Perspectives on mental health difficulties amongst second-generation Chinese individuals in Germany:Stigma, acculturation, and help seeking

Migration demands may put Chinese people living abroad at higher risk for mental health difficulties. However, mental illness is stigmatised and often neglected. The aim of this study was to investigate mental illness stigma endorsement amongst second-generation Chinese individuals in Germany and explore the role of acculturation and stigma on mental health service-seeking behaviours. In semi-structured interviews with 23 second-generation Chinese individuals, half of whom had a history of mental illness and half did not, we explored beliefs contributing to mental illness stigma, manifestations of stigma, the influence of acculturation, experience with mental health difficulties, and barriers to help seeking. Findings indicate that, within Chinese immigrant communities, people with mental illness are perceived as crazy, abnormal, weak, of poor character, having poor genes, or coming from a 'bad' family. Manifestations of mental illness stigma were avoidance, social exclusion, labelling, blame, and gossip. Stigma by association of family members was also reported. Acculturation appeared to attenuate stigma endorsement with most participants expressing considerate attitudes towards people with mental illness. However, acculturation also contributed to mental health difficulties through intergenerational differences in view on mental illness and help seeking. Findings highlight the importance of considering family dynamics when providing mental health services to second-generation Chinese individuals