From The Patient’s Perspective: Asian Americans and Mental Health

By Kelley Hattox, Behavioral Health Consultant
Doyen Consulting Group

When we think of mental health in minority populations, a certain kind of profile may come into cultural our consciousness.  Rarely does the face that auto-generates have Asian characteristics.  Growing up in a Japanese household, my family used to remark that we didn’t relate to the biases and discriminations that most minorities faced because we belonged to the one race that was expected to be more stable, more educated, more law-abiding and more achievement-oriented than the average non-Asian.  This stereotype is called the “model minority.”  These seemingly advantageous prejudices can create their own set of complications when it comes to addressing mental health issues. 

According to the US Government’s Office of Minority Health, Asian Americans have significantly lower rates of reported severe psychological distress than non-Asian populations1 (1.9% Asians vs 3.2% white non-Hispanic). But is that data valid?  That is the accumulation of reported cases. Consider, that the findings from 2016, where the American Psychological Association determined that Asian Americas were three times less likely to report mental health issues and/or seek services. The math implies that unmet needs and barriers remain unaddressed in today’s society.

Among Asian Americans that are second, third, (or more,) generation Americans, the trend is toward better reporting, but the results of that are alarming.  For example, the rates of suicidal ideation and suicide attempts among adolescents are about 4 full percentage points higher than the rest of the population2.  If you consider that there are 42,000,000 adolescents in the United States and 4.2% are Asian, this means that close to a half a million Asian adolescents attempt to or commit suicide each year.  A suicide-focused report produced by the CDC discovered that among Asian women 15-25 years old, suicide death rates were thirty times higher than for white females2.  In a 2007 APA publication, suicide was determined to be the second leading cause of death for Asian Americans aged 15-24 and third leading cause of death for ages 25-343Why? One interpretation of this data is that Asian Americans are less likely to voluntarily seek or report mental health issues, but in the case of suicide attempts, which often require emergency room documentation, the data is more reflective of accuracy. 

So, what do these statistics mean and what are the barriers to services?  The short answer is this: Asian-Americans are more likely to seek solutions privately. 

Culturally speaking, protection of the family or the culture’s pride at the expense of personal wellness is innately rooted in Asian culture, alongside the archetypical paradigms of Asian honor and shame, that date back to the Samurai and Hari-Kari Honor Suicides.  However, today, Asian-Americans are more likely to address their issues through a family member, a temple or church leader; or to do their own personal research4. This is particularly true for recent immigrants or refugees, where language and cultural barriers, and lack of awareness of services exists.  Asian-Americans are also more likely to seek services at agencies that are culture-specific, such as Asian-American community centers or resource agencies. 

How can someone outside of the Asian community be helpful? 

The answer is the same as to most dilemmas about mental health services – end the stigma.  If you are a mental health care provider, don’t hesitate to talk to your Asian client about cultural roadblocks, pride and shame.  If you are a personal recovery and you see an Asian-American walk into a 12-Step meeting, welcome them and know that it may have taken an extra layer of courage for them to attend.  If you have an Asian-American friend that seems troubled but tells you that everything is okay – trust your gut and ask again, and again – with compassion and empathy. 

Our task is not to unravel the traditions and values of Asian cultures, but to help create a social climate that can join them in accessing mental health care shame free, and the normalization of mental health issues.  During Minority Mental Health Month, we, [the mental health community], call upon the nation, our communities and ourselves to examine how we are addressing the underserved populations and how we can better invite all minorities into the journey of well-being.  In doing this, we are all enriched better for it. 

Sources:

  1. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=54
  2. https://www.mentalhealthamerica.net/issues/asian-americanpacific-islander-communities-and-mental-health
  3. https://www.apa.org/pi/oema/resources/ethnicity-health/asian-american/suicide
  4. https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/MHServicesUseAmongAdults.pdf

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