Intergenerational conflicts in the families of immigrant Chinese mental health service users in New Zealand: A qualitative study

Methods

Data collection

Data were collected through semi-structured interviews designed to elicit detailed personal experiences while maintaining flexibility for relevant topics (see Table 1 for the interview schedule). The interview schedule was developed iteratively between RY, GC, and LN and reviewed by an independent psychiatrist, two Chinese mental health cultural workers, and a Chinese mental health patient at the first author’s employment.

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Table 1.

Interview schedules for participants

1. What is your experience of growing up/living as a Chinese person in New Zealand?

2. What is your experience of being someone with a mental illness?

3. What culture or cultures do you identify with - Chinese, Western, some other culture or a mix of these? In what ways?

4. Who in the family do you mainly have conflicts with? [prompt if needed to discuss up to 2 people (X +/− Y)]

5. How would you describe your relationship with them growing up? [or ‘when they were growing up’] And what about now?  [4a if not already covered] in particular, how did they look after your psychological and emotional needs? (or ‘did they appreciate your psychological and emotional needs?’)

6. What are the conflicts or clashes that you’ve had with X +/− Y generally about? [prompt if needed: For example, what do you usually argue about or tend to disagree over? Can you give some examples?]

7. What expectations do X +/− Y have for you in terms of Chinese culture? Do you agree with these expectations – including both things you are supposed and you’re not supposed to do? [or ‘you have for X +/− Y’ and ‘do they agree with’]

8. Why do you think these conflicts/disagreements have happened? [prompt if needed: For example, is it because of personality differences, cultural differences or something else?]

9. How did you deal with/tolerate/cope with these conflicts and the associated stresses? [prompt if needed: For example, try to problem-solve with X +/− Y, ask for help/advice from others, try to avoid talking about these issues, or some other ways?]  [9a if not already covered] what are some of your own skills or abilities that have helped you to deal with these conflicts?  [9b if not already covered] Are there any kinds of external support that have helped you to cope with these conflicts, such as support from family, friends, or others e.g., health professionals?  [9c if not already covered] Does your religion or faith help you to cope with these conflicts?

10. Overall, how have these conflicts affected your *** [mental health condition(s)]?  [11a if not already covered] Are there any positives that have come out of them for your recovery?

11. Do you think you’re doing well in resolving these conflicts? [10a if not already covered] Do you think these conflicts can be resolved? If not, what do you think is the best way to deal with them?

12. Has Chinese culture made it harder for you and X to manage or resolve these conflicts?

13. Do you and X +/−Y support each other in positive ways?

14. Has Chinese culture been helpful for your relationship in some ways?

Interviews were conducted in the participant’s preferred language, either in person or online, after completing a demographic questionnaire. Details of psychiatric diagnoses were obtained from referring clinicians and verified with participants. All interviews were audio-recorded and transcribed verbatim.

Results

Ten service user participants were recruited, all by clinician referrals, from a variety of ages and geographical origins (Table 2). Of these, eight were adult children and two were parents in relation to family conflict. Participants (60% female, including one transgender person) were aged between 22 and 50 years, with a diversity of psychiatric diagnoses. Time since migration to New Zealand ranged from 5 to 34 years; one participant was New Zealand-born.

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Table 2.

Participant demographic information

Participant number	Parent/child in IGC	Sex	Age	Number of years lived in New Zealand	Country/Territory of birth	Generation status	Diagnosis
1	Child	F	26	26	New Zealand (family from South East Asia)	Second	Dissociative disorder NOS
2	Child	F	21	20	China	1.5	MDD, BPD traits
3	Parent	M	50	6.5	China	First	GAD
4	Child	F	33	11	China	First	MDD, GAD
5	Child	F	41	23	China	First	Adjustment disorder with depressed mood & somatic symptoms
6	Parent	M	49	6–7	China	First	MDD
7	Child	F	40	21	China	First	BPAD
8	Child	F	41	14	Hong Kong	First	Schizophrenia
9	Child	M	43	34	Taiwan	1.5	Schizophrenia
10	Child	M	22	5	China	First	OCD, anxiety, ASD, ADHD

Themes

There were three main themes: (1) Types of IGCs and perceived associations with mental illness; (2) Family cultural factors associated with conflicts; and (3) Navigating IGCs and building resilience amid mental illness.

