Background: Literature about experiences of mental illness among ethnic minority has tended to focus on first-generation migrants. This study fills that gap by exploring experiences among highly acculturated Chinese-American patients with mental illness.

Materials: Twenty-nine participants completed semi-structured interviews based on Kleinman’s explanatory model, which were audio-taped, transcribed and coded for qualitative analysis.

Discussion: Beliefs about the causes of mental illness included biological factors, head trauma and personal losses. Issues relating to stigma and shame were also discussed.

Conclusion: Highly acculturated ethnic minority patients may ascribe to a biomedical model at the same time as ascribing to culture-specific beliefs.