Mental illness stigma and help-seeking behavior: a focus on college-age children of immigrants

Our blog this week discusses an interesting and thought-provoking peer-reviewed research paper titled “Mental Illness Stigma and Help-Seeking Attitudes of Students with Immigrant Parents.” It was written by Danna Bismar and Chiachih DC Wang and published in the Journal of College Counseling in July of 2021. In the research paper, the authors explore the relationship between the mental illness stigma that college-age children of immigrants may hold and their subsequent willingness to pursue professional help. As part of this investigation, the authors also examine in depth the role of two other factors: the communication between parent and child around issues of mental health and the gap that exists between parent and child regarding levels of assimilation to the U.S. 

Why did they do it?

As the authors point out, there are a lot of differences between the experiences of a child of an immigrant parent as compared to a child who doesn’t come from an immigrant family. One of the most important differences is how they communicate with their parents. Typically, communication between immigrant parents and their children is heavily influenced by their original culture. This means that patterns of communication and the parent-child relationship can look very different from those practiced in the individualistic U.S. As an international student from a collectivistic culture, I can attest to much of this! Furthermore, there is often a disparity between how much the parent and child assimilate into American culture. Sometimes, children are much more connected to American culture than their parents, and this can cause conflicts. 

These differences are crucial to consider. They may change the experience and understanding of mental health that these college students have. Often, they play a role in why conversations around mental health can look and sound different for children of immigrant parents. Indeed, this demographic is more likely to hold a unique stigma towards mental health, mental illness, and the pursuit of professional help when necessary. 

However, despite their importance, there is little discussion of these distinctions in the literature. Truly, not enough research exists that examines the specific experiences of children of immigrant parents, and how this links to their attitudes towards issues of mental health. As someone who identifies similarly, this can be slightly discouraging. However, the authors have carried out this research to fill this gap and make a significant contribution to the field. Bismar and Wang are also the first of a few authors to take into account the important socio-cultural context of the research and consider the role of unique immigrant parent-child interactions. I’m eager to share with you the details of this study and expand on the results that I found most important and resonated with. 

How did they do it?

The researchers recruited their participants from several psychology classes at a public university. There were a few requirements to participate in the study. First, participants had to be between the ages of 18 to 24 and have been either born in the U.S. or moved to the country before 5 years of age. Finally, to participate in the study, they had to have at least one parent who identified as an immigrant to the U.S. 

Out of the 219 participants that were included in the study, 46 participants had one immigrant parent and 173 had two. 

As part of this study, participants completed several questionnaires. Not only did these surveys measure mental illness stigma and negative attitudes towards seeking professional mental health services, but they also looked at indicators of the immigrant parent-child relationship. The questionnaires measured an acculturation gap (which measured the difference in levels of assimilation to the U.S. between them and their parents) and communication about mental health concerns (this measured the strength of communication between parent and child surrounding issues of mental health). Participants either filled these out alone in a given space on campus or in small groups. The largest group had 8 participants. As a reward for their participation, participants were given extra credit for the psychology classes they were enrolled in. 

What did they find?

There were some fascinating results from this paper. Not only did the researchers find that mental illness stigma alone affects negative beliefs about getting professional help, but they also found that it is directly linked to the quality of communication around mental health. Interestingly, the researchers found that better quality communication is associated with more mental illness stigma. 

Furthermore, Bismar and Wang found that when they took into account the role of parent-child communication in developing stigma, the latter was still indirectly associated with negative feelings about getting professional help. However, it is important to note that they only found this relationship for those participants for which the acculturation gap was small or moderate. 

What does it all mean (our take)?

As an international student, reading and understanding the results of this research paper was significant to me. Not only did it make me feel seen by the researchers and the literature, but it also helped me to understand how my identity and experience could affect my relationship with mental health and the pursuit of professional help. This is powerful. 

The implications of these results are important. If addressed, it can make a difference to the lives of college-age children of immigrant parents. These results may help other children of immigrant parents  better navigate their relationship with mental health. Furthermore, these results will help college counselors, college administrators and even nonimmigrant peers better accommodate these students. 

For example, these results demonstrate that counselors must be intentional in considering the sociocultural background of the student when helping them and providing them guidance. They must understand how each student relates to and communicates with their parents - with a focus on the acculturation gap. Furthermore, counselors must also take into account the unexpected positive association between stigma and communication that the researchers found. This was the result that I most resonated with. I do have a strong relationship with both my parents. If counselors take advantage of this effective and communicative relationship with other students, then they may be able to inspire students to start conversations with their parents around seeking help if necessary. Perhaps, over time, this will encourage their parents to be more open to the option as well. 

I cannot stress how vital it is for counselors, administrators, and students themselves to understand these results. The researchers have highlighted that there is an entire demographic of college students whose unique perspectives have been somewhat ignored and whose experiences have not been catered to. These important results also shed light on the fact that there is more research still to be done and other groups of participants to consider. For example, I’m now asking myself what do these experiences look like for international students? Are they the same, or different? Do these differences matter? For now, these are all crucial questions that need further attention.