Factors influencing stress and mental health help-seeking in Asian Americans: A qualitative study focused on Karen refugee parents.

Authors

Jian Chen, Jessica Williams, Paohwa Lin, Grace Wu, Jada Brooks, Warren Lu, Hannah Feng, Cheryl Woods-Giscombe

Published in

Archives of psychiatric nursing. Volume 64. Pages 152224. Epub Aug 22, 2026.

Abstract

Suicide is the leading cause of death among Asian Americans aged 15-24 years, and Asian American populations experienced some of the highest increases in suicide rates from 2021 to 2022. Despite these trends, Asian Americans have the lowest rates of mental healthcare help-seeking and remain underrepresented in mental health research. Addressing mental health disparities requires awareness of the cultural, familial, and systemic factors that shape help-seeking behaviors.
Given the heterogeneity across more than 50 Asian American groups that speak over 100 languages, it is critical to examine the distinct needs of individual groups, including Karen refugees. Karen youth in North Carolina identified mental health as their top health concern. However, no research has examined parents' perspectives on mental health help-seeking in this population. This qualitative descriptive study was designed to address this gap.
The study used codebook thematic analysis. Through prolonged community engagement, the interview guide was developed to ensure cultural relevance, linguistic accessibility, and sensitivity to mental health stigma. Twelve Karen refugee parents in North Carolina completed individual semi-structured interviews; nine were conducted in Karen language and three in English.
Four major themes were identified: refugee camp experiences, post-refugee camp resettlement challenges, intergenerational conflict between parents and children, and resilience. Participants described barriers to mental health help-seeking at the personal, interpersonal, health-system, and societal levels.
Parents commonly describe parent-child disconnection as negatively affecting mental health. The findings underscore the importance of understanding culturally specific and structural barriers to mental health care.

PMID:
42863918
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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