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Cultural mechanisms of stigma among Chinese mental health consumers
In Chinese culture, it is critical to maintain one’s moral standing, or “face”, in order to preserve social resources. Stigmatization occurs through “losing face”, which results in degenerating social status as well as emotional health. Guanxi, an interpersonal connection founded on trust, and renqing, a principle of reciprocity, are indigenous norms that underlie “face”. These mechanisms may play a major role in stigma, and be crucial in facilitating recovery among Chinese consumers.
Objective/Purpose
The purpose of this study is to analyze integral mechanisms of stigma for Chinese consumers, and formulate suggestions for stigma interventions in this community. To do this, guanxi and renqing effects are investigated in relation to stigma.
Methods
Forty-nine Chinese consumers were interviewed in NYC from 2006 to 2010. Forty-three (87.8%) were born in China, and all were diagnosed with a psychotic-spectrum disorder. Semi-structured interviews on mental illness and stigma were conducted by two Chinese-English bilingual psychologists. Following transcription, five coders conducted systematic content analysis to identify experiences related to guanxi and renqing.
Results
Thirty-six interviewees (73%) identified pre-existing guanxi or renqing as factors protecting them from stigma and isolation. “Good feelings for [the consumer]” (guanxi), or desire to reciprocate past acts of generosity (renqing), enabled access to emotional and practical support. Conversely, twelve participants (25%) reported that their guanxi was severed due to a reduced ability to work, as well as from prejudice and stereotypes. Loss of guanxi was associated with individual-level discrimination (N=9), diminished social status (N=8), and loss of face and social death (N=6).
Discussion/Conclusions
Preventative measures for mental health stigma in Chinese communities may utilize protective mechanisms of guanxi and renqing. In order to restore and strengthen consumers’ social apparatus, it is crucial to help improve their ability to work and make a functional contribution to their network.
Learning Areas:
Assessment of individual and community needs for health educationDiversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Name two relational and community constructs that protect Chinese mental health consumers from stigma.
Discuss preventative measures against community stigma using indigenous cultural norms.
Formulate possibilities for anti-stigma interventions for Chinese immigrant communities.
Keyword(s): Asian Americans, Mental Health
Qualified on the content I am responsible for because: I have been a co-author of multiple funded projects focusing on mental health stigma (including schizophrenia treatments, depression interventions, and culture-specific programs) in Asian American communities. My research interests include preventative and intervention strategies for community and and self-stigma in Asian American mental health consumers.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.