Recruitment Process

Although there are no specific guidelines as to how many participants are needed in order to complete one study, qualitative researchers have recommended using a sample size ranging from as few as 6 participants to as many as 30 for a grounded theory study (Creswell, 1998). Mental health is a heavily stigmatised subject in the Chinese community (as previously mentioned in Chapter 2) and as such the recruitment process for research participants was particularly challenging. Participants were recruited through advertising flyers placed both at City University and Chinese community mental health charities, through social media (Facebook, Weibo) and through six weekly advertisements in a national Chinese newspaper. Through these approaches a total of 12 participants were recruited for the study. The study examines the cultural perspectives on mental health beliefs and treatment expectations within the Chinese immigrant community in the United Kingdom so I determined that all participants for this study needed to be first generation immigrants. Previous research suggests that cultural perspectives are more pervasive with first generation immigrants who were not born in the host country when compared to the second generation of immigrants (Kruzykowski, 2011; Gordon, 1964). Regardless of gender, all participants had to be over 18 years old and have experience of using mental health services in the United Kingdom. In 2011, the Department of Health released a policy paper for the new government (Department of Health, 2011) about a mental health strategy for England. It aimed to help more people with mental health problems while promoting public understanding of mental health and reducing stigma and discrimination. It was hoped that this new strategy would decrease negative attitudes and behaviours towards people with mental health problems (Lawton-Smith & McCulloch, 2015). For the study to be updated and relevant to the current mental health service climate, the participants had to have received their treatment within the previous five years.

Geographically speaking, 10 participants were from London and 2 participants were from outside London. The geographical distribution coincided with the Census (ONS,

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2001) report that London is the home for the majority of Chinese immigrants in the United Kingdom, with one in three Chinese immigrants living in London. Eight female participants and four male participants were recruited. The gender difference in the study was consistent with findings in other studies, which suggest that women are more emotionally expressive (and hence more willing to share personal experiences) than men (Hall, Carter, & Horgan, 2000; see also LaFrance & Banaji, 1992; Niedenthal, Kruth-Gruber, & Ric, 2006). Other research also suggests that gender influences the response rate, with a higher rate of females participating in studies (Smith, 2008; Cull, O'Connor, Sharp, & Tang, 2005). In addition, the practice of emotional restraint is a key feature of Chinese culture (Kleinman, 1986). This is particularly true for Chinese men, where showing their emotions can be seen as a sign of weakness and can even bring shame to their family (Sue, 1994; Sundararajan & Averill, 2007). The gender sample difference in participants is acknowledged during the analysis process in Chapter 4.

A total of five participants were recruited through advertisements placed in the most widely circulated Chinese (language) newspaper in the United Kingdom, U.K. Chinese Times (See Appendix 1). In addition, three participants were recruited through social media, specifically a widely-used Chinese version of Twitter (Weibo). One participant was recruited through my personal network and three participants were recruited through advertising flyers. The average age of the participants was 32, with 5 participants born in the 1980s, 3 participants born in the 1990s, form the majority of the participants group. Given the previous discussion on the changing Chinese cultural context, in particular the generation subculture, it is possible that because of the increased level of self-awareness associated with an individualistic thinking framework (Shuai, Mi, & Zou, 2015), the participants from these two generations were more likely to take part in a study on mental health beliefs and treatment expectation. Table 1 contains a breakdown of the demographic information for all the participants. The average years of immigration for the participants was 9 years, with 15 years being the longest immigration time to the UK and 5 years being the shortest immigrant period for the participants. Given the different length of immigration among the participants, it was possible that their level of “acculturation” (Berry, 1998, 2003, 2008; Noh & Kaspar, 2003) would be different, hence my decision to give participants the choice for the interviews to be conducted in either English or Mandarin Chinese to minimise any potential inaccuracies caused by limitations of vocabulary or expression in either

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language. Language can be a barrier to allowing participants to clearly express their experiences (Squires, 2008; Lee, Sulaiman-Hill, & Thompson, 2014). Conducting interviews in the preferred language of the participant was one way of overcoming that

barrier and meeting their cultural needs. It also showed respect for the participant’s

cultural preference (Ponterotto et al., 2009). Pragmatically speaking, this choice also allowed me to include participants from a wider range of social backgrounds, as it provided less restriction on the levels of education and social integration into the United Kingdom to ensure that the study covered as wide a selection of first generation Chinese immigrants as possible. Amongst the 12 participants, 11 chose to be interviewed in Mandarin Chinese, with one interview conducted in English. All the interviews were recorded and transcribed verbatim, and then translated into English (11 in total) for the final presentation by the researcher. As a bilingual researcher, I combined the functions

of both researcher and translator. All participants’ details were kept confidential during

this process. Table 1 contains a breakdown of the demographic information for all the participants.

Table 1: Breakdown of the Demographic Information

Gender Pseudonym Age

(in years) Year of immigration Year of accessing mental health service

Participant 1 Female Rose 27 2010 2011 & 2012

Participant 2 Male Stone 33 2006 2014

Participant 3 Female Lily 28 2009 2012

Participant 4 Female April 24 2008 2013 & 2015

Participant 5 Female May 24 2011 2013

Participant 6 Female June 47 2003 2014

Participant 7 Male Wood 28 2008 2014

Participant 8 Male Max 38 2004 2014

Participant 9 Female August 37 2001 2010

Participant 10 Female Poppy 47 2003 2014

Participant 11 Male Jay 28 2004 2015

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