Understanding how culture shapes Chinese patients’ mental health decision-making in Australian general practice

BACKGROUND: Individuals of Chinese cultural background make up the second largest group within Australia's culturally and linguistically diverse population. However, there is limited understanding of the use of mental healthcare services in general practice by the Chinese community, particularly when considering the influence of cultural nuances. This study aimed to investigate how cultural factors shape the experiences of Chinese individuals in accessing mental health support through general practice. METHODS: One-on-one semi-structured interviews were conducted with 12 Chinese participants who had consulted a general practitioner for mental health care in Australia. RESULTS: Thematic analysis captured five themes: (1) attitudes or beliefs about mental ill-health, (2) barriers to seeking mental health care, (3) facilitators to seeking mental health care, (4) preferences in GP selection, and (5) experience in mental health recovery. These also encapsulated participant perceptions of GPs' roles in mental health care and patients' treatment preferences. CONCLUSIONS: This study suggests that cultural stigma surrounding mental illness is a potential cause of underdiagnosis and underutilisation of mental health services among Chinese individuals in Australia. Practical barriers, such as costs, perceived care effectiveness and GP availabilities, further complicate care usage. Nonetheless, self-motivation and support from family and friends encourage positive help-seeking behaviours. Overall, the evolving beliefs about mental illnesses emphasise the need for strengthened communication and trust between GPs and Chinese patients to enhance prioritisation of GPs' role in mental health care. Future investigations into the adequacy of current cultural competency trainings for GPs are needed.