Interview quotes supporting each theme are presented in Table 3.

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Table 3.

Data to support themes

Types of intergenerational conflicts and perceived associations with mental illness

Interviewer: So, in what areas do you mainly clash with your parents? ‘In every area – from where you go, where and what you study, where you live, which company you join, what sort of boyfriend you date, how you bring up your children, which house you buy – absolutely everything.’ – P5, child

‘When it comes to my child’s education and academic knowledge, I suppose I have rather high expectations; I want him to study more… In that respect, he feels he can communicate normally, and he has no real concerns about life here…He reckons that, as adults, we shouldn’t interfere with children – that it’s a matter for young people to sort out among themselves – so that’s where we sometimes clash.’ – P3, parent

‘Because this preference for sons over daughters was brought over from China, and my father’s tendency towards domestic violence and aggression is partly linked to his personality; he’s very controlling…His attitude is that he is the head of the family, and whatever he says was law; he believes he is always right, and we have to do exactly as he says.’ – P7, child

‘They [participant’s parents] make you feel as though you cannot go against their wishes; if you do, it would be a sign of disobedience.’ – P5, child

‘Nowadays, many of my friends don’t interfere (guan) in their children’s affairs, so I’m gradually learning to do the same. I’m not sure if it’s the right approach, in my view it’s not a good thing. If you don’t keep an eye on children, you have no idea what they get up to outside; you’re completely in the dark. And when something does happen – if something really does go wrong – they’ll ask, ‘Did you ever guide/look out for (guan) me?’’- P3, parent

Interviewer: What are some other topics that you would say you disagree with your parents significantly? ‘Um I’d say like my mum who believes that mental illness doesn’t exist…She pulled me aside and says, “You know your dad – he’s on antidepressants (whispering).” And I’m like, “Oh good for him.” And she’s like, “That’s so bad.” And I’m like, “Oh, I see. Why?” And she’s like, “You don’t need medicine, you can just push through it.”’ – P1, child

‘After I fell ill, both my parents and his parents… said I wanted too much, that I’d worn myself out to the point of illness… They’d also say I was a burden on everyone and causing them all worry, because I’d fallen ill as a result of doing all these things… Even when I went to see a psychologist, they just thought I was making a mountain out of a molehill, that I was just idle…rather than seeing me as someone who actually needs professional help to work through my issues or anything like that… Once I showed them the doctor’s certificate from the hospital and explained my condition, but they dismissed it as a hoax. They said no one in their generation had ever suffered from such things — that nobody had ever had any mental health issues.’ – P4, child

Interviewer: These conflicts with your parents, how have they affected your mental health? ‘Yeah, all that definitely did make the depression worse for sure. I don’t think they helped at all in any way…I think even just having to think about, gosh do I tell my parents, how do I tell them, how do I tell them that? And that was quite stressful, having to explain why I’m going to the doctors today.’ – P2, child

‘Yes, my bipolar disorder actually stemmed from my family life; my emotions had never been allowed to be expressed since childhood. It was actually like a balloon – it just kept getting bigger and bigger, but that argument was like a knife, and it suddenly bursted.’ – P7, child

Interviewer: So how do you think these conflicts have affected your mental health? ‘They’ve certainly had a significant impact. I Think family members can have greater and deeper influences on your emotions, and it’s a process over a long period of time…I’ve been feeling rather down for a while now. I just can’t seem to feel happy.’ – P5, child

Intervierwer: Who do you tend to clash with most at home? ‘Everyone, really. It’s because I suffered a head injury, which is what was causing these symptoms. But I’m much better now, and I have the utmost respect for my mum.’ – P9, child

‘In addition, there’s my own depression, which may be related to…sometimes I… last time I yelled at him a few times, a few times…… About two or 3 months ago, before my medication was increased, I felt I was having a lot of arguments with my child; I was having a lot of arguments.’ – P6, parent

Family cultural factors associated with conflicts

Interviewer: Could you give me a rough idea of what your relationship with your parents was like during your formative years? ‘I was always in my room with the door shut, reading comic books and building up a huge collection of them.’ Interviewer: So you didn’t really talk to your parents much? ‘But I did have friends at school, and we’d play video games together or play table tennis.’ – P9, child

