Op-Ed: A Third Culture Kid in Pursuit of Clinical Psychology and Three Themes in Chinese Mental Health Research

As a British-born Chinese girl, the idea of entering Psychology as a profession was something that I never considered. However, when I was in secondary school Psychology, it was something I thought about. My family didn't discuss emotions or have discussions about mental health. My parents weren't particularly strict about my academic pursuits. However, I recall having conversations with them about whether I wanted to go into medicine or law. My parents were influenced by my older brother, who studied Psychology. Psychology is a stable and rewarding career. They have been supportive of my desire to become a Clinical Psychoologist.

Similar to other Chinese diaspora people, I struggled to find my identity as a child and to understand what it meant to be British and Chinese. While all teenagers struggle to understand their identity, those from ethnic minorities can add an additional layer of confusion. Being from an ethnic minority background can add another layer of confusion to adolescents.

My Journey to Clinical Psychology: Mental Healthcare Accounting for Cultural Sensitivity

It takes a long time to become a Clinical Psychologist in the UK. I had the opportunity to do a clinical placement under a great clinical supervisor, which allowed me to publish my first peer-reviewed article. There I gained clinical and research experience in a variety of roles, including Support Worker, Research Assistant, and Assistant Psychologist. Additionally, I completed a Clinical Forensic Psychology MSc that included a clinical placement.

My third year of Clinical Psychology doctoral study is currently over. We are required to complete a research project as part of our training. This project aims to increase the evidence base for mental health knowledge and understanding. In my interview and doctoral application, I mentioned that I wanted to help increase mental health knowledge and understanding that takes into account cultural sensitivity. My research project was eye-opening. It is a project that I treasure. Although the full paper will be published in a peer-reviewed journal shortly, these are my most compelling findings.

This research focuses on the experiences of second-generation Chinese immigrants from Hong Kong in accessing mental healthcare support in the UK. It also explores why this population might be underusing mental health services. Seven interviews were conducted, and audio-recorded. The transcripts were then transcribed. The transcripts were analysed using a method that allows for people to share their experiences. It also attempts to account for the researcher’s perspective (also known as Interpretative Phenomenological Analysis).

Theme 1: Mental Health in the Chinese Community

Interviewees were affected by negative representations of mental illness in Chinese media, mainly Chinese television. Parents and relatives from older generations are more likely to have a limited view of mental health.

Second-generation Chinese immigrants noted differences in Western media representations of mental health. They saw more diverse representations as a plus. They felt that Western media representations of mental health were a negative portrayal of emotional control and weakness. Because of the negative stereotypes, second-generation Chinese immigrants were less likely to talk about their mental health with their families and parents. The family's reluctance to discuss emotional problems had negative consequences for the whole community of Chinese immigrants, including being excluded from social activities and other potential adverse effects.

Theme Two - Sharing Emotions in Chinese Culture

Interviewees said that it was not common for Chinese families to have positive (i.e. According to those interviewed, it was rare for Chinese families to share both positive (i.e. verbalizing pride and love) and negative emotions. Second-generation Chinese immigrants did not seek out support from their families for emotional problems. Interviewees talked about how emotions might be expressed differently in Chinese culture and in Western families. Second-generation Chinese immigrants shared their experiences with how they expressed care and affection in practical ways (e.g. By making food for a relative

Second-generation Chinese immigrants were expected to suppress their emotions in difficult situations like grieving a death. Emotions were often viewed as weakness or an inconvenience by others. Second-generation Chinese immigrants were often dismissed from their families when they shared their emotional problems. They received no support or comfort.

Theme Three - Trying to Meet Chinese Standards

This study found that second-generation Chinese immigrants used "striving for victory" to manage their mental health problems. Their striving attitude was passed down from their parents. Second-generation Chinese immigrants have learned from their grandparents the struggles they faced and are determined to take advantage of all opportunities, including higher education.

As such, mental health problems were seen as a barrier to the family's traditional Chinese roles (i.e. as the unmarried only child in the family). Second-generation Chinese immigrants from China placed the needs of their families above their own. Parents openly discussed the successes and failures of second generation Chinese immigrants, which contributed to increased pressure to achieve.

Second-generation Chinese immigrants felt fully assimilated into Britain and were not subject to parental pressure. However, they still felt pressured to succeed in relationships with extended families. Second-generation Chinese immigrants found comparisons with their parents, relatives, and even themselves to be stressful, anxiety-provoking, and often lead to burnout. Second-generation Chinese immigrants are likely to keep trying to succeed. This is due to unwelcome discussions about mental illness, shameful feelings, and loss in reputation or 'face.

Final Thoughts

Many of the topics discussed by interviewees resonated with me personally. I was particularly struck by how difficult it is to share emotions with family members and the desire to succeed. Although this research has its limitations, it is not intended to be generalizable to a wider Chinese population. This is in contrast to studies that use larger sample sizes. However, these themes could be applicable to the wider AAPI community. These findings may help to increase our understanding of unique cultural concepts and the willingness of Chinese people to seek out mental health support. This is something that the AAPI community should also be aware.