Mental illness disclosure in Chinese immigrant communities

Fang Pei Chen, Grace Ying Chi Lai, Lawrence Yang

Research output: Contribution to journalArticlepeer-review


Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed.

Original languageEnglish (US)
Pages (from-to)379-391
Number of pages13
JournalJournal of Counseling Psychology
Issue number3
StatePublished - Jul 2013


  • Chinese/Asian-American
  • Mental illness disclosure
  • Schizophrenia
  • Social network
  • Stigma

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Mental illness disclosure in Chinese immigrant communities'. Together they form a unique fingerprint.

Cite this