‘I didn’t really talk to them [participant’s parents] so they didn’t really know what I was thinking.’ Interviewer: …your dad did a regular job, was he home for dinner most days? ‘Ah no… he hired a person to cook…My mum socialised a lot, like meet friends…I spent a lot of time by myself.’ Interviewer: would you say your parents were trying to look after your emotional and psychological needs as you were growing up? ‘I can’t get anything good… like any emotional comfort from them, yeah.’ – P10, child

‘They [participant’s parents] didn’t really pay much attention to me anyway – but whenever there is any communication, it’s basically always criticism or disagreement with me.’ – P5, child

‘My mum give me a lot of anxiety and my dad sometimes give me anxiety too.’ Interviewer: why did they make you feel anxious? ‘Because I’m not good enough so I was depressed…She wants everything to be perfect but I’m not perfect.’ – P8, child

Interviewer: Do you feel that your parents were sort of were sensitive to your emotional, psychological kind of needs or wants? ‘Oh no. No. I think they’re definitely on that mindset of like doing so like how productive you are is the way to go because they’re both very hard workers and like so even if you are feeling not the best mentally, how come you just can’t do it? Something like that.’ – P1, child

‘In the past, when Chinese people talked about bringing up children, they used to say that “spare the rod, spoil the child” — strict discipline was the norm. But now, since I’ve been here, I’ve noticed that when I go out and observe Westerners with their children, they get on very well. Sometimes it seems they focus more on encouraging their children… They prioritise their children’s happiness; they let them be happy, to grow up happy and content, without fussing over them too much…Whereas a Chinese person might be quite strict, wouldn’t they? They try to subdue the child, don’t they? “You must do as I say.” And if the child cries, “No, that won’t do,” they’ll just shout loudly and point at them. I really think the Chinese mindset needs to change.’ – P6, parent

‘My children are actually perfectly capable of feeding themselves and getting dressed, but the moment they [participant’s parents] arrive, it’s as if they’ve all suddenly become disabled; I feel as though they can’t do a thing, and even need to be fed water. I try my best not to let them help look after them.’ – P4, child

‘Year 5 was my first year here [New Zealand] in primary school. And I was bullied quite a lot when I first came here to do Year 5, I didn’t speak a single word of English, so school was quite difficult.’ – P2, child

‘There are actually still some people who aren’t very friendly towards Chinese people… The sort who walks past you and just start swearing at you.’ – P4, child

‘The bitter reality for everyone is that, of course, it’s quite exhausting. After all, as a Chinese person, you’re just an ordinary employee, a regular worker – you don’t have the money to buy a house. Even though you’ve secured residency, you can’t see a future, and you just don’t know when you’ll finally break down.’ – P6, parent

‘When we first immigrated, we faced all sorts of difficulties, for instance, when we arrived, we couldn’t speak the language. Dad relied entirely on his connections; he’d pay agents to advise him, or attend immigration seminars or consult solicitors. They’ve [participant’s children] probably never really experienced the difficulties of getting things done themselves. To put it bluntly, even with my children’s daily lives, I’ve handled everything myself; they’ve never been involved.’ – P3, parent

‘I think it’s like…its kind of complicated because you’re surrounded by a New Zealand mindset but your parents and family are, especially the older generation, such as my parents and all that.’ – P1, child

‘They’ve [participant’s parents] grown up in obviously in Chinese culture but even when they have come to New Zealand, they’re still, they haven’t really integrated into New Zealand culture. All their friends are still Chinese. They go to Chinese events. And yeah, that would have been very different to me who, you know, I came here to a public school in New Zealand, all my friends were obviously not many of them were could speak Chinese, you know. Um so that’s what caused that big cultural gap.’ – P2, child

‘It’s just that Chinese parents’ love is perhaps a bit different from what you find here. They tend to be willing to sacrifice themselves, yes, and then come to help you… As parents, they might feel they have to take care of everything for you, and they’re not keen on spending extra money. For example, if we want to go out for a meal, they’ll say it’s a waste of money; they’ll say, “We’ll just cook at home.”… Then, after all this builds up over a long time, something might happen that makes them snap, and they’ll say to you: “We’ve sacrificed our own time, our own happiness, and our retirement to help you, yet this is how you treat us.”’ – P4, child

