A culture-centered exploration of mental health among predominantly South Asian second-generation immigrant women in the United States

Using a culture-centered approach (CCA), this study examined the mental health experiences of predominantly South Asian second-generation immigrant women in the United States. Specifically, it explored how participants made sense of, negotiated, and navigated mental health within immigrant households in the United States. Drawing on 23 semi-structured, in-depth interviews with women aged 18–43, the study identified two interrelated communication processes: navigating structural conditions and negotiating cultural meanings of mental health, and enacting agency through strategic communicative practices. Findings reveal that participants experienced misalignment between available services and lived needs, shaped by barriers such as cost, representation, and language, as well as by community and family norms that regulate disclosure. At the same time, participants enacted agency through strategic communicative practices, including selective disclosure, peer support, and negotiated family engagement. Across the two communication processes, silence functioned as both a constraint on disclosure and a strategic resource for managing relational risk, while agency was enacted through everyday communicative practices rather than solely through overt resistance. The findings suggest that mental health interventions for immigrant women should move toward co-created, structurally responsive approaches that center lived experience.