Mental health and unmet needs for mental health care in Asian Americans

Updated on Feb 5, 2020; Author: Yuka 

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I stepped into my first therapy group at my university when I was in my early twenties. As expected, I was the only Asian, let alone a foreigner. Nobody else had a similar set of struggles that came with immigrant status and cultural-linguistic barriers like I did. I kept secret that I was seeing a counselor from my family as seeing a counselor was recognized as a symbol of weakness in my culture. My counselor was very supportive and well-intentioned; however, I could not see their advice as helpful as if It were coming from somebody in my community.

This personal story is not a unique experience of Asian immigrants. Mental health needs are ever growing among Asian Americans and Pacific Islander (AAPI) communities in recent years. Over 19 million people in the United States identify as Asian -American or Pacific Islander today, and of that population, more than 13% were diagnosed with a mental illness in 20181. Asian-Americans report fewer mental health conditions than their white counterparts. Yet, they are more likely to consider and attempt suicide. In fact, suicide was the leading cause of death for Asian Americans, ages 15 to 24 in 20182. This high suicide rate is ascribable to numbers of various barriers to this population seeking help from mental health professionals, including language barriers, stigma, insurance coverage, cultural belief, and lack of awareness of resources and mental health services. There is an underlying fear among APPIs that getting mental health treatment means you are “crazy”, “weak”, and “shameful”. If young AAPIs admit they need mental health support, it is highly likely that their parents and other family members might experience fear and shame rather than worrying about their children. They may blame themselves for their poor parenting or a hereditary flaw that led to a “broken” child. Seeking help from those outside their immediate family also conflicts with the Asian and Pacific Islander cultural value of interdependence.

The need to create new language and spaces to address Asian-American mental health is especially urgent on college campuses and school. We need to raise more awareness and encourage the AAPI community, especially young people, to ask for help and prioritize mental health. Eliminating stigma is critical and sadly we don’t have the right legislation in Illinois that officially requires mental health education and awareness in schools like ones in Virginia and New York. Until such legislation is passed, it is up to us individuals to break down stigma within our circles of friends and family. On the provider side, more mental health professionals today need to be trained in cultural competency. Only with cultural humility and understanding, can professionals finally discuss mental health in the context of the daily experiences of cultural minority groups and help them get through their mental health tunnels.

Where do we start? What can we do about it? The stigma associated with mental illness is so deeply entrenched in AAPIs culture; it’s just unrealistic to think people can change their minds overnight. But there is no doubt that this pressure to hide our problems away has dangerous consequences on individual’s wellbeing. The silent shame is killing uncountable numbers of voiceless people. If we want to see change, it needs to come from everywhere both big and small. I therefore urge everybody to open up and discuss their emotions, vulnerable feelings and mental health with their friends and family more often. Additionally, looking for a therapist who can understand your cultural values, and preferably

speak your native language could ease the discomfort of being in therapy for the first time. Do not be discouraged. By continuing to share our experiences, we can give each other strength to come out of “hiding” in the dark tunnel.

1 SAMHSA (2019) Results from the 2018 National Survey on Drug Use and Health: Mental Health Detailed Tables 2 Mental Health America (2019), Infographic: Minority Mental Health

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