Asian American Parents’ Beliefs About Helpful Strategies for Addressing Adolescent Mental Health Concerns at Home and School

Abstract

Asian American adolescents tend to underutilize mental health services at school and often do not receive the mental health services they need. Parents play an important role in youth mental health service utilization. However, few studies have examined Asian American parents’ knowledge and beliefs about the help-seeking process. The present qualitative study explores Asian American parents’ beliefs about helpful strategies for addressing youth mental illness (i.e., depression and eating disorders) with special attention to school-based strategies. Nineteen Asian American parents (M = 46.05 years, SD = 4.2) completed a semi-structured interview. The interviews were coded for themes to understand Asian American parents’ beliefs about helpful strategies for addressing youth mental illness. Four general themes relating to ways of addressing youth mental health concerns emerged: providing social support, teaching and educating about mental health, seeking professional help, and identifying the problem and finding the cause. The roles that the school and culture play in each of these strategies are discussed. Implications are given for school-based mental health providers based on the finding.

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References

  1. American Academy of Pediatrics. (2004). School-based mental health services. Pediatrics, 113(6), 1839–1845.

    Article  Google Scholar 

  2. Anyon, Y., Ong, S. L., & Whitaker, K. (2014). School-based mental health prevention for Asian American adolescents: Risk behaviors, protective factors, and service use. Asian American Journal of Psychology, 5(2), 134–144.

    Article  Google Scholar 

  3. Anyon, Y., Whitaker, K., Shields, J., & Franks, H. (2013). Help-seeking in the school context: Understanding Chinese American adolescents’ underutilization of school health services. Journal of School Health, 83(8), 562–572. https://doi.org/10.1111/josh.12066.

    Article  Google Scholar 

  4. Becker, K. D., Buckingham, S. L., & Brandt, N. E. (2015). Engaging youth and families in school mental health services. Child and Adolescent Psychiatric Clinics of North America, 24(2), 385–398.

    PubMed  Article  Google Scholar 

  5. Bonabi, H., Muller, M., Ajdacic-Gross, V., Eisele, J., Rodgers, S., Seifritz, E., et al. (2016). Mental health literacy, attitudes to help seeking, and perceived need as predictors of mental health service use: A longitudinal study. The Journal of Nervous and Mental Disease, 204(4), 321–324.

    PubMed  Article  Google Scholar 

  6. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Article  Google Scholar 

  7. Campbell, J. L., Quincy, C., Osserman, J., & Pedersen, O. K. (2013). Coding in-depth semistructured interviews: Problems of unitization and intercoder reliability and agreement. Sociological Methods and Research, 42(3), 294–320.

    Article  Google Scholar 

  8. Campos, L., Dias, P., Duarte, A., Veiga, E., Dias, C. C., & Palha, F. (2018). Is it possible to “find space for mental health” in young people? Effectiveness of a school-based mental health literacy promotion program. International Journal of Environmental Research and Public Health, 15(7), 1–12.

    Article  Google Scholar 

  9. Chao, R. K. (1994). Beyond parental control and authoritarian parenting style: Understanding Chinese parenting through the cultural notion of training. Child Development, 65(4), 1111–1119.

    PubMed  Article  Google Scholar 

  10. Cheng, H., Wang, C., McDermott, R., Kriedel, M., & Rislin, J. (2018). Self-stigma, mental health literacy, and attitudes toward seeking psychological help. Journal of Counseling and Development, 96(1), 64–74.

    Article  Google Scholar 

  11. Cook, C. R., Frye, M., Slemrod, T., Lyon, A. R., Renshaw, T. L., & Zhang, Y. (2015). An integrated approach to universal prevention: Independent and combined effects of PBIS and SEL on youths’ mental health. School Psychology Quarterly, 30(2), 166–183. https://doi.org/10.1037/spq0000102.

    PubMed  PubMed Central  Article  Google Scholar 

  12. Corrieri, S., Heider, D., Conrad, I., Blume, A., König, H.-H., & Riedel-Heller, S. G. (2014). School-based prevention programs for depression and anxiety in adolescence: A systematic review. Health Promotion International, 29(3), 427–441. https://doi.org/10.1093/heapro/dat001.

    PubMed  Article  Google Scholar 

  13. Denzin, N. (1994). The art and politics of interpretation. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 500–515). Thousand Oaks: Sage.

    Google Scholar 

  14. Farmer, E. M. Z., Burns, B. J., Phillips, S. D., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54(1), 60–66.

    PubMed  Article  Google Scholar 

  15. Gong, A. T., & Furnham, A. (2014). Mental health literacy: Public knowledge and beliefs about mental disorders in mainland China. PsyCh Journal, 3(2), 144–158.

    PubMed  Article  Google Scholar 

  16. Gudino, O. G., Lau, A. S., & Hough, R. L. (2008). Immigrant status, mental health need, and mental health service utilization among high-risk Hispanic and Asian Pacific Islander youth. Child & Youth Care Forum, 37, 139–152. https://doi.org/10.1007/s10566-008-9056-4.

