BIPOC Mental Health Month – Beyond The Numbers: Asian/Pacific American Heritage

It is estimated that there are approximately 22.9 million Asian/Pacific Americans living in the U.S., including those with a combination of Asian Pacific Heritage and another race. Of this population, 2.9 million are living with mental health conditions. For brevity, the Asian/Pacific heritage group consists of those with heritage originating from East Asia and the Pacific Islands, including Native Hawaiians.

Historical Context | Barriers to Well-Being | Cultural Beliefs | Strengths & Resiliency Factors | Resources

Historical Context

Asian/Pacific Americans come from a variety of cultures and experiences, including over 40 countries and territories. Throughout history, these cultures have seen the rise and fall of ancient civilizations, political conflict, and the effects of colonization on their lands. War has torn through several Asian countries, including Laos, Cambodia, and Vietnam, causing individuals to flee, many to the U.S.. During World War II, Japanese Americans were unjustly subjected to internment camps in the U.S. Most Asian Pacific communities are no stranger to the effects of colonization, with communities such as Native Hawaiians and Polynesians most recently affected by mass colonization. Furthermore, the isolation of many Pacific Islander communities has contributed to high costs of living, which make living within one’s means difficult.

Historically, two specific narratives have made living in the U.S. difficult for Asian/Pacific communities: the “perpetual foreigner” and the “model minority” stereotypes. The first of these stereotypes include the myth that Asian/Pacific individuals are inherently foreign to American society, regardless of actual experiences and perspectives, and place of birth. Throughout history, this myth has led to the ostracization of Asian/Pacific Americans and xenophobic ideals. Furthermore, the model minority myth gives the impression that Asian/ Pacific Americans are always successful through strict adherence to Asian cultural norms and no longer face social barriers This myth minimizes the very real needs of Asian/Pacific Americans and further contributes to the lack of cultural understanding.

Asian/Pacific Americans have made major contributions to American society through high economic involvement, the origins of birthright citizenship, and technology. The inclusion of holistic medicines has shaped the way many Americans live. Influences on food, festivals, architecture, art, fishing, and surfing also have shaped much of today’s culture. Despite struggles, Asian/Pacific Americans have had massive effects on the U.S. as we know it.

Barriers to Well-Being

Access to mental health care is one of the largest barriers to well-being for Asian/Pacific Americans, especially since nearly a third of Asian Americans do not speak English fluently. Additionally, health education is significantly lacking in Asian/Pacific American populations. There is a high need for support that is linguistically and culturally responsive to the unique needs of these populations.

Asian/Pacific communities have had additional challenges accessing health care and insurance. Many Asian/Pacific individuals lack health insurance, making the option of mental health care financially inaccessible. This may be due to the access barriers listed above, as well as the high number of undocumented immigrants who are unable to get the insurance they need. The Affordable Care Act has closed much of this gap, but disparities remain and must continue to be addressed.

Beyond access, cultural beliefs and stigma toward mental illness must be acknowledged. Beliefs that mental health challenges are weakness and character flaws can often lead to secrecy in families and/or not being honest with oneself, leading to denial and neglecting symptoms of mental illness.

The COVID-19 pandemic has led to a much-needed media spotlight on the realities of being Asian/Pacific in America. Hate crimes against Asian Americans rose significantly within the first two years of COVID-19 and has had a direct impact on the mental health of those within these communities, leading to feelings of fear and uncertainty. Though it was a universal characteristic of pandemic life, research shows that anxiety about leaving the home disproportionately affected Asian/Pacific Americans compared to other groups, preventing them from getting health care and essentials. It is unclear what exactly contributed to this, but it is hypothesized that fear of violence and harassment played a role.

Cultural Beliefs

Across Asian/Pacific cultures, stigmatized beliefs around mental health often lead to shame and guilt. Most Asian/Pacific cultures are collectivist, meaning the needs of the group are more important than individuals, and often place high value on reputation and relationships. This can cause a lower engagement with mental health treatment and cultures that seek to hide mental health challenges behind perceived strength and pride.

Asian/Pacific Americans, especially those who are foreign-born or first-generation immigrants, are the least likely group in the U.S. to access mental health care from therapists and doctors, often seeking help amongst loved ones rather than within the medical system. However, third-generation individuals and beyond have much higher rates of using mental health services. While these results are promising for later generations of Asian/Pacific Americans, it is a stark difference that highlights an increased need for more immigrant and early generation support.

Cultural perspectives around body image, skin color, and facial features also influence the mental health of Asian/Pacific Americans. For many East Asian cultures, especially those in China, Japan, and Korea, the ability to maintain a light skin tone and thin frame is highly favorable in comparison to a darker skin tone and average or larger-sized bodies. Those with “unfavorable” traits may be subject to the stress of societal standards and comments from family and others within their community, contributing to poor mental health such as eating disorders and body dissatisfaction.

Beliefs of perfectionism and high standards set by parents and families have been known to lead to distress, depression, and maladaptive behaviors.

Strengths & Resiliency Factors

There is strong evidence that community plays an important role in Asian/Pacific American well-being, and many individuals often find solace among religious community members, family, friends, and other loved ones. While mental health treatment may not be commonly sought in these communities, especially when paired with strong stigmas against mental health care, there is strength in finding community-centered care right for each individual.

Some of the most significant protective factors among Asian, Native Hawaiian, and other Pacific Islander populations are:

  • Cultural identification
  • Family relationships
  • Help-seeking with native healers