a documentary film by Pearl J. Park

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Several studies report that Asian Americans exhibit more severe disturbances compared to non-Asians, suggesting that they are more likely to endure psychiatric distress for a long time, only coming to the attention of the mental health system at the point of acute breakdown and crisis.

— SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA)

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THE ISSUE

Asian Americans have often been celebrated in the media as the "model minority." Their diligent work ethic, self-effacement, and strong family unit have been lauded in the media as if antidotes to complacency and Western individualism. What many do not know is that the same code of ethics that spurs Asian Americans to achieve may also be precisely what causes many Asian American individuals and families to conceal the mental illness in their families. Asian Americans experience a equally high rate of mental illness as the general population, but are one-fourth as likely to seek help. The “loss of face,” the fear of social ostracism and shame make the disclosure of emotional or mental difficulties nearly unbearable for many.

Asian Americans who suffer from mental illness are the less likely to seek treatment than Euro-Americans, African-Americans, Latino-Americans, and Native Americans, typically seeking psychological care as a last resort when they have become desperate and can no longer conceal their illness. Even when they choose to pursue treatment in spite of the social stigma, they are likely to confront numerous challenges in finding culturally and linguistically competent care. The found that Asian Americans had less access to mental health services and, when they did receive treatment, they were more likely to receive lower quality care than other racial groups.

More than 60% of the Southeast Asian refugee population in the US suffer from depressive, anxiety, and post-traumatic stress disorders because of the devastating experience of war in their countries of origin.1 Many are resigned to accepting one’s lot in life, rather than pursuing treatments to alleviate the pain because of Buddhist beliefs that attribute human suffering to deeds committed in previous lives, i.e., one’s karma. In addition, Southeast Asians, like other Asians who are influenced by Confucian ideology, are reluctant to seek psychiatric help or counseling in fear of shaming their family.

Asian American women between the ages of 15 to 24 commit suicide at a rate higher than Caucasians, African-Americans, and Latinos.2 On the other end of the age spectrum: Chinese-American women over the age of 65 are killing themselves at a faster rate than any other ethnic group.3,4 According to the 1999 Surgeon General's report, "stigma and loss of face over mental health problems" is one of the primary contributors to this Asian American mental health crisis. All too often, Asians simply do not seek help.

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Asian Americans frequently somatize their problems,
preferring to go to their primary care physician rather
than seek help from a mental health clinician.

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Most Asian Americans with mental health issues encounter complex linguistic and cultural barriers in pursuit of treatment. Finding a mental health professional who can speak their native tongue and can understand their cultural milieu is exacerbated by the grave shortage of Asian-language bilingual mental health professionals.5 Most mental health professionals have little to no cross-cultural training and may be unfamiliar with traditional Asian practices and beliefs. 

Asian Americans and Pacific Islanders in the United States have, as a group, great linguistic diversity. Approximately 70% of the AAPI population are foreign-born and bring with them the cultures and languages from their countries of origin. They speak over 100 languages and dialects. Estimates indicate that 35 percent of Asian Americans and Pacific Islanders live in linguistically isolated households, where no one age 14 or older speaks English very well. For some Asian American ethnic groups, this rate is much higher. For example, 61 percent of Hmong American, 56 percent of Cambodian American, 52 percent of Laotian American, 44 percent of Vietnamese American, 41 percent of Korean American, and 40 percent of Chinese American house-holds are linguistically isolated (Presidents Advisory Commission on Asian Americans and Pacific Islanders, 2001).

1 Nicholson, B.L. (1997) "The influence of pre-emigration and post migrations stressors on mental health: A study of Southeast Asian refugees." Social Work Research. Vol 21(1), 19-31.

2 Centers for Disease Control and Prevention, National Center for Health Statistics, Health, United States 1998. Hyattsville, MD: US Public Health Service, 1998

3 Centers for Disease Control and Prevention, National Center for Health Statistics, Health, United States 1998. Hyattsville, MD: US Public Health Service, 1998

4 Browne, C, & Broderick, A. (1994) "Asian and Pacific Island Elders: Issues for Social Work Practice and Education." Social Work. Vol. 39 (3) 252-259.

5 Chung H. The challenges of providing behavioral treatment to Asian Americans. Western Journal of Medicine 2002 vol. 176 4:222-223.



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