Mental Illness Public Stigma and Generational Differences Among Vietnamese Americans

Contributors to Underdiagnosis of ADHD among Asian Americans: A Narrative Review

OBJECTIVE

Rates of ADHD are lowest among Asian American children (1-6.1%) compared to all other major ethnic and racial groups in the US, but there is limited literature on reasons for the disparity in estimated prevalence rates.

METHOD

We conducted a narrative review to integrate the literature on ADHD in children in Asian countries with that on ADHD among Asian American youth to highlight potential explanations for disparities in ADHD diagnosis and treatment among Asian American children relative to other racial and ethnic groups.

RESULTS

Factors possibly contributing to the low estimated prevalence rates of ADHD among Asian American children include: a higher proportion of Inattentive ADHD presentation among Chinese, Malaysian, and Indian children; racial bias and the influence of the Model Minority Myth; cultural differences in classroom identification; mental health stigma in Asian American communities; parent perception of ADHD as misbehavior rather than a neurodevelopmental disorder; and parent support for children's academic activities that may mask impairment.

CONCLUSION

We offer recommendations to inform individual and community-level psychoeducation, and new directions for research to address this health disparity.

Medical students' perception towards mental health recovery: a descriptive qualitative study

The conceptualisation of recovery in mental healthcare, for which two definitions ('clinical' and 'personal') prevail, remains inconclusive. In most curricula of medical education, undergraduates are taught straightforward concepts of clinical recovery, which result in their perfunctory and rudimentary understanding. A qualitative descriptive approach was adopted to explore medical undergraduates' perceptions of recovery for people with mental health conditions. Participants were recruited from a Singapore-based university through convenience sampling; the required sample size was determined by data saturation. Individual face-to-face interviews were conducted through Zoom, an online conferencing platform using semi-structured questions from March to July 2021. Recordings of the interviews were transcribed verbatim and thematically analysed. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting of this study. Seventeen medical students with the majority (fifteen) of them in their fourth year of medical undergraduate education participated in this study. Four themes were identified: the relationship between mental illnesses and well-being; opinions on mental well-being; understanding of mental illnesses; and perceptions of recovery from mental illnesses. The medical undergraduates in this study predominantly conceptualised recovery based on functions, although many also agreed on respecting patients' perspectives in defining it. This aligns with contemporary approaches that emphasise more shared decision-making opportunities and empowering people with mental health conditions. Accordingly, our findings highlighted the need for foundational medical education to incorporate these constructs in their curricula and strategise to provide more meaningful discussions about them.

Development of Junior High School Students to Secondary Vocational Students Stigma Scale

Background and Aim

It is particularly obvious that vocational and technical education (VTE) has been stigmatized for a long time in the field of secondary vocational education. The severe stigma that secondary vocational students suffer from may negatively affect junior high school students' choice to attend secondary vocational schools and become such students. This study aims to develop the junior high school students to Secondary Vocational Students Stigma Scale (SVSSS) and to test its reliability and validity.

Methods

The initial questionnaire was formed following an open-ended questionnaire and expert review based on the conceptual model of stigma as a theoretical framework. A total of 316 junior high school students (sample 1) were administered with the resulting data subjected to item analysis and exploratory factor analysis (EFA). And a total of 416 junior high school students (sample 2) were administered with the data applied for validity, reliability, and cross-group invariance test.

Results

It was revealed in the EFA that the SVSSS consists of 20 items in total, including three dimensions, namely negative labeling, social isolation, and devaluation and discrimination. Favorable structural validity of the questionnaire was demonstrated in confirmatory factor analysis (CFA) (x ²/df=2.907, RMSEA=0.068, RFI=0.925, CFI=0.956, NFI=0.934, IFI=0.956, PNFI=0.816, PCFI=0.835). The aggregate scores of the SVSSS, exhibiting cross-gender invariance, were significantly negatively associated with willingness to choose secondary vocational education and positively correlated with academic performance. Cronbach's α coefficient of the SVSSS and each dimension ranged from 0.815 to 0.963, with split-half reliability from 0.777 to 0.969.

Conclusion

Featuring favorable reliability and validity, the SVSSS was found to be an effective tool for the measurement of the secondary vocational education stigma among junior high school students, with its measurement invariance across genders.

The window to the world for individuals with mental disorders: A qualitative study about social media

This study aimed to determine the views of individuals with mental disorders on the experience of social media. This was a qualitative study conducted using the content analysis method. Using purposive sampling, 12 individuals with mental disorders were selected and interviewed. Data were collected using semi-structured interviews and were analyzed using the content analysis method. Four main themes and 10 subthemes were identified. The themes included the window opening to the world (source of information, facilitating life), from invisibility to visibility (feeling good, liberation and socialization), negative experiences (feeling lost, envy, and privacy), and the rejection of society (escape and stigmatization). Individuals with mental disorders stated that social media had both positive as well as negative effects on their lives. The results of the study highlight the various aspects of social media use and its effects on individuals with mental disorders. These results can be used in planning and implementing mental health services for individuals with mental disorders. ACCESSIBLE SUMMARY: What is known about the subject? What does the paper add to existing knowledge? What are the implications for the practice?

Discrimination and Stress Among Asian Refugee Populations During the COVID-19 Pandemic: Evidence from Bhutanese and Burmese Refugees in the USA

OBJECTIVES

To measure COVID-19 pandemic-related discrimination and stress among Bhutanese and Burmese refugees in the USA and to identify characteristics associated with these two measures.

METHODS

From 5/15-6/1/2020, Bhutanese and Burmese refugee community leaders were invited to complete an anonymous, online survey and shared the link with other community members who were English-proficient, ≥18 years old, and currently living in the USA. We identified characteristics associated with pandemic-related discrimination and stress applying ordinal logistic regression models.

RESULTS

Among 218 refugees from 23 states, nearly one third of participants reported experiencing at least one type of discrimination, and more than two-thirds experienced at least one type of pandemic-related stress. Having had COVID-19, having a family member with COVID-19, and being an essential worker were associated with discrimination. Discrimination, financial crisis, and female gender were associated with stress.

CONCLUSIONS

Reducing pandemic-related discrimination should remain a priority, as should the promotion of social support and coping strategies. Noting that this is a nonrepresentative sample, we recommend that larger national studies tracking experiences with pandemic-related discrimination and stress include Asian American subgroups with limited English proficiency.