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Mental Health in Asian Pacific American Communities

Cardinal Innovations Healthcare — July 22, 2020 — 5 min read
Asian Americans and Pacific Islanders are often a demographic left out of discussions about mental health disparities. However, plenty of national data shows that there are mental health disparities between Asian Americans and Pacific Islanders and non-Hispanic white people.

In the United States, over 2.7 million Asian Americans or Pacific Islanders (AA/PIs) have a mental illness or substance use disorder (SUD).

In 2017, suicide was the leading cause of death for Asian American youth (ages 15 to 24).
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Compared to all other ethnic groups, AA/PIs are the least likely to receive or seek mental health services; specifically, they are three times less likely to access mental health services than their white peers.

Factors in Asian Pacific American Mental Health

Environmental
Like every ethnic minority, Asian Pacific Americans have a unique set of challenges that they face when it comes to accessing and receiving quality mental health care.

One in every two Asian Americans who meet the criteria for a mental illness will not seek mental health help due to a language barrier.

According to the National Asian Pacific American Families Against Substance Abuse, 70 percent of Southeast Asian refugees receiving mental health treatment were diagnosed with post-traumatic stress disorder (PTSD). This could be in part due to the political unrest or oppressive governments that exist in certain Southeast Asian countries.

Cultural
Asian and Pacific Island cultures are widely diverse, though many share some similarities when it comes to mental health.

Because many first-generation immigrants experienced trauma when fleeing an oppressive regime or when adjusting to their new life in America, their children and grandchildren “often feel guilty about sharing their mental health struggles,” according to research conducted by the Urban Institute. They may believe their mental health challenges are small compared to their parents’ struggles.

The Model Minority Myth and Its Impact on Asian Pacific Mental Health

There is also the myth of the “model minority” (that one ethnic minority is perceived to be higher achieving and more polite than other minorities). This stereotype used against Asian Pacific Americans may seem complimentary, but it is, in fact, very damaging. As Sarah-Soonling Blackburn explains in this article, “The model minority myth says Asian Americans are doing well today and must therefore have benefitted from an elevated status among people of color, in spite of centuries of systematic discrimination.”

The model minority myth can also strain second- and third-generation Asian Pacific children and teens. They are pressured to live up to the stereotypes and unfair high expectations. The inability to achieve those model minority goals can have a big impact on their mental health.

Furthermore, the model minority myth makes Asian Pacific Americans seem “better off” than other minorities. This leads to less research, less funding, and less attention paid to Asian Pacific mental health barriers and disparities.

Disparities in Asian Pacific Mental Health Care

The disparities in mental health care for Asian Pacific Americans are different than those for Black or Hispanic Americans.

Many medical professionals aren’t trained for cultural competency when it comes to the very diverse Asian Pacific populations. They often see their Asian Pacific patients as having one culture rather than hundreds of unique cultures.

As mentioned before, there is often a language barrier that Asian Pacific Americans face. Unlike Hispanic and Latino Americans who speak mainly Spanish and Portuguese, Asian Pacific American immigrants come from an area in which more than 16 languages are widely spoken. This means that some Asian Pacific Americans might require an interpreter that just isn’t as widely available as a Spanish one.

The Lack of Asian Pacific Mental Health Care Professionals

Only four percent of the members of the American Psychological Association identify as Asian. This means there is a shortage of Asian, and surely Pacific Islander, American psychologists and therapists available for Asian Pacific patients. While some white medical professionals may receive cultural competency training, they cannot completely understand the cultural subtleties of the diverse Asian Pacific populations. This could lead to many white therapists using microaggressions* and turning their Asian Pacific patients from therapy for good.

*A microaggression is a brief and common daily verbal, behavioral, and environmental communication, whether intentional or unintentional, that transmits hostile, derogatory, or negative messages to a target person because they belong to a stigmatized group. For example, if a therapist said, “I don’t see you as Asian. I just see you as a regular person,” that’s a microaggression.

What Needs to Be Done to Support Asian Mental Health?

We must start talking about mental illness to help not only our Asian Pacific communities, but all communities. Ending the stigma surrounding mental health will have a huge impact on how many people come forward to get help.

It’s important to avoid “model minority” stereotyping when working with Asian Americans. This can put unrealistic expectations on the person being treated.

The U.S. needs more Asian Pacific American mental health professionals, but anyone can start by seeking cultural competency training. The Pacific Islands and the continent of Asia constitute a diverse region, full of vastly different cultures, languages, and ideals. Educate yourself about the potential cultural differences of the people you treat.

Language barriers must be torn down—whether that’s from employing more translators/interpreters or from therapists giving their patients a little more time to express themselves in English (if English is their second language).

Psychiatrist Geetha Jayaram also suggests the “incorporation of traditional interventions. When appropriate—culturally and individually—consider traditional practices, as a supplemental treatment. This includes, if indicated, diets, exercises, and other traditional methods used to reduce stress and increase relaxation, such as Yoga, Tai-Chi, breathing exercises, etc.”

The American Psychiatric Association offers these suggestions:
  • Allow enough time for interviews and be patient. Some Asian American members may not feel comfortable sharing intimate, personal information with outsiders.
  • Promote educational resources about mental health in English and Asian languages to help reduce stigma.
  • Ask about traditional beliefs and how they influence an individual's expression of mental distress; and ask about preferred treatment methods.
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