The Impact of Individual and Parental Confucian Attitudes on Mental Illness Stigma and Help Seeking Attitudes Among Asian Americans from Confucian Cultures

Background: Asian Americans have the lowest rates of mental health service utilization among all racial and ethnic groups. Previous qualitative research suggests more traditional Asian values, including Confucianism, may be associated with higher levels of mental illness stigma and negative attitudes towards service utilization. However the limited quantitative literature among immigrant families shows mixed findings, and no quantitative studies have explored Confucianism as a distinct construct in relation to mental health stigma or service utilization attitudes. Objectives: The first monograph seeks to present the philosophical foundations of mental illness beliefs among East Asians, which include Traditional Chinese Medicine, Confucianism, Daoism, and Buddhism. The second monograph seeks to test whether Mental Illness Stigma (MIS) mediates the relation between Individual Confucian Values (ICV) and Help-Seeking Attitudes (HSA). We also test whether Parental Confucian Values (PCV) moderates the relation between ICV and MIS. Design: The first monograph is a synthesis of the extant literature. The second monograph utilizes local and national online survey recruitment of individuals from ethnicities with Confucian cultural values (i.e. Chinese, Japanese, Korean and Vietnamese Americans, n=345). Results: In the second monograph, using Structural Equation Modeling, MIS mediates the relation between ICV and HSA, and PCV moderates the relation between ICV and MIS such that there is a positive relation between ICV and MIS only for those who report low PCV. Conclusion: Confucianism relates to mental illness stigma and service-seeking attitudes, but is impacted by intergenerational parental Confucian beliefs. Specific cultural individual and intergenerational values should be considered in future research in lieu of general or proxies for acculturation measures