When discussing mental health, it is crucial to include Asian-Americans in the conversation. In a community where topics of mental health are clouded with discomfort and silence, misconceptions, and avoidance of mental health issues are all too common. To involve Asian-Americans in discussions regarding mental health and allow them to access the resources they need, we must understand and acknowledge the causes of this issue, which are deeply rooted in society and contain transgenerational trauma that impacts people to this day.
Much of the stigma surrounding mental health in Asian-American communities can be traced back to struggles associated with immigration and acculturation, or the period of time that it takes for a person to assimilate and fully adopt the lifestyle of a new culture. Because of the stress and hardship that is common when adapting to a new environment, immigrant families tend to place great emphasis on the family unit. Within this unit, each person is expected to uphold and contribute to the family within their specific role, creating a system of enforced expectations and behavior that is considered “proper”. Often, this is where issues begin to arise.
Ironically, because of the emphasis placed on family, opening up to family members can feel like a burden. Asian-American children, in particular, may have difficulties sharing their hardships or mental health struggles, due to both societal expectations and immigrant culture. From a young age, Asian-American children are often taught to control and hide their emotions, and feelings and emotions are generally not conveyed between family members. Sharing their struggles can also be accompanied by feelings of guilt. Many Asian-American children may feel that their mental health issues are insignificant compared to their parents’ or grandparents’ hardships involving conflict in their home countries (such as Cambodian refugees escaping the Khmer Rouge in the ’70s) and immigration to America. Older members of the Asian-American community often have misconceptions regarding mental health, again because of the stigma and familial expectations put into place in the community. The belief that individuals suffering from mental illnesses can not be contributing members of society is common, and mental illness is generally viewed negatively, creating widespread public stigma. Self-stigma, or feelings of inferiority to those without mental health issues, is also present reportedly much higher among Asian-Americans than other ethnic groups in America. This is largely due to the lack of both awareness and treatment within the Asian-American community.
Traditionally, incorrect beliefs regarding mental health have existed in Asian-American culture for decades upon decades. In some cases, Asian-Americans tend to deny the existence of mental illness or attribute it to physical or spiritual ailments. In Chinese-American communities, for example, “neurasthenia” is a diagnosis used to cover a range of symptoms, some of which are depressive. This way, mental illnesses can be labeled in a more culture-friendly way, allowing individuals to deny their mental health issues and therefore reduce stigma. The traditional beliefs that mental illnesses are caused by evil spirits or disruption of harmony also remain surprisingly prevalent in immigrant communities, leading people to avoid seeking professional help and therefore not receiving the care they need. Seeking professional help is often viewed as unnecessary and wasteful, again because of the emphasis upon the interdependent family unit. After all, why talk to a stranger when you already have a support system within your own community?
Societal pressures such as the model minority myth also contribute to Asian-American stigma surrounding mental health. The model minority myth is the stereotype that Asian-Americans are highly educated, economically stable, and often wealthy, contributing to mental burden and societal expectations for Asian-Americans and feelings of perceived failure and shame for those who do not meet the stereotype. Asian-Americans can, therefore, be incorrectly perceived to have a lower rate of mental illness than the general population, when this statistic is simply a result of the stigma surrounding mental health and people refusing to acknowledge their symptoms. In a survey conducted from 2008-2012 by SAMHSA (Substance Abuse and Mental Health Administration), it was found that only around 8.6% of Asian-American adults, compared to about 18% of white adults, utilized mental health services. Among Asian-Americans below the Federal Poverty Level, this statistic was even more striking. While 57.1% of white Americans up to 200% below the Federal Poverty Level utilized mental health services, only 15.5% of Asian-American adults in the same category utilized these services.
As the most diverse community in America with over 50 racial and ethnic groups speaking more than 100 different languages and dialects, Asian-Americans and Pacific Islanders are often lumped into one single category when receiving mental health treatment. Many providers are unable to address mental health issues specific to Asian-Americans, often due to cultural and linguistic differences. Mental health issues that have connections to traditional values or culture require higher understanding and knowledge to solve, and some Asian-American households may also be linguistically isolated, meaning that several members above the age of 14 have difficulties speaking English, therefore making it nearly impossible to access conventional mental health resources. These structural barriers are not only harmful to individuals but also the community as a whole. The consolidation of all AAPI people into one category further perpetuates the model minority stereotype, as on average, members of the community are typically perceived to fit the harmful stereotype of the “model minority”, with higher levels of education, occupation, and wealth and fewer health issues.
It is crucial to acknowledge the multiple cultural, structural, societal, and linguistic barriers perpetuating stigmas and preventing Asian-Americans from accessing the mental healthcare they need. Of course, the issues mentioned thus far are only a few of the most important factors that allow stigma and misinformation regarding mental health to spread within the Asian-American community, and there are far deeper problems to be aware of. However, with time and awareness, it is possible for everyone to have a say in what should be the global discussion of mental health.
BY: Serena Li
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