‘They [participant’s parents] tend to focus more on what they’ve done for me and their own views… Although Chinese parents may not have an emotional connection with their children, financially speaking, they generally do support them. They might use this as a means of coercion – or, how shall I put it? — they might use family ties to pressure you.’ – P5, child

‘I think that for our generation – since I was born in the 1980s – the issues we face with our parents are perhaps a bit more pronounced. This is because their generation lived through the Cultural Revolution in China. Relatively speaking, they may have had fewer resources at their disposal.’ – P5, child

Navigating intergenerational conflicts and building resilience amid mental illness

‘I’ve tried to talk things through, but at first I’d make an effort and he’d [participant’s son] respond with a word or two. Later on, though, it seemed as though he wasn’t taking it on board at all; he just did whatever he wanted. To put it bluntly, he feels that we’re too long-winded these days.’ – P3, parent

‘I used to try to explain things to them, to make sure they understood, but it seemed I couldn’t get the message across, and it just made things worse, so I decided not to say anything.’ – P4, child

‘I talked to him [participant’s father] many times, and when I talked to him every day, he wouldn’t give in. It is only after the psychiatric team here intervened that it was effective. …[they] provided a respite at that time and I am very grateful to them…because there may be one more channel…there a kind of buffer that [name of psychiatric service] can act as.’ – P10, child

‘My eldest uncle, he cared about me. Yes, it was mainly my uncle who was talking to him. What my uncle was able to do is talk to my dad, that is, talk about my situation and help me. That’s right.’ – P10, child

‘When I was in China, I used to get away to my relatives’ houses — for example, I’d go and stay with my aunt or my other aunt for 2 or 3 days…' – P7, child

‘I think my GP was very helpful…She helped me a lot in that sense to get the right medications…I think the thing that has helped the most is many of my friends have offered a place to stay temporarily or just to hang out with me to give me a reason to leave the house. I think a lot of that was very, very helpful.’ – P2, child

‘I think we still need to focus on Chinese education, because you’re ultimately dealing with Chinese people – your parents are Chinese, your children are Chinese. Yes, you can’t change thousands of years of culture. If you approach it this way, there will likely be fewer family conflicts.’ – P6, parent

‘He [participant’s father] has money, so a lot of things are not needed…he supported me to study…and then the third is that he actually has a lot of wisdom in life, so you can, for example, what you should do and what you shouldn’t do, you can also learn.’ – P10, child

‘I feel that when they’re here, they just give me – I don’t know – emotional support. At the very least, it feels as though my whole family is here, so I feel really confident… Even though I feel quite under pressure when they’re here, I can still sense that there are people supporting me.’ – P4, child

‘I can’t say I can completely forgive them [participant’s parents]. But at least I can learn to let go of the things from my childhood – how they treated me badly… There is a saying in the Bible: ‘Forget what lies behind and strain towards what lies ahead, running towards the goal.’…At least since I’ve found my faith, I’ve been able to let go. Before, I couldn’t let go; I had a grudge, always feeling they owed me a great deal…’ – P7, child

‘I know that my mum has helped me a great deal. She brings me food, coffee and clothes, and provides things like the television. And it is God who provided these things to me through her. So I must remember to show filial piety to her, yes, to love her.’ – P9, child

‘It is because of their experiences and the historical context of the time that our current relationship has developed as it has…However, that is all in the past, and I believe that only if everyone recognises this and works together, then we can possibly bring about change. The problem I face now, though, is that I am unable to make the people around me aware of this issue, or persuade them to work together to address it.’ – P5, child

‘They [participant’s parents] have their own mindset so it’s about being able to like understand two points of view. And trying to be like not leaning to one side or the other.’ – P1, child

‘I did have a bit of a row with him about this at the time, but I eventually came to terms with it and realised that as long as the children are happy…there’s nothing we can do about it. It’s just like when he was preparing for university: I suggested engineering would be a good choice, and he agreed to study it, but it turned out he just couldn’t cope…When I think about it now, I suppose we parents might bear some of the blame, because we didn’t take the child’s feelings into account.’ – P3, parent

