Breaking the Silence: Mental Health Barriers in Asian American Communities

Written by: Sasha Lovitz

Edited by: Christine Huang

Mental health in Asian American and immigrant communities has been overlooked but not unseen. Within the U.S., the AAPI community comprises around 22.6 million people with 40 distinct ethnicities, all bringing distinct languages, customs, traditions, education, and socioeconomic backgrounds (Schlossberg, 2023). Studies have shown that of this population, Asian Americans are three times less likely than European Americans to seek mental health services (Matsuoka et al., 1997), with only 17% of those diagnosed with a mental disorder seeking professional help (Abe-Kim et al., 2007). Many Asian Americans rarely report personal mental health struggles due to cultural stigmas, structural inequalities, and the harmful impact of these stereotypes. Because of these barriers, more inclusive and culturally responsive approaches to mental health should be implemented to reduce stigma, promote diverse perspectives, and dismantle systemic obstacles to seeking care.

The stigma surrounding mental health in Asian American and immigrant communities is deeply rooted in cultural values, collectivistic identity, and the model minority myth, leading to underutilization of mental health services. Asian Americans are perceived to be “model minorities,” a hardworking and successful population that has easily fit into American society; however, this perception has proven to be damaging (Eng & TenElshof, 2020). This term incites blame and harmful sociopolitical dynamics as it disregards systemic inequalities, unfairly contrasts Asian Americans with other marginalized groups, and ignores disparities in wealth and access to resources. Moreover, the myth contributes to the neglect of mental health struggles among Asian Americans by downplaying their difficulties and reducing funding for culturally sensitive services (Wei, 1993). Many Asian Americans internalize the expectations of self-sufficiency, which, when combined with cultural stigmas around mental illness, discourages them from seeking professional help (Fuchs, 2017). Many Asian cultures emphasize values of family honor and social harmony, discouraging open discussions about mental health due to fears of “losing face” (Zane & Yeh, 2002). Language barriers and a lack of culturally competent mental health professionals further limit access to care (Leong & Lau, 2001). These cultural barriers are further compounded by Western mental health frameworks, which often fail to acknowledge the collectivist and holistic perspectives found in many Asian traditions.

While Asian American and immigrant communities internalize these mental health struggles, Western mental health frameworks have been critiqued to be overly individualistic. Many non-Western cultures view mental health as an interconnected experience, involving the mind, body, family, and community. Gopalakrishnan (2018) emphasizes that cultural understanding is pertinent to mental health care, arguing that medicalization diagnoses, pharmacological treatments, and talk therapy do not always align with holistic and community-based perspectives. For example, Chinese traditional medicine incorporates Yin and Yang, Ayurveda links well-being with karma and energy flows, and Indigenous traditions emphasize spiritual balance–all of which contrast with Western psychiatric approaches. The imposition of Western psychiatric categories without recognizing these cultural dimensions can lead to misdiagnosis and unnecessary medication. While Western mental health models emphasize individual treatment through pharmacology and psychology, they often overlook the collectivistic nature of mental health within Asian cultures. However, integrating traditional healing methods–such as Chinese medicine’s concept of Yin and Yang or Ayurveda’s emphasis on balance–into mainstream mental health care could create responsive treatments without disregarding the benefits of evidence-based psychiatric care (Eng & TenElshof, 2020). 

Because of societal misunderstandings and stereotyping, structural barriers such as economic disparities may discourage Asian American and immigrant communities from mental health care. Economic struggles are a major mental health stressor for many Asian American and immigrant communities, yet Western mental health systems often fail to consider how financial insecurity influences well-being and access to care. Wong and Tsang (2004) discuss how women face job instability, low wages, and financial dependency on their male partners, making it difficult to prioritize mental health. Women frequently avoid seeking out professional mental health help because of the cost or financial contributions to the household that take precedence over personal well-being. Low-wage and unstable jobs with little access to healthcare lead to higher levels of untreated mental distress (Gopalakrishnan, 2018). Similarly, Kudva et al. (2020) expand on this issue from a global perspective, showing that in low-income Asian countries, mental health services are often inaccessible, forcing individuals to rely on traditional healers rather than medical professionals. Even in wealthier nations, mental health care remains expensive, and many individuals cannot afford long-term treatment, particularly in Asian American and immigrant communities where insurance coverage may be inadequate. A study by the National Asian American Pacific Islander Mental Health Association (NAAPIMHA) found that over 55% of Asian Americans cite cost and lack of insurance coverage as primary reasons for not seeking mental health care (NAAPIMHA, 2021). Furthermore, undocumented individuals face additional barriers such as lacking access to Medicaid or other healthcare subsidies (Gee et al., 2015). 

Moreover, racism and discrimination significantly impact Asian American and immigrant populations, contributing to the growing disparities in mental health care access. Systemic racism manifests through implicit bias among providers, lack of culturally competent care, and disparities in treatment accessibility (Metzl & Hansen, 2014). Studies have shown that racial and ethnic minorities receive lower-quality mental health care, are less likely to be diagnosed accurately, and are not more likely to have their symptoms dismissed (Snowden, 2001). 

One major structural issue in mental health care is provider bias, where clinicians misdiagnose or underdiagnose in minority patients due to cultural misunderstandings. Research has found that Asian Americans are more likely to be diagnosed with severe psychotic disorders, while White patients exhibiting similar symptoms are diagnosed with mood disorders, which receive more compassionate treatment approaches (Gara et al., 2019). This suggests racialized diagnostic disparities, where providers perceive and interpret symptoms differently based on a patient's racial background, compounded by the eurocentric foundation of mental health frameworks, which often fail to incorporate collectivistic and holistic approaches common in non-western cultures (Gone, 2013). Western models emphasize individualism, autonomy, and verbal self-expression, which may not align with how Asian American communities conceptualize mental well-being. As a result, individuals from collectivist backgrounds may feel alienated or dismissed from their cultural perspectives, reducing their likelihood of seeking professional care (Sue et al., 2009). 

The stigma and structural barriers affecting mental health care for Asian American and immigrant communities require urgent attention. Addressing these challenges includes expanding culturally competent Mental Health Services, increasing funding for accessible care, and integrating traditional healing practices into Western Psychiatric models. Public awareness campaigns and community-based mental health programs can also help reduce stigma and encourage help-seeking behaviors. By implementing these solutions, we can create a more inclusive and equitable mental health system that truly meets the needs of Asian American and immigrant populations. 

References

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