 2012 Feb 16;12:11
references: 22339944
references: Soc Sci Med. 2008 Aug;67(3):398-408
references: 18420325
references: Soc Sci Med. 2007 Jul;65(2):245-61
references: 17462800
references: Sociol Health Illn. 2007 Nov;29(7):1059-74
references: 18092983
references: Patient Educ Couns. 2009 Apr;75(1):67-76
references: 18963721
references: Acad Psychiatry. 2008 Mar-Apr;32(2):87-91
references: 18349326
references: Int J Cult Ment Health. 2013;6(2):141-155
references: 28163779
references: Schizophr Bull. 1999;25(3):467-78
references: 10478782
references: Lancet. 2009 Jun 13;373(9680):2002-4
references: 19524763