‘You have to change yourself—just like us Chinese people who’ve come out here; we’re actually changing ourselves… Children are growing up, so you have to… even though you need to educate them, you have to change your approach to parenting.’ – P6, parent

Theme 1: Types of IGCs and perceived associations with mental illness

IGCs were most commonly attributed to clashes over a variety of topics and values, including filial piety (孝顺), patriarchy, paternalism, educational/occupational achievements, accommodation, marriage/childbearing, friendships, parenting of the third generation, substance use, and gender identity. Indeed, there was a common perception that parents sought to impose their own values globally over a child’s life choices under the guise of benign paternalism. While parent-generation participants expressed helpful intentions to guide/supervise (管, guan) their children’s behaviours, child-generation participants sometimes interpreted these as interferences that were poorly suited to their own circumstances. These differing interpretations were frequently associated with experiences of conflict and psychological stress.

Some participants described IGCs arising from mismatched mental health-related beliefs. They recounted experiences in which parents appeared to dismiss medical explanations for distress or questioned the need for treatment. One participant described feeling blamed by her parents for her illness and for causing family disharmony as a result, moralised through traditional gender norms. Another participant described experiencing stigma and emotional distancing from parents following a diagnosis of schizophrenia.

Several participants perceived relationships between particular personality traits of family members and conflict frequency and intensity. Regardless of how those arose, participants generally endorsed negative impacts of these conflicts on their psychological wellbeing and mental illnesses. Conversely, some participants reflected that symptoms of mental illness had shaped their behaviours and interactions in ways that intensified family conflicts.

Theme 2: Family cultural factors associated with conflicts

Most child-generation participants described family cultures where parents appeared to lack interest, capacity, or skills to respond to their emotional needs since childhood. Participants frequently associated this perceived lack of emotional understanding and support, along with high parental criticality, with detrimental effects on their mental wellbeing. Multiple participants commented on the continuing sense of emotional distance between themselves and their parents/children. Conversely, two participants associated parental emotional overinvolvement with psychological stress, one in relation to herself and the other in relation to her own children.

Participants, particularly those from the parent-generation, made links between cultural stress factors arising through migration and increased IGCs. These ranged from economic hardship, unemployment, to language barriers and discrimination, leading to downward social drift, that is, downward movement in socioeconomic position. Participants linked these experiences to psychological distress and described how unacknowledged parental sacrifices and aspirations for children could result in intergeneration friction. The acculturation gap as a cultural stressor was commonly discussed by participants as an important contextual factor for both IGCs and mental distress. These were underpinned by divergent values, beliefs and behavioural choices between generations that created misunderstandings and disagreements. Some participants interpreted these differences as reflecting broader generational differences in social environments and experiences, rather than migration alone.

Theme 3: Navigating IGCs and building resilience amid mental illness

While some participants found open communication with their family members helpful, a majority described difficulties in resolving conflicts through direction communication, which often instead led to withdrawal, avoidance and further emotional suppression. Multiple participants cited intervention and support from others, including spouses, relatives, and mental health professionals as beneficial. Other helpful factors were maintaining resilience while navigating conflicts, psychotropic medications, individual psychotherapy, creative art, and support from friends. While professional supports were mostly positively received, one participant noted limited therapeutic resonance with psychotherapy due to their perceived mismatch between Western therapy models emphasising individual autonomy and their own Chinese family’s value system.

When reflecting on possibilities for intergenerational reconciliation, participants from both generations acknowledged the need for and endorsed observed efforts in mutual understanding and self-reflection, which included children learning about and respecting aspects of Chinese culture, and parents appreciating and adopting aspects of Western-style parenting. Some participants wanted to spend more time together as a family. Several participants positive aspects of the intergenerational relationship, particularly caring supports. Four participants highlighted religious faith as important for individual emotional healing and intergenerational reconciliation. Others described difficulties translating intentions for reconciliation into effective practical actions, due to lack of knowledge and skills, and reported difficulties in locating resources to help them resolve IGCs.

