Facilitation or Hindrance? The Role of Social Support in Asians’ and Asian Americans' Pathways to Mental Health Care

Abstract

Compared to other racial/ethnic groups, Asians and Asian Americans have the lowest rate of mental health service utilization (MHSU). Existing studies on social support and MHSU among this population show inconsistent findings. Moreover, they typically focus on perceived emotional support, overlooking received and provided support. New immigrant destinations often lack the infrastructure to support immigrant communities, making support networks crucial in these places. Yet, less is known about MHSU for this group in these places. To address these research gaps, I utilize and integrate the network episode model (NEM), social resource theory (SRT), and social cost theory (SCT). Drawing on 51 in-depth interviews with a diverse sample of Asians and Asian Americans living in Nashville, Tennessee, I examine how received social support affects MHSU. In line with SRT, I find that emotional and informational support facilitates MHSU by circumventing structural barriers. Additionally, network members initially provide support to help participants recognize their mental health problems and consider using mental health services, a process I term as planting a seed. Over time, sustained support nurtures this seed, ultimately leading participants to engage in MHSU. Moreover, when instrumental, emotional, and appraisal support alleviate stressors, it renders mental health services no longer needed. However, in line with SCT, social support, particularly from parents, discourages one from seeking care. Yet, when stressors persist despite receiving support, participants are likely to seek out mental health care services. The motivation to provide support is often driven by care and a willingness to pay it forward. Mental health literacy and mental health care experience enable participants to provide tailored support that aligns with the receiver’s needs. Participants use a specific framework, which I term the comparative physical-mental health framework, to destigmatize MHSU. This framework functions to destigmatize MHSU by equating the reasons for seeking mental health care to those for seeking physical health care. This dissertation underscores the double-edged role of social support in MHSU; integrates NEM, SRT, and SCT; and highlights the role of support in MHSU among Asians and Asian Americans in new immigrant destinations.