Mental illness stigma has adverse effects on both the caregivers’ psychological well-being and the effectiveness of care that consumers receive. While anti-stigma interventions for family caregivers from Western settings have recently shown efficacy, these interventions may not be equally applicable across culturally diverse groups. Specifically, Chinese immigrant caregivers experience heightened internalized stigma, which predisposes the adoption of harmful coping strategies and reduced quality of social networks. We present an anti-stigma intervention based on a peer-family group format, co-led by a clinician and a trained family caregiver, to counter stigma among Chinese immigrants. Data are presented from a brief intervention administered to a pilot sample of 11 Chinese immigrant caregivers that provides: psychoeducation, strategies to counter experienced discrimination, and techniques to resist internalized stigma. Case vignettes illustrate implementation of this intervention, and how the peer-family format via interactive contact counteracts internalized stereotypes, encourages adaptive coping strategies, and reinvigorates social networks. Quantitative results further suggest preliminary efficacy in reducing internalized stigma for caregivers who evidenced at least some prior internalized stigma. This study constitutes an initial but important step towards reducing mental illness stigma among Asian Americans, for whom stigma has played a powerful role in the delay and underuse of treatment.

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This article provides a brief summary of existing literature on mental health disparities for Asian Americans. Emerging evidence suggests that in the aggregate, Asian Americans appear to have lower lifetime and 12-month prevalence rate for psychiatric disorders than other racial/ethnic groups, as judged by the Western psychiatric criteria. However, disparities continue to exist for segments of Asian American populations with respect to rates of mental illness, as well as access to care and treatment. We review a number of cultural and structural factors that sustain disparities and identify questions that remain unresolved with respect to the continuing disparities. Finally, drawing from public health and health disparities research, we discuss the community-based participatory research (CBPR) approach as a promising avenue for addressing the remaining questions in mental health disparities research. Specifically, we argue that CBPR approaches are well suited to address the nature of distress and help-seeking process within particular communal and ethnocultural contexts and to promote dialogue between Asian American community members, researchers, and practitioners.

Chinese immigrants tend to rely on family and close community for support given their vulnerable societal position. Yet stigma, especially from structural and familial sources, may have a particularly harmful impact upon Chinese immigrants with psychosis. Using a descriptive analysis based upon grounded theory, we examined stigma experiences of 50 Chinese immigrant consumers with psychosis, paying particular attention to frequency, sources, and themes of social and structural stigma. Although past research indicates that family is a recipient of stigma, we found instead that family members were common perpetuators of social forms of stigma. We also found that perceptions of work deficit underlie many forms of stigma, suggesting this is "what matters most" in this community. Lack of financial resources and language barriers comprised most frequent forms of structural stigma. Anti-stigma efforts should aim to improve consumer's actual and perceived employability to target what is most meaningful in Chinese immigrant communities.

Model minority stereotypes of Asian Americans as high educational and occupational achievers are perpetuated by conceptual and methodological issues in career development research that aggregate across Asian ethnicities and oversample high achievers. These issues render those marginalized, such as working-class immigrants with limited English proficiency, as well as their children, as invisible within research, practice, and policy. A new theoretical framework, entitled the Asian American Intergenerational Model of Psychology of Working (AAIM), questions the mainstream career development assumptions of linearity, stability, and upward mobility that reveal inherent classism. Building on the Psychology of Working Theory (Duffy et al., 2016); the AAIM broadens the scope and definition of work beyond career, and acknowledges the significance of structural and cultural forces on people's work and life. An expanded qualitative analysis of interviews with 17 low-income, working-class, Chinese immigrant parents (Tu et al., 2019) provides an empirical illustration of the intergenerational and coethnic dynamics of vocational experiences central to the AAIM. The working-class immigrants relied on coethnic networks to secure employment within a narrow range of options, many straddling helplessly between arduous manual labor and family demands. Though they had immigrated primarily to provide a better future for their children, many parents struggled to participate meaningfully in their children's development. These findings highlight the need to expand Asian American psychology of working to incorporate systems and social justice perspectives. Research, practice, and policy implications of AAIM advocate for maximal inclusivity and offer directions to address invisibility of the most marginalized and disenfranchised Asian American workers.

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Limited research has investigated how culture impacts expressions of social support, which is crucial in developing culturally sensitive care. Using a classification based on theories of social support, we examined the social support experiences of 49 Chinese immigrant mental health consumers with psychosis, paying particular attention to frequency and sources. We found that the most common forms of social support were belonging and companionship, perceived emotional support, social control, and perceived instrumental support, while self-esteem and sense of mastery were the least common forms. Family and friends were the main sources of support. These results demonstrate the influence of Confucian values of renqing (or fulfillment of relational obligations) and guanxi (or social networks) and the negative effects of stigma in diminishing the social standing of these consumers by compromising 'personhood.' Clinical implications for increasing the cultural competency of clinicians and improving the mental health outcomes of Chinese immigrants are discussed.

Encounters with Western psychiatric treatment and acculturation may influence causal beliefs of psychiatric illness endorsed by Chinese immigrant relatives, thus affecting help-seeking. We examined causal beliefs held by forty-six Chinese immigrant relatives and found that greater acculturation was associated with an increased number of causal beliefs. Further, as Western psychiatric treatment and acculturation increased, causal models expanded to incorporate biological/physical causes. However, frequency of Chinese immigrant relatives' endorsing spiritual beliefs did not appear to change with acculturation. Clinicians might thus account for spiritual beliefs in treatment even after acculturation increases and biological causal models proliferate.