Discussion

This exploratory study sought to understand immigrant Chinese mental health service users’ experiences of IGCs. Participants’ narratives identified salient recurring themes and lent insights into meanings attached to distress, interpretations of family dynamics and stressors, and reflections on coping, resilience, and reconciliation. These findings can be understood as context-bound accounts constructed within the intersecting clinical, cultural, relational, and personal circumstances of this sample; rather than implying representation of Chinese parenting or intergenerational family relationships more broadly.

Our findings align with previous research suggesting bidirectional associations between family conflicts and mental distress. This literature indicates that mental illness can predispose family systems to stress and intrafamilial conflicts, ²¹ as emotions are suppressed and communication difficulties maintained. ²² Conversely, IGCs, linked to high expressed emotion ²³ and unmet filial expectations, ²⁴ are associated with increased psychological symptoms and distress.

Stigmatised attitudes towards mental illness are still held by many Chinese people.^25,26 When such attitudes are expressed by family members, can create perceptions of being blamed, criticised, or emotionally unsupported during periods of psychological difficulty. Conflicts in cultural values including patriarchal preferences and filial piety noted by the study participants have been reported in other research. ²⁷

Traditional Chinese culture emphasises parents’ role in guiding and regulating children’s behaviours to enable children to succeed academically and socially.^28,29 Within cultural concepts of parenting such as ‘guan’ (管, guidance/discipline), parental control and criticism can function as care – aimed at improvement rather than rejection, with parental authority used to protect the child’s best interests. ²⁸ Love and warmth may be conveyed instrumentally rather than verbally, through investing in education and providing practical support. ³⁰ When experienced within the broader socio-cultural context of the host country however, children can experience such practices as pressure to achieve, emotionally distant or overinvolved, censorious, and authoritarian, ³¹ and associated with psychological distress. ²⁹

Consistent with cultural stress theory, participants frequently endorsed the presence of cultural stresses, including the acculturation gap, as important contexts within which IGCs were experienced. Migration brings challenges including discrimination, financial strain, and loss of social networks. ³² These difficulties may contribute to economic precarity or downward social mobility experience by parent-generation participants. This may further elevate implicit pressure on children to succeed ²⁹ and to reciprocate parental sacrifice through filial obligations. Other cultural stressors, such as a need to work long hours or bicultural identity tensions, may render parents emotionally less available or overprotective, while sensitising children to perceived parental criticism. ³

In adaptively responding to IGCs, many participants’ described conflict avoidance as their default strategy. This can reduce short-term tension but increase risks of further emotional distancing ²¹ in family systems already strained by poor communication and trust; for some, the associated emotional suppression can lead to mental distress. ³³

Conversely, mutual perspective-taking and behavioural changes effected by both generations have been reported to foster intergenerational understanding.^12,34 The concept of biculturalism, that is, the integration of knowledge, behaviours, and identity from both heritage and host cultures, ³⁵ can be gainfully embraced by both generations. Specifically, children could balance desire for autonomy with respect for filial piety ³⁶ and engage with Chinese cultural customs and knowledge^15,37; while parents might espouse more emotionally attuned communication styles ³⁸ and allow for greater autonomy of children according to their developmental stage.^12,16 Participants’ narratives support the argument for parenting styles within immigrant Chinese families to combine strong limit setting and high expectations with both emotional and practical supports, for pursuits aligned with a child’s strengths and own aspirations.

Professionals and family members with authority may serve positive functions in alleviating IGCs, given an inclination to defer to authority in Chinese culture. ³⁹ Informal family and community supports may be particularly useful for immigrant Chinese where cultural stigma could limit helping-seeking from mental health services, ⁴⁰

Taken together, participants’ narratives suggest that filial piety, guan, and related beliefs and practices regulating parent–child relationships form part of the meaning-making framework through which IGCs, in relation to mental wellbeing, were individually interpreted and understood. Such frameworks are also created through other psychological and social determinants of mental health at the structural, relational and individual levels, ⁴¹ for example, minority stress, socioeconomic constraints, personality factors, and spiritual beliefs. Effective support for conflict reduction in these families means intervenes on multiple factors. Our findings suggest the potential value of approaches that create opportunities for family members to discuss important matters in an emotionally contained and safe setting. Topics of interest include host-vs-heritage and generational cultural gaps; individual circumstances, experiences and meaning-making; and, the impact on differing assumptions, experiences and interpretations of shared event.

