Understanding Mental Health Service Perceptions in Chinese Americans with Type 2 Diabetes and Co-Occurring Mental Health Challenges Living in New York City: A Qualitative Study

Purpose: Chinese Americans face disproportionately higher rates of Type 2 Diabetes (T2D) and co-occurring mental health challenges. Little is known about how they perceive mental health care during their journey with diabetes. This study aimed to provide an in-depth exploration of mental health care perceptions in this population. Patients and Methods: Two focus group discussions involving 12 participants were conducted in Mandarin. Participants were purposively sampled from a previous survey of Chinese immigrants with T2D who reported co-occurring mental health challenges and were recruited through referrals from primary care practices and community-based organizations in New York City. Data were analyzed using inductive content analysis. Results: The participants in this study ranged in age from 45 to 67 years. Most were female, married, and had low educational attainment (less than a college education) and low annual household incomes (less than USD $25,000). All participants were first-generation Chinese immigrants with limited English proficiency and had health insurance. HbA1c levels ranged from 6.5% to 12.6%. Depressive symptoms and elevated stress were the most commonly reported mental health issues in this sample. Data analysis revealed five categories related to participants’ perceptions of mental health care: 1) interactions between mental health and T2D, 2) barriers to accessing mental health care, 3) facilitators of accessing mental health care, 4) coping strategies for mental health challenges, and 5) preferences for mental health services. Conclusion: This study suggests the complex interactions between T2D and mental health issues among Chinese Americans. The findings indicate that seeking professional mental health services is uncommon among many individuals in this population and highlight several barriers and facilitators to access. The findings also suggest directions for future interventions to support mental health among Chinese Americans with T2D. Addressing mental health needs through effective interventions is essential for providing comprehensive care to this underserved population. Future research should explore the role of stigma in mental health-seeking behaviors, as well as design and assess the effectiveness of mental health interventions for Chinese Americans with T2D.

Duke Scholars

Author Bei Wu School of Nursing