Temple or Therapy?

This article was originally published in our Fall 2018 print issue.

Despite a growing awareness and acceptance of mental health issues in America, the Asian American and Pacific Islander (AAPI) community still has progress to make in comparison to other demographics. The AAPI community is extremely diverse, containing more than 43 different ethnic subgroups who cumulatively speak more than 100 languages and dialects.

Studies have shown that while more white Americans suffer from mental illness, greater numbers of Asian-Americans lack the resources and knowledge to address their struggles. For instance, 2014 statistics from the Mental Health Bureau and the United States Census show that suicide rates are higher in both younger — 5.3% in Asians versus 4.0% in whites — and older female Asians — 4.8% in Asians versus 4.5% in whites — with mental illness when compared to white female counterparts of the same age. Two key factors perpetuating this disparity are cultural barriers that discourage people from seeking professional treatment and logistical obstacles to receiving mental health care.

In the AAPI community, especially among older generations, traditional and religious beliefs dissuade individuals from receiving necessary professional treatment. For instance, Chinese traditions consider mental illness as a lack of emotional harmony within an individual caused by evil bodily spirits. Instead of seeking psychiatry or therapy, family members will rush to recommend traditional herbal medicines to their afflicted loved ones.

Broadly, many AAPI cultures believe that depression is merely sadness, so they rely on their loved ones to cheer them up. They view depression as a “mood” rather than a chronic, debilitating condition that necessitates professional help. While Western countries like the U.S. are moving away from the depression-as-sadness view, this perspective is still rooted in the AAPI community. Discussing one’s mental health concerns in the AAPI community is generally taboo.

This, combined with mistaken belief systems regarding mental illness, prevent the AAPI community from getting necessary mental health care. Additionally, Asians value being self-reliant and less open about personal matters. Cultural practices normalize divulging what they are truly going through to close family and friends, which further decreases the chance that they will seek appropriate professional help.

Besides cultural barriers to access, there are additional language and logistical obstacles that prevent AAPI individuals from getting mental health treatment. Many older Asians and immigrants do not know English very well, so visiting a therapist who only speaks English would be a significant barrier to effective communication. Moreover, therapy can be expensive, especially without health insurance. The average session costs anywhere between $75 to $150. In fact, before the Affordable Care Act, 15% of Asians lacked health insurance, according to a 2014 study completed by the Mental Health Bureau.

The disproportionate amount of suicides and other manifestations of untreated mental health illness suggest that there is a negative stigma around those mental health conditions in the AAPI community. Additional language and financial barriers also prevent them from obtaining the treatment they need for those concerns.

As readers, be advocates for mental health. Remain vocal about mental health concerns. Push for more representation; have multilingual professionals speak to AAPI communities to bring an objective, scientific view to mental illness, entirely free of religious or cultural bias. Finally, be open to talking about mental health with fellow community members.

Changing cultural norms may take time, but it’s time to give mental health the attention it deserves.