Considerations for practice

This study revealed associations between cultural stressors, intergenerational conflicts, and experiences of mental illnesses in immigrant Chinese-New Zealanders utilising mental health services. Current psychiatric interventions for adults are typically individual-focused, overlooking the family system’s role in illness and recovery. Community-based education to reduce cultural stigma and family-based interventions that target the nexus of culture values, health beliefs, and communication patterns may be valuable. International educational programs enhancing bicultural awareness, emotional attunement, and communication^30,42 have shown benefits in improving parent–child relationships. Alleviating cultural stressors experienced by patients and family members is also relevant.

In other studies, problem-solving ¹⁶ and peer support^26,40 in relation to IGCs have achieved improved psychological outcomes. Peer-led support groups, facilitated by local Asian mental health teams or non-governmental organisations such as Asian Family Services, could foster shared learning and growth within each generation. In the context of New Zealand’s growing Asian population, enhanced government investment in family-inclusive mental health services could improve outcomes for Chinese immigrants experiencing mental illness and family conflicts.

Strengths and limitations

This exploratory study involved a purposive sample of immigrant Chinese mental health service users, an underrepresented cultural group in mental health research in Australasia. The use of an interpretive description methodology ¹⁸ through a dual clinician–researcher lens, by researchers of Chinese cultural backgrounds, fostered rapport and open communication with participants during data collection and enriched the analysis through strong reflexive engagement. Consistent with this methodological framework, information power, that is, that data collected provides relevant and rich information to support practice-useful interpretations, rather than data saturation, is a key concept in determining data adequacy. ⁴³ Thus, despite the modest sample size, results provided novel and meaningful insights which are of high clinical relevance for this population, notably with respect to meaning-making of family dynamics and conflicts, as well as experiences in seeking conflict resolution and mental resilience, supporting the information power of this study in relation to its aims.

Our study, however, have inherent limitations of the sampling method ⁴⁴ and in the transferability of findings, particularly to Chinese immigrants not presenting to health professionals. The paucity of self-referred participation may reflect persisting stigmatised attitudes towards help-seeking for mental illness, ⁴⁵ desire to keep family conflicts private, ¹³ and to avoid controversial discussion, as seen in the phenomenon of courtesy bias, ⁴⁶ all issues that need addressing to improve service engagement and outcomes for all immigrant Chinese with mental illnesses. Participants’ accounts represent context-bound understandings of Chinese family relationships in specific clinical settings, cannot be generalised to Chinese culture or families generally, especially in considering intersecting factors such as family roles and socioeconomic positions.

The research team’s Chinese cultural background served as a resource for interpretation of data, for example, with implied meanings of expressions used and identification of clinically salient narratives. Nevertheless, there was a risk of cultural assumptions being taken for granted, and this was addressed through reflexive discussions where data was reviewed to confirm interpretations.

Directions of future research

We suggest future research to explore second-generation migrants’ perspectives of acculturative/bicultural stress and mental illness, who have a higher mental illness burden than first generation migrants. ⁴⁷ Perspectives of family members on family conflicts and supporting a family member with mental illness would also be invaluable. It may be useful to compare IGCs with host and other migrant groups, which was beyond the scope of this study, to gain additional insights on their culture-specific dimensions.

Conclusion

Narratives from this clinical sample of immigrant Chinese-New Zealand mental health service users, best understood within each participant’s specific clinical, cultural, migration, and relational contexts, suggested perceived interconnection and mutual influence between mental illness and intergenerational conflicts. Participants also described parenting practices characterised by guidance, high expectations, and a stronger emphasis on achievement than emotional expression, that within the context of cultural stressors, are experienced as authoritarian, controlling, or critical, and associated with feelings of limited parental support, heightened parent–child tensions, and emotional distress for both generations. Participants identified a range of resources that support resilience and intergenerational reconciliation, including biculturalism, religious faith, social support, and assistance from trusted others, including professionals. Culturally responsive, family-oriented interventions may help support bicultural adaptation, mutual understanding, and constructive communication across generations.