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Intersectionality as an Analytic Framework for Understanding the Experiences of Mental Health Stigma Among Racialized Men

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Abstract

The objective of this research was to use intersectionality to explore Asian men’s experiences of stigma and mental illness to tease out the ways in which stigma of mental illness among Asian men is mediated by age, immigration experiences, sexual and gender identities, racism and racialization processes, normative expectations about masculinity, and material inequality. The data for this research are based on a 4-year, multi-site (Calgary, Vancouver, and Toronto) mixed-methods intervention study that evaluated the effectiveness of interventions in reducing self and social mental health stigma among Asian men (Livingston et al. International Journal of Social Psychiatry 64, 679-689, 2018; Guruge et al. Contemporary Clinical Trials 71, 133–139, 2018). Participants were Asian men living with or affected by mental illness and community leaders interested in stigma reduction and advocacy. Quantitative survey data captured participants’ self-reports of stigma, psychological flexibility, valued life domains, mindfulness, and empowerment readiness. Qualitative data included focus group transcripts, field notes, and participants’ logs about anti-stigma activities in their communities. The data analyzed here are from ten pre-intervention and seven post-intervention focus groups conducted at the Vancouver site. The data collected pre- and post-interventions revealed that men understand and experience stigma as inextricably linked to social location, specifically age, race, masculinity, ethnicity, and time of migration. Our analysis also revealed that mental health stigma cannot be understood in isolation of other social and structural barriers. The application of intersectional frameworks must figure prominently in psychological research and in public health policies that seek to reduce mental health stigma in racialized communities.

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Notes

  1. In the context of this paper, we use the term “‘Asian”’ broadly to refer to people from countries including China, Japan, Taiwan, Southeast Asia, Korea, India, Pakistan, and the Philippines.

  2. Asia represents the top source of recent immigrants, with 61.8% of new Canadians in 2016 having been born in Asia (Statistics Canada 2017).

  3. Two of the seven focus groups were immediately post-intervention and five of the focus groups were six 6 months post-intervention.

References

  • Anisef, P., & Kilbride, K. M. (2003). Managing two worlds: the experiences and concerns of immigrant youth in Ontario. Toronto: Canadian Scholars Press.

    Google Scholar 

  • Augsberger, A., Yeung, A., Dougher, M., & Hahm, H. C. (2015). Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Services Research, 15(1), 542.

    PubMed  PubMed Central  Google Scholar 

  • Beiser, M., Simich, L., & Pandalgat, N. (2011). Stresses of passage, balms of resettlement and posttraumatic stress disorder among Sri Lankan Tamils in Canada. Canadian Journal of Psychiatry, 56, 333–340.

    PubMed  Google Scholar 

  • Chen, X., & Tse, H. C.-H. (2010). Social and psychological adjustment of Chinese Canadian children. International Journal of Behavioral Development, 34, 330–338.

    Google Scholar 

  • Chen, C., Smith, P., & Mustard, C. (2010). The prevalence of over-qualification and its association with health status among occupationally active new immigrants in Canada. Ethnicity & Health, 15, 601–619.

    Google Scholar 

  • Chiu, M. Y. L., Yang, X., Wong, H. T., & Li, J. H. (2015). The mediating effect of affective stigma between face concern and general mental health – the case of Chinese caregivers of children with intellectual disability. Research in Developmental Disabilities, 36, 437–446.

    Google Scholar 

  • Chow, H. P. (2010). Growing old in Canada: physical and psychological well-being among elderly Chinese immigrants. Ethnicity & Health, 15, 61–72.

    Google Scholar 

  • Cole, E. (2009). Intersectionality and research in psychology. American Psychologist, 64(3), 170–5 180.

    PubMed  Google Scholar 

  • Combahee River Collective. (1977). The Combahee River Collective statement. Retrieved from http://www.sfu.ca/iirp/documents/Combahee%201979.pdf. Access July 3, 2019.

  • Connell, R. W. (1995). Masculinities. St Leonards: Allen and Unwin.

    Google Scholar 

  • Courtenay, W. H. (2000a). Engendering health: a social constructionist examination of men’s health beliefs and behaviors. Psychology of Men & Masculinity, 1(1), 4–15.

    Google Scholar 

  • Courtenay, W. H. (2000b). Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Social Science and Medicine, 50(10), 1385–1401.

    CAS  PubMed  Google Scholar 

  • Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: a Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(8), 139-67.

  • Crenshaw, K. (1991). Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43, 1241–1299.

    Google Scholar 

  • Dardas, L. A., & Simmons, L. A. (2015). The stigma of mental illness in Arab families: a concept analysis. Journal of Psychiatric and Mental Health Nursing, 22(9), 668–679.

    CAS  PubMed  Google Scholar 

  • Davis, A. (1981). Women, race and class. New York: Random House.

    Google Scholar 

  • Demetriou, D. (2001). Connell’s concept of hegemonic masculinity: a critique. Theory & Society, 30(3), 337–361.

