New Research Explores Language and Culturally Anchored Mental Health Attitudes
March 6, 2023
A study of bilingual speakers found them to be more receptive to mental health treatment when using their foreign English, versus their native Chinese.
By Sarah Steimer
The language we use plays a significant role in the way we think about mental health, according to a new study of bilingual speakers. The research, published in Clinical Psychological Science, found participants more strongly endorsed seeking treatment when information was presented in their foreign, English language rather than their native tongue.
The cross-discipline research team included Uriel Heller, Leigh H. Grant, and Boaz Keysar of the Multilingualism and Decision-Making Lab in UChicago’s Department of Psychology, along with Miwa Yasui of the Culture, Mental Health & Development Lab in UChicago’s Crown Family School of Social Work, Policy, and Practice. Their studies rely on psychological theory and have strong clinical implications primarily for immigrants. The findings apply to the initial stage of treatment-seeking and suggest it may be preferable for the conversation around the prospect of treatment to take place in bilingual speakers’ second language. This can guide any service provider who may be involved, whether a physician, therapist, social worker, or even simply in the course of conversation among friends.
Speaking on the motivation for the studies, Heller recalls, “My very first week in Chicago I had participated in this civic engagement program and — walking through City Hall — I remember wondering in just how many languages does the city provide services to its people, having had just learned it was long considered one of the immigrant destinations of the country. On the face of it, you’d think the more the better, in order to reduce language barriers. But what I also later learned was that using a foreign language can provide distance from cultural and social norms that sometimes go against our own wellbeing.”
Mental health services in particular seemed like a prime candidate for how language and social norms interact, says Grant. “Seeking treatment often involves grappling with emotional barriers that could be enhanced by sociocultural influences and stigma,” she says.
The team did, in fact, find that study participants were more likely to recommend mental health treatment in their foreign English than in their native Chinese. Not only was it true for Chinese participants in China, but also for Chinese immigrants in the U.S. The researchers found that using English reduced the salience of traditional Asian values, thereby making seeking treatment more acceptable.
The team chose to focus on individuals of Asian culture because of their lower utilization of mental health services and relatively pronounced stigma toward mental illness. In recent years, Asian adults with a mental illness were only half as likely as white adults to use such services in the U.S.
“Expressing emotional distress is something that is sometimes counter to certain cultural values,” Yasui says. The focus on Chinese individuals was motivated by their outsize share of the 280 million migrants worldwide. “The findings from this study will probably be similar in other cultures where mental health or emotional distress is not openly discussed and may also extend to other cultures more broadly, given that stigma toward mental illness — while varying in form — is near universal.”