Content Warning: Mentions of suicide.

Despite the increasing need for quality mental health care, members of marginalized communities continue to struggle against a shortage of the psychological treatments they require to deal with serious personal matters. From high financial costs to a lack of ethnocultural understanding within psychology as a field of study, mental health care can be inaccessible and even ineffective for many. 

The U.S. Department of Health and Human Services Office of Minority Health (OMH) reported that in 2019,  “Suicide was the leading cause of death for Asian/Pacific Islanders ages 15 to 24.” 

Further data collected by the OMH points to Asian-Americans having a much lower likelihood of seeking out and receiving mental health treatment as well as alarmingly high rates of suicidal ideation. Southeast Asian Americans in particular were found to face substantial risks for PTSD with an unfortunate lack of access to psychological care. 

Asian-Americans, particularly adolescents and young adults, are still struggling to find treatment which takes into account the complex interplay between eastern values and western psychology. This dissonance indisputably shapes the Asian-American experience with mental health into something that may almost feel discouraging — like a lost cause. 

With this in mind, it is all but imperative that we confront the reality of western psychology’s shortcomings and its lack of consideration for the different needs of people of color, which only causes further harm to these minority communities. 

For Asian-Americans, the solution lies somewhere in the middle of this supposed dichotomy of east and west. Navigating the intricacies of culture-specific treatment is no easy task, but it is indeed a necessary one for expanding the level of accessibility and quality of the mental health space for marginalized groups. However, without an increase in Asian-American mental health care providers and a rapid development in culturally-informed psychological research, this progress would be incredibly difficult to achieve.

A study conducted by the University of Maryland School of Public Health suggests that the common sources of stress for Asian-American young adults include a multitude of factors, such as parental pressures for academic success as well as the myriad anxieties of cultivating a “bicultural sense of self.” The taboo nature of mental health across eastern cultures compounded with the pressure of fitting the impossible standard of the ‘model minority’ can often lead APIDA youth to internalize feelings of emotional distress.

Speaking from personal experience, these expectations were so deeply ingrained in my experience as an Asian-American adolescent that it became instinctive to dismiss their negative consequences. These pressures were normalized, as if the serious effects that they had on my own mental health were merely rites of passage — normal parts of growing up which I was expected to endure. This seems to be a rather common internal conflict for APIDA youth, something which often worsens into adulthood.  

“Addressing Asian and Pacific Islander mental health in the U.S.”, a Stanford Medicine article by Nina Bai, explores the insights offered by a panel of six APIDA mental health experts. Dr. Pata Suyemoto of the National Asian American Pacific Islander Mental Health Association describes her journey with seeking out professional mental health care, from her family’s history with mental illness to her own experience as a survivor of attempted suicide.

Dr. Suyemoto explains, “I’m 60 years old — until my current therapist, no one ever asked me about the impact of my culture on my mental health.” 

Most institutions in the United States, from the public school system to law and legislation, were based on models of whiteness from their very inception. These structures based in white supremacy have resulted in a lasting deficiency of cultural inclusivity. Alas, psychology and mental health treatment are no exception. 

In a piece for Knowable Magazine, author Diana Kwon speaks with clinical psychologist Janie Hong on observations regarding her Asian-American patients. Hong assures that western psychology is ultimately beneficial for Asian-Americans. However, she notes that the positive effects took much longer to manifest for them than it did for her white patients. 

Kwon writes, “For Hong, a key consideration for effective therapy is moving away from the view that behaviors inconsistent with Western ideas of mental health are pathological.” Hong cites communication styles that are associated with Asian cultures as a prime example, particularly how there is a tendency to interact in less direct ways than the typical western ideal. 

Through this lens, Hong urges us to cease comparing our own behaviors to western normative standards. She says about this unique eastern aspect of nonverbal communication, “it’s almost like this really beautiful choreography and silent dance – they’ve learned to move together and achieve certain goals without having to sit down and have a direct conversation about how they feel.”

While this lack of direct communication may cause conflict within relationships, that does not mean that it is an inherently negative feature of eastern cultures. For instance, us Asian-Americans might clash with our parents for a multitude of reasons. And instead of vocalizing an apology, our parents may instead opt to offer us a plate of sliced fruit. In many eastern cultures, the offering of food can be considered a sacred act of respect and love. 

Psychological treatment that fails to account for these crucial cultural nuances may cause harm to patients by attempting to shape the psyches of people of color into a mold of whiteness. Asian-Americans face enough pressures to assimilate in our daily lives, so it becomes all the more vital that we cease to adhere our own values and worth to western and white ideals. 

Asian-Americans and other marginalized groups continue to face these obstacles when seeking out professional mental health care. Nevertheless, the steadily growing diversity of care providers in the field is quite promising.

Through my research on specialists of culture-specific mental health treatment methods, I reached out to licensed clinical social worker and psychotherapist, Cynthia Siadat. 

Siadat was kind enough to sit down with me for a Saturday morning video chat. During our conversation, the mental health care professional explained her process and approach to serving her clientele of Filipino-American high-achieving caregivers. Siadat’s patients consist of those in high-stress careers who are simultaneously caring for ill loved ones. 

She explains, “I started working with high-achieving caregivers, specifically, because I felt like a high-achieving caregiver in recovery myself. I felt like I understood the need — I felt like that was a population that was not being served.” 

Siadat and I also discussed the Filipino concept of kapwa, something that we are both deeply familiar with as Filipino-Americans. Kapwa, as Siadat explains it, refers to the interconnectivity between us as humans. She notes how Filipino collectivist ideas such as kapwa and utang na loob, create unique patterns of conflict for her patients, as well as the larger Filipino-American community. 

“I would find… those sort of hard and fast boundary situations were not feasible for many Filipino-Americans. It was commonly met with a sense of shame or guilt for being so intertwined with their family members. Like, ‘Oh, I shouldn’t be this enmeshed,’ is a phrase that I’ve heard from other Filipino Americans.” 

Siadat’s specialized work with her distinct clientele serves as just one example of this delicate form of mental health care. But, as I see it, the possibilities of culture-specific psychotherapy are truly endless. For the sake of underserved communities, like Filipino-American caregivers and beyond, inclusive and high-quality treatment such as the care offered by Siadat must be made more widely accessible.

Creating a structure of mental health care which works not only for the western majority, but for all people requires us to start these difficult but important conversations. The stigma around mental illness can only be broken once we dispel the idea of seeking professional help as some sort of social, cultural or moral failing. 

On the other hand, seeking professional help through the means of western psychology does not mean that we Asian-Americans have to suppress our cultures’ collectivist values. Ultimately, collectivism centers our reverence and love for community – which should not be focused on the pressures of fulfilling expectations and obligations, but instead the exchange of unwavering support and care.

Towards the end of our conversation, Siadat kindly added, “…So if people are looking for clinicians who look like them, who understand the culture, there are listservs for inclusive therapists so that people can talk to somebody who gets much of the familial stuff. And if they need any help finding those things, please be in touch with me — I’m happy to connect them to those resources.” 

There are an endless number of gracious mental health care providers like Siadat who aim to put forward their services to those who need them.

Additional resources can be found below:

Los Angeles AAPI Therapists

Black Therapist List

Indigenous Circle of Wellness

Latinx Therapy

Visual Credit: Alex Green

Comments are closed.