    Google Scholar 

  • Desai, S., & Sabramanian, S. (2003). Colour, culture and dual consciousness: issues identified by South Asian immigrant youth in the greater Toronto area. In P. Ansief & K. Murphy (Eds.), managing two worlds: the experiences and concerns of immigrant youth in Ontario. Toronto: Canada Scholars Press Inc.

    Google Scholar 

  • Dossa, P. (2002). Narrative mediation of conventional and new “mental health” paradigms: reading the stories of immigrant Iranian women. Medical Anthropology Quarterly, 16(3), 341–359.

    PubMed  Google Scholar 

  • Falicov, C. (2007). Working with transnational immigrants: expanding meanings of family, community, and culture. Family Process, 46(2), 157–171.

    PubMed  Google Scholar 

  • Fung, K., & Wong, Y.-L. R. (2007). Factors influencing attitudes towards seeking professional help among East and Southeast Asian Immigrant and Refugee women. The International Journal of Social Psychiatry, 53, 216–231.

    PubMed  Google Scholar 

  • George, U., Thomson, M., Chaze, F., & Guruge, S. (2015). Immigrant mental health, a public health issue: looking back and moving forward. International Journal of Environ. Res. Public Health, 12, 13624–13648.

    Google Scholar 

  • Gilroy, P. (1987). There ain’t no black in the union jack: the cultural politics of race and nation. Chicago: University of Chicago Press.

    Google Scholar 

  • Gorman, R. (2013). Mad nation? Thinking through race, class, and ad identity politics. In R. Menzies, G. Reaume, & B. LeFrançois (Eds.), Mad matters: A critical reader in Canadian Mad studies. Toronto: Canadian Scholars Press.

    Google Scholar 

  • Guruge, S., Fung, K., Sidani, S., Este, D., McKenzie, K., Morrow, M., & Wong, J. (2018). Study protocol: mobilizing Asian men in Canada to reduce stigma of mental illness. Contemporary Clinical Trials, 71, 133–139.

    Google Scholar 

  • Han, M., & Pong, H. (2015). Mental health help-seeking behaviors among Asian American community college students: the effect of stigma, cultural barriers, and acculturation. Journal of College Student Development, 56(1), 1–14. https://doi.org/10.1353/csd.2015.0001.

    Article  CAS  Google Scholar 

  • Hankivsky, O. (Ed.). (2011). Health inequities in Canada: intersectional frameworks and practices. Vancouver: UBC Press.

    Google Scholar 

  • Hill Collins, P., & Bilge, S. (2016). Intersectionality. Cambridge: Polity Press.

    Google Scholar 

  • Kalich, A., Heinemann, L., & Ghahari, S. (2016). A scoping review of immigrant experience of health care access barriers in Canada. Journal of Immigrant and Minority Health, 18, 697–709.

    PubMed  Google Scholar 

  • Kishore, J., Gupta, A., Jiloha, R. C., & Bantman, P. (2011). Myths, beliefs and perceptions about mental disorders and health-seeking behavior in Delhi, India. Indian Journal of Psychiatry, 53(4), 324–329.

    PubMed  PubMed Central  Google Scholar 

  • Lapalme, J., Haines-Saah, R., & Frohlich, K. L. (2019). More than a buzzword: how intersectionality can advance social inequalities in health research. Critical Public Health. https://doi.org/10.1080/09581596.2019.1584271.

  • Lauber, C., & Rossler, W. (2007). Stigma towards people with mental illness in developing countries in Asia. International Review of Psychiatry, 19(2), 157–178.

    PubMed  Google Scholar 

  • Li, S., Hatzidimitriadou, E., & Psoinos, M. (2014). “Tangled wires in the head”: older migrant Chinese’s perception of mental illness in Britain. Journal of Aging Studies, 30, 73.

    PubMed  Google Scholar 

  • Liu, C., & Bryson, S. (2017). Why informally employed Chinese women do not go to the doctor. Health Promotion International, 32(3), 558–566.

    PubMed  Google Scholar 

  • Livingston, J., Patel, N., Bryson, S., Hoong, P., Lal, R., & Morrow, M. (2018). Stigma Associated with mental illness among Asian men in Vancouver, Canada. International Journal of Social Psychiatry, 64, 679–689. https://doi.org/10.1177/0020764018805125.

    Article  PubMed  Google Scholar 

  • Man, G. (2004). Gender, work and migration: deskilling Chinese immigrant women in Canada. Women's Studies International Forum, 27(2), 135–148.

    Google Scholar 

  • McKenzie, K., Agic, B., Tuck, A., & Antwi, M. (2016). The case for diversity: building the case to improve mental health services for immigrant, refugee, ethco-cultural and racialized populations. Report to the Mental Health Commission of Canada. Ottawa: National Library of Canada.

    Google Scholar 

  • Mohanty, C., Russo, A., & Torres, L. (Eds.). (1991). Third world women and the politics of Feminism. Bloomington: Indiana University Press.

