Understanding the Hidden Struggles: Asian American Mental Health Barriers
Written by Sophia Hu, reviewed by Dr. Yishan Xu
Asian Americans represent the fastest-growing minority group in the U.S., yet they significantly underutilize mental health services. Despite facing similar mental health challenges as other communities, Asian Americans are less likely to seek professional support. According to recent studies, Asian Americans have the lowest rate of mental health service utilization, which does not correlate with the prevalence of mental illness in this population.
The Impact of Mental Health on Asian Americans
In 2023, the CDC reported higher depression rates among women (24%) compared to men (13.3%). The prevalence of mental illness in Asian Americans was 7.3%, significantly lower than in white Americans (21.9%). Disturbingly, suicide ranks as the leading cause of death among Asian American and Pacific Islander (AAPI) youth, with a 72% increase in male and a staggering 125% increase in female suicide rates between 1999 and 2021.
Cultural Beliefs and Stigma
Asian American adults who immigrate to the U.S. often face pressures but refrain from seeking mental health services due to cultural beliefs. Many fear being labeled as "weak" or “crazy” due to psychological issues, leading to avoidance of professional support. Feelings of shame often outweigh the need for mental health services, fueled by traditional views that regard anxiety and depression as taboo. These stigmas are rooted in Confucian principles, where mental illness is seen as an inability to fulfill familial or societal duties. In tightly-knit family cultures, a person's role is strongly tied to their capacity to care for loved ones. Therefore, a mental health struggle is not just a personal issue but one that is seen as failing one's core responsibilities.
The impact of this cultural stigma results in lower utilization of mental health services among Asian Americans, despite evidence that these services are necessary. Fear of judgment from the community often leads individuals to conceal their struggles, making it even harder to break the silence around mental health. This underutilization is further perpetuated by the belief that discussing or seeking treatment for mental health could bring shame upon the family. Consequently, many Asian Americans opt to keep their challenges hidden rather than risk being seen as someone who cannot uphold family and societal expectations.
Pressure to Succeed and Ignoring Mental Health
Asian Americans often face immense pressure to excel academically and professionally, sometimes from a young age. “Self-care“ is a topic rarely discussed or emphasized. The community's emphasis on hard work and achievement, while fostering excellence, can lead to ignoring mental health needs in favor of pursuing success. This behavior perpetuates the "model minority" stereotype — the expectation that Asian Americans must consistently perform well and not show vulnerability. For instance, many young Asian Americans feel compelled to meet high parental expectations in education or career paths, leaving little room for self-care. This constant pressure can exacerbate stress, anxiety, and burnout, yet many may avoid seeking help, fearing it will be perceived as a weakness or failure.
Balancing these cultural expectations with mental health needs is a challenge, as prioritizing success often means suppressing stress, emotional struggles, or other mental health issues. It's vital to acknowledge that self-care and mental health support do not contradict the drive for success but are essential for long-term well-being and fulfillment.
Medical Misattribution and Lack of Cultural Awareness
In many Asian American communities, mental health symptoms are often mistaken for physical health issues due to cultural beliefs. This can lead to seeking help from medical doctors rather than mental health professionals. For example, symptoms of anxiety — such as heart palpitations, dizziness, or insomnia — may be perceived as heart disease or other physical conditions. This medical misattribution stems from the emphasis on tangible, physical ailments and a lack of awareness or acceptance of mental health issues. Consequently, many individuals miss out on the necessary mental health support and treatments they need.
The Need for Culturally Competent Providers
Asian Americans face significant barriers to mental health care due to language differences, limited nearby clinics, and low awareness of available services. For example, a lot of mental health clinics may not be located within Asian communities, increasing problems with access. Older Asians may struggle with using telehealth platforms, further reducing access to mental health support. A crucial solution is to integrate mental health services within primary care settings and improve coordination between health systems and Asian communities to enhance accessibility.
Mental health providers must develop cultural competence to enhance care quality. Understanding diverse backgrounds, the impact of discrimination, and adapting practices to be more individualized can improve patient retention and outcomes. Consistently delivered, culturally sensitive care is key to building trust and promoting better mental health in Asian American communities.
Community Support as a Coping Mechanism
Asian Americans often turn to friends and family for emotional support, a practice rooted in the communal traditions of early Chinese culture. This reliance on close-knit relationships provides a safe space for discussing stress and mental health challenges, circumventing the stigma of seeking professional help. However, while community support is invaluable, there's a growing need to improve access to culturally tailored mental health services. Expanding therapy practices specifically geared towards Asian American needs can bridge the gap, offering professional help that aligns with cultural values and overcoming barriers to care.
Overall, improving access to culturally tailored mental health services is essential to address the unique challenges faced by Asian Americans. Efforts to raise awareness, reduce stigma, and offer targeted support are necessary to break down the barriers preventing this community from seeking and benefiting from mental health care. If you or people you know are seeking mental health services provided by multi-cultural and multi-lingual providers, please check out our clinic’s website (Mind & Body Garden Psychology).
References:
https://www.mcleanhospital.org/essential/why-asian-americans-dont-seek-help-mental-illness
https://www.uclahealth.org/news/article/confronting-mental-health-barriers-asian-american-and-2
Image: https://herbaldispatch.com/blogs/news/from-anxiety-to-zen-cannabis-and-its-effects-on-mental-health
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821493
https://www.cdc.gov/mmwr/volumes/72/wr/mm7224a1.htm#:~:text=The%20age%2Dstandardized%20prevalence%20of%20depression%20was%20higher%20among%20women,(14.6%25)%2C%20and%20non%2D
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