Why do we care about mental health? Why do we care about Asian American mental health specifically?
Asian Americans continue to be the fastest growing group in the US. Despite their increasing presence, consider the following mental health facts (Abe-Kim et al., 2007; Alba et al., 2009; Yang et al., 2020):
Low mental health care usage compared to Whites. Overall prevalence of mental illness in Asian and White populations is comparable. Yet according to a 2019 study, 78% of Asian Americans with serious psychological distress (SPD) and 73% of Asian Americans who experienced a major depressive episode (MDE) within the past year did not seek out mental heath treatment during that time, compared to 51% and 42% of Whites in those respective categories.
Low mental health care usage compared to the general population. Asian Americans exhibit significantly lower rates of mental health care usage (9%) compared to the general US population.
Lack of representation in research. Asian Americans are underrepresented in mental health clinical research. Studies that do focus on Asian Americans often use treated populations in healthcare settings or other convenience samples.
Immigration-related help-seeking patterns. Asian Americans born in the US are more likely to seek mental health services compared to Asian immigrants.
Barriers to mental health care consist of many layers. A lack of education, limited awareness of services, and variable perceived need may be present at the individual level. The individual may also be experiencing low income, lack of health insurance, or other financial obstacles (Tung, 2011). At the interpersonal level, stigma surrounding mental health (as opposed to physical health) may prevent honest self-disclosure and help-seeking behaviors. Alba et al. (2009) argue that given this general stigma, Asian Americans may experience their psychological illnesses manifest physically in a form that is more societally acceptable (e.g., headaches, fevers, chest pain). This somatization of mental illness may pose additional barriers to receiving appropriate treatment. Finally, the presence of certain cultural values and beliefs may also present a barrier. For example, the belief that family is an extension of the self, coupled with interpretation of mental illness as failure, may result in fear of bringing shame on the family and therefore decreased chances of seeking help.
Systemically, racism and discrimination harm Asian American mental health and are consistently linked to adverse psychological and physical outcomes including substance abuse, depression, body image concerns, self-esteem, PTSD, and heart and respiratory disease (Alba et al., 2009).
These findings point to the reality that Asian Americans are not receiving mental health care support despite the clear ongoing need. In order to address the cultural barriers to accessing Asian American mental health services, we must first understand the nature of the presenting illness and the benefits of receiving treatment. Education, clarification of misconceptions, interprofessional collaboration, and creation of accessible, culturally relevant materials are necessary to better service Asians and Asian Americans.
Acknowledgment
Thank you to Professor Rooshey Hasnain for providing the course content reflected in this post.
Resources
A Mental Wellness Activity Book for Asian Americans. A wellness activity workbook hosted by the Asian American Mental Health Collective.
Asian American Psychological Association. Asian American association of psychologists and other mental health professionals in the San Francisco Bay Area. Hosts the Asian American Journal of Psychology, AAPA Digital History Project, and provides other AA mental health resources including fact sheets and annual reports.
US Therapist Directory provided by the Asian Mental Health Collective. Asian American therapists by region, state, city, zip code.
References
Abe-Kim, J., Takeuchi, D. T., Hong, S., Zane, N., Sue, S., Spencer, M. S., Appel, H., Nicdao, E., & Alegría, M. (2007). Use of Mental Health–Related Services Among Immigrant and US-Born Asian Americans: Results From the National Latino and Asian American Study. American Journal of Public Health, 97(1), 91–98.
Alba, G., Lam, M. & Alvarez, A. (2009). Mental health. Encyclopedia of Asian American Issues Today.
Tung, W. (2011). Cultural barriers to mental health services among Asian Americans. Home Health Care Management Practice.
Yang, K. G., Rodgers, C. R. R., Lee, E., & Lê Cook, B. (2020). Disparities in Mental Health Care Utilization and Perceived Need Among Asian Americans: 2012–2016. Psychiatric Services, 71(1), 21–27.
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