    Google Scholar 

  • Morrow, M., Halinka Malcoe, L (Eds) (2017) Critical inquiries for social justice in mental health. University of Toronto Press.

  • Morrow, M., & Hardie, S. (2014). An intersectional approach to inequity. In W. Bryant, J. Fieldhouse, & K. Bannigan (Eds.), Creek’s Occupational Therapy and Mental Health (5th ed., pp. 188–203). UK: Elsevier Publishing.

    Google Scholar 

  • Morrow, M., Smith, J., Lai, Y., & Jaswal, S. (2008). Shifting landscapes: immigrant women and post partum depression. Health Care for Women International, 29(6), 593–617.

    PubMed  Google Scholar 

  • Nadal, K. L., Escobar, K. M., Prado, G., David, E. J. R., & Haynes, K. (2012). Racial microaggressions and the Filipino American experience: recommendations for counseling and development. Journal of Multicultural Counseling and Development, 40, 156–173.

    Google Scholar 

  • Nadal, K. L., Griffin, K. E., Wong, Y., Hamit, S., & Rasmus, M. (2014). Racial microaggressions and mental health: counseling clients of color. Journal of Counseling & Development, 92, 57–66.

    Google Scholar 

  • Noone, J., & Stephens, C. (2008). Men, masculine identities, and health care utilisation. Sociology of Health & Illness, 30(5), 711–725.

    Google Scholar 

  • Pahwa, P., Karunanayake, C. P., McCrosky, J., & Thorpe, L. (2012). Longitudinal trends in mental health among ethnic groups in Canada. Chronic Diseases and Injuries in Canada, 32, 164–176.

    CAS  PubMed  Google Scholar 

  • Rossiter, K., & Morrow, M. (2011). Intersectional frameworks in mental health: moving from theory to practice. In O. Hankivsky (Ed.), Health Inequities in Canada: Intersectional Frameworks and Practices (pp. 312–330). Vancouver: UBC Press.

    Google Scholar 

  • Somerville, K. (2007). Life cycle events and the creation of transnational ties among second generation South Indians. In L. Tepperman & H. Dickinson (Eds.), Sociology in Canada: A Canadian Sociological Association Reader. Canada Oxford University Press.

  • Spivak, G. C. (1988). Can the subaltern speak? Basingstoke: Macmillan.

    Google Scholar 

  • Statistics Canada (2017). Immigration and ethnocultural diversity: key results from the 2016 Census Ottawa, ON. Retrieved from: https://www.150.statcan.gc.ca/n1/en/daily-quotidien/171025/dq171025b-eng.pdf?st=bkg5mQbV.

  • Tam, L. (2013). Whither indigenizing the Mad movement? Theorizing the social relations of race and madness through conviviality. In R. Menzies, G. Reaume, & B. LeFrançois (Eds.), Mad matters: A critical reader in Canadian Mad studies (pp. 281–297). Toronto: Canadian Scholars Press.

    Google Scholar 

  • Thomson, M., Chaze, F., George, U., & Guruge, S. (2015). Improving immigrant populations’ access to mental health services in Canada: A Review of Barriers and Recommendations. Journal of Immigrant and Minority Health, 17(6), 1895–1905.

    PubMed  Google Scholar 

  • Thompson, A., Anisimowicz, Y., Meidema, B., Hogg, W., Wodchis, W., Aubrey-Bassler, K. (2016) The influence of gender and other patient characteristics on health care-seeking behaviour: A QUALICOPC study. In BMC Family Practice. Vol. 38(17):1471-2296.

  • Yang, L. H., & Kleinman, A. (2008). ‘Face’ and the embodiment of stigma in China: the cases of schizophrenia and AIDS. Social Science & Medicine, 67(3), 398–408.

    Google Scholar 

  • Yang, L. H., Thornicroft, G., Alvarado, R., Vega, E., & Link, B. G. (2014). Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing ‘what matters most’ to identify culture-specific aspects of stigma. International Journal of Epidemiology, 43(2).

  • Yeung, KT., Stombler, M., Wharton, R. (2006) Making men in gay fraternities: resisting and reproducing multiple dimensions of hegemonic masculinity. Gender & Society, Vol. 20(1), pp.

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Acknowledgments

This research was supported by the Movember Foundation (Canada).

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Correspondence to Marina Morrow.

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Research on stigma and mental health has rarely investigated the specific needs of Asian men. Our research showed the importance of understanding mental health stigma in the context of other social factors that impact the lives of Asian men, such as experiences of migration, deskilling, racism and age. Attention to these social factors will help to develop more effective anti-stigma programs and supports in mental health.

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Morrow, M., Bryson, S., Lal, R. et al. Intersectionality as an Analytic Framework for Understanding the Experiences of Mental Health Stigma Among Racialized Men. Int J Ment Health Addiction 18, 1304–1317 (2020). https://doi.org/10.1007/s11469-019-00140-y

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