    Article  Google Scholar 

  17. Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry. https://doi.org/10.1186/1471-244X-10-113.

    PubMed  PubMed Central  Article  Google Scholar 

  18. Hart, L. M. (2010). Mental health first aid for eating disorders: The development of first aid guidelines and interventions for the public. Ph.D. thesis, Medicine, Dentistry & Health Sciences, Centre for Youth, Mental Health, The University of Melbourne.

  19. Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action. American Psychology, 67(3), 231–243.

    Article  Google Scholar 

  20. Jorm, A., Korten, A., Jacomb, P., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166(4), 182–186.

    Article  Google Scholar 

  21. Jorm, A. F., Morgan, A. J., & Wright, A. (2010). Actions that young people can take to prevent depression, anxiety and psychosis: Beliefs of health professionals and young people. Journal of Affective Disorders, 126, 278–281.

    PubMed  Article  Google Scholar 

  22. Jorm, A. F., Nakane, Y., Christensen, H., Yoshioka, K., Griffiths, K. M., & Wata, J. (2005). Public beliefs about treatment and outcome of mental disorders: A comparison of Australia and Japan. BMC Medicine, 3(12), 1–14.

    Google Scholar 

  23. Kazdin, A. E., & Wassell, G. (2000). Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families. Mental Health Services Research, 2(1), 27–40.

    PubMed  Article  Google Scholar 

  24. Kelly, C., Jorm, A., & Wright, A. (2007). Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Medical Journal of Australia, 187, 26–30.

    Google Scholar 

  25. Kramer, E. J., Kwong, K., Lee, E., & Chung, H. (2002). Cultural factorings influencing the mental health of Asian Americans. Culture and Medicine, 176, 227–231.

    Google Scholar 

  26. Kutcher, S., Wei, Y., & Morgan, C. (2015). Successful application of a Canadian mental health curriculum resource by usual classroom teachers in significantly and sustainably improving student mental health literacy. The Canadian Journal Of Psychiatry/La Revue Canadienne De Psychiatrie, 60(12), 580–586. https://doi.org/10.1177/070674371506001209.

    Article  Google Scholar 

  27. Li, C., & Li, H. (2017). Chinese immigrant parent’s perspectives on psychological well-being, acculturative stress, and support: Implications for multicultural consultation. Journal of Educational and Psychological Consultation. https://doi.org/10.1080/10474412.2016.1275648.

    Article  Google Scholar 

  28. Li, C., Li, H., & Niu, J. (2016). Intercultural stressors in Chinese immigrant students: Voices of Chinese–American mental health professionals. Asian American Journal of Psychology, 7, 64–73. https://doi.org/10.1037/aap0000044.

    Article  Google Scholar 

  29. Li, H., & Seidman, L. (2010). Engaging Asian American youth and their families in quality mental health services. Asian Journal of Psychiatry, 3(4), 169–172. https://doi.org/10.1016/j.ajp.2010.08.008.

    PubMed  PubMed Central  Article  Google Scholar 

  30. Lindsey, M. A., & Marcell, A. V. (2012). “We’re going through a lot of struggles that people don’t even know about”: The need to understand African American males’ help-seeking for mental health on multiple levels. American Journal of Men’s Health, 6(5), 354–364.

    PubMed  Article  Google Scholar 

  31. Logan, D. E., & King, A. C. (2002). Parental identification of depression and mental health service use among depressed adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 41(3), 296–304.

    PubMed  Article  Google Scholar 

  32. Lyon, A. R., Ludwig, K. A., Stoep, A. V., Gudmundsen, G., & McCauley, E. (2013). Patterns and predictors of mental healthcare utilization in schools and other service sectors among adolescents at risk for depression. School Mental Health, 5, 155–165. https://doi.org/10.1007/s12310-012-9097-6.

    Article  Google Scholar 

  33. Mendenhall, A. N., & Frauenholtz, S. (2013). Predictors of mental health literacy among parents of youth diagnosed with mood disorders. Child and Family Social Work, 20, 300–309.

    Article  Google Scholar 

  34. Mond, J., Hall, A., Bentley, C., Harrison, C., Gratwick-Sarll, K., & Lewis, V. (2014). Eating-disordered behavior in adolescent boys: Eating disorder examination questionnaire norms. International Journal of Eating Disorders, 47(4), 335–341.

    PubMed  Article  Google Scholar 

  35. Moses, T. (2011). Parents’ conceptualization of adolescents’ mental health problems: Who adopts a psychiatric perspective and does it make a difference? Community Mental Health Journal, 47, 67–81. https://doi.org/10.1007/s10597-009-9256-x.

    PubMed  Article  Google Scholar 

  36. Na, S., Ryder, A. G., & Kirmayer, L. G. (2016). Toward a culturally responsive model of mental health literacy: Facilitating help-seeking among east Asian immigrants to North America. American Journal of Community Psychology, 58(1–2), 211–225. https://doi.org/10.1002/ajcp.12085.

    PubMed  Article  Google Scholar 

  37. Olsson, D. P., & Kennedy, M. G. (2010). Mental health literacy among young people in a small US town: Recognition of disorders and hypothetical helping responses. Early Intervention in Psychiatry, 4, 291–298.

    PubMed  Article  Google Scholar 

  38. Pew Research Center. (2017). Chinese in the US fact sheet. Retrieved from https://www.pewsocialtrends.org/fact-sheet/asian-americans-chinese-in-the-us/.8.

  39. Schomerus, G., Angermeyer, M. C., Matschinger, H., & Riedel-Heller, S. G. (2008). Public attitudes towards prevention of depression. Journal of Affective Disorders, 106, 257–263.

    PubMed  Article  Google Scholar 

  40. Schwadt, T. A. (2000). Three epistemological stances for qualitative inquiry: Interpretivism, hermeneutics, and social constructionism. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 189–213). Thousand Oaks: Sage.

    Google Scholar 

  41. Stiffman, A. R., Pescosolido, B. A., & Cabassa, L. J. (2004). Building a model to understand youth service access: The gateway provider model. Mental Health Services Research, 6(4), 189–198.

    PubMed  PubMed Central  Article  Google Scholar 

  42. Teagle, S. E. (2002). parental problem recognition and child mental health service use. Mental Health Services Research, 4(4), 257–266.

    PubMed  Article  Google Scholar 

  43. Wang, C., Barlis, J., Do, K. A., Chen, J., & Sandra, A. (2019). Barriers to mental health help-seeking at school for Asian- and Latino-American adolescents. School Mental Health. https://doi.org/10.1007/s12310-019-09344-y.

    Article  Google Scholar 

  44. Wang, C., Do, K., Frese, K., & Zheng, L. (2018). Asian immigrant parents’ perception of barriers preventing adolescents from seeking school-based mental health services. School Mental Health, 11, 364–377. https://doi.org/10.1007/s12310-018-9285-0.

    Article  Google Scholar 

  45. Wang, C., La Salle, T., Do, K. A., Wu, C., & Sullivan, K. E. (2019). Does parental involvement matter for students’ mental health difficulties and suicide thoughts and behaviors in middle school? School Psychology, 34, 222–232. https://doi.org/10.1037/spq0000300.

    PubMed  Article  Google Scholar 

  46. Wang, C., Shao, X., Do, K. A., Lu, H., O’Neal, C., & Zhang, Y. (2019). Using participatory culture-specific consultation with Asian American communities: Identifying challenges and solutions for Asian American immigrant families. Journal of Educational & Psychological Consultation. https://doi.org/10.1080/10474412.2019.1614453.

    Article  Google Scholar 

  47. Weissman, M. M., Berry, O. O., Warner, V., Gameroff, M. J., Skipper, J., Talati, A., et al. (2016). A 30-year student of 3 generations of high risk and low risk for depression. JAMA Psychiatry, 73(9), 970–977.

    PubMed  PubMed Central  Article  Google Scholar 

  48. Whitaker, K., Nicodimos, S., Pullman, M. D., Duong, M. T., Bruns, E. J., Knaster Wasse, J., et al. (2018). Predictors of disparities in access and retention in school-based mental health services. School Mental Health, 10, 111–121. https://doi.org/10.1007/s12310-017-9233-4.

    Article  Google Scholar 

  49. Yap, M. B. H., Reavley, N. J., & Jorm, A. F. (2012). Intentions and helpfulness beliefs about first aid responses for young people with mental disorders: Findings from two Australian national surveys of youth. Journal of Affective Disorders, 136, 430–442.

    PubMed  Article  Google Scholar 

  50. Yeh, M., McCabe, K., Hough, R. L., Dupuis, D., & Hazen, A. (2003). Racial/ethnic differences in parental endorsement of barriers to mental health services for youth. Mental Health Services Research, 5(2), 65–77.

    Article  Google Scholar 

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Acknowledgements

This Project was supported by funding from Psychological Association (APA), Promoting Psychological Research and Training on Health Disparities Issues at Ethnic Minority Serving Institutions (ProDIGs) Small Research Grant. The authors also want to thank Dr. Shawn Bediako and Dr. Alfiee Breland-Noble for being the mentors for this Project.

Funding

This study was funded by American Psychological Association Promoting Psychological Research and Training on Health Disparities Issues at Ethnic Minority Serving Institutions (ProDIGS) Grant (no Grant Number).

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Correspondence to Cixin Wang.

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Wang, C., Marsico, K.F. & Do, K.A. Asian American Parents’ Beliefs About Helpful Strategies for Addressing Adolescent Mental Health Concerns at Home and School. School Mental Health 12, 523–536 (2020). https://doi.org/10.1007/s12310-020-09362-1

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Keywords

  • Mental health literacy
  • School-based mental health services
  • Asian American parents
  • Prevention