I feel like I just wrote a mini research paper…
FULL DISCLOSURE – I completely forgot how to cite things so if there is something that I didn’t cite don’t take it as something I’m trying to pass off as my own!! I pulled a lot of information from only a few resources that are listed at the end of this post. If you see any corrections please let me know via the comments and I will change accordingly.
Also do not take anything I wrote as hard facts. While I did a lot of research, there are 100 more things I do not know. This is as much as I can explain from what I understood while gathering information.
Final ALSO — scroll to the end to find out about my fundraiser! 🙂*
*edited to add that it is now over.
And without further ado:
These two things couldn’t have been better paired together.
I cannot speak from a collective of Asian Americans, but throughout my life, I’ve known that talking about mental health is a challenge. As a child, it was something we dealt with behind closed doors. As an adult, it was very strange for me to hear from friends about their therapy sessions and their mental health issues.
Don’t get me wrong I have the same issues, but I was never encouraged to talk about it in public. We’d be able to discuss our thoughts and feelings at home, but outside of the home, it wasn’t a conversation you would want to have. Some things were better left to deal with at home and with immediate family. I’ve started to change that dynamic a bit after seeing how much I feel better when I discuss my anxiety or other traumas I’m handling with my friends, family, and in therapy.
Now, I also know that it’s taken a long time for us as a society to take a stand on mental health. We, in the mental health community, collectively have fought a battle for recognition and increasing/ expanding mental health care facilities at all the emergency rooms and hospitals AND including coverage for mental health services in our insurance.
In We Don’t Talk About That. the culture and stigma played a huge role in why Kevin didn’t get the help he needed.
And the numbers don’t lie. Asian Americans are not seeking the treatment they need and it’s time we change that.
The Numbers:
According to the website of the Department of Health and Human Services Office of Minority Health, in 2017 Asian American women in grades 9