Asian American & Pacific Islander Heritage Month: Understanding the Mental Health Needs of Other Cultures

Mental health affects all ethnicities, cultures, and nationalities, but our cultural upbringing also shapes how we experience, discuss and seek support.

Ideas around what mental health represents and added pressures around race and culture can lead to some ethnicities being more impacted than others. 

Understanding Asian American experiences of mental health and the challenges they face in seeking support and resources is an important part of the work of therapists and clinicians. This Asian American and Pacific Islander Heritage Month, I wanted to highlight how these challenges affect those who identify with these cultures.

The Model Minority Myth

The myth of the ‘Model Minority’ perpetuates the idea that all Asians are highly educated, quiet, and obedient, with a primary focus in life on becoming high-income earners. It perpetuates the idea that Asian Americans don’t have as many struggles as their Black and Latine counterparts and drives a divisive spirit among marginalized people of color.

This inaccurate cultural representation of Asian Americans has resulted in many of their struggles going unseen and unacknowledged.

When it comes to mental health, this myth lumps all Asian Americans together, undermining and dismissing the collective differences that exist across these populations. Their lived experiences can be very different, and the impact this has on their mental health cannot be ignored.

Barriers to Support

The National Latino and Asian American Study reported that compared with 18% of the general U.S. population, only 8.6% of Asian Americans sought mental health services and resources. 

Research has sought to understand why this is and identify some of the key barriers that prevent these groups from accessing the support they need.

One study from the University of Maryland explored the mental health needs of young Asian American adults. Participants were born in India, Cambodia, China, Indonesia, Korea, Taiwan, Thailand, or Vietnam and had recently immigrated from those countries.

The study discovered that these individuals face a range of pressures that discourage them from seeking help for their mental health concerns. 

Some said they felt tremendous pressure to be academically or professionally successful – perhaps owing to the ‘Model Migrant’ myth. Some voiced that to stay focused, they often ignored or denied symptoms related to their mental health. Other participants talked about cultural concerns, explaining that experiencing or voicing mental health concerns was viewed as a taboo topic in their families or communities. 

Similar studies have identified these common themes when working with these cultural groups. When it comes to seeking support for their mental health, the challenges faced by Asian Americans can be largely grouped in two ways:

1. Societal stigma around acknowledging and expressing mental health needs.
2. Accessing support and resources for mental health issues.

Challenges in Therapy

Asian Americans face different challenges and difficulties during therapy, as Jenny Wang, Ph.D. a Licensed Psychologist in Houston, Texas, and the creator of the Asian Pacific Islander Desi American Therapist Directory stated in an interview in May 2020:

“The difficulty in working with individuals from ‘Asia’ is that it comprises a huge breadth of cultures, languages, religions, and ethnic groups. Simply being ‘Asian’ does not necessarily equip me to work with all the individuals who fall under the ‘Asian.’” 

Jenny goes on to outline three key things clinicians can do to support these groups:

1. Listen Well: It’s important to never make assumptions about a client, especially ones based on their ethnic or cultural background. First and foremost, we must listen to the client and what they’re telling us about their current experiences.
   
2. Challenge Implicit Bias: This follows from point one in that we need to ensure we aren’t acting or responding from our own implicit bias. It’s important that we all work to uncover and challenge our implicit bias and ensure it doesn’t impact the high-quality support clients need.
   
3. Understand the impact of the ‘Western’ Narrative: Much of psychology is driven by Western research, ideas, and practices. We must be sensitive to how this narrative directly or indirectly pathologizes cultural practices and dynamics. What might seem ‘unusual’ in the Western narrative might be completely acceptable in other cultures (and vice versa). It’s important to unpick this narrative when working with diverse clients.

Supporting Asian American Clients

One approach to supporting Asian American clients is for them to be provided access to ethnically and linguistically matched mental health professionals. 

But as clinicians, we should all seek to find ways to develop our understanding and capacity to work with diverse clients. By focusing on culturally relevant and sensitive services, more clinicians can seek to support clients with an Asian American background.

The American Psychological Association provides some excellent guidance around this. Here’s a little overview of this: 

• Be aware of the ‘Model Migrant’ myth and how it undermines lived experiences for many diverse cultural groups.
  
• Be aware of the ongoing racism, discrimination, and oppression experienced by these groups and its validity in their lived experiences, including in the community, the workplace, and within relationships.
  
• Understand the effects of transgenerational trauma and how this can show up for Asian Americans and Pacific Islanders in their lived experiences and the ways they might feel comfortable seeking support.
• Stay up to date on studies, research, and resources surrounding the mental health issues of Asian Americans and Pacific Islanders and incorporate this into your practice
  
• Understand the potential harm of underdiagnosis, misdiagnosis, and overmedication of Asian-American and Pacific Islander individuals.

Looking Ahead

The advice provided by the APA  highlights the simple but extremely effective ways we can make a difference to the diverse clients of our communities. There is also an increasing number of therapists working hard to normalize and de-stigmatize mental health within the Asian community.

One admirable example is the Asian Mental Health Collective, which aspires to make mental health readily available, approachable, and accessible to Asian communities worldwide.

I would encourage everyone to check out their webpage for some excellent resources and starting points around what we can all do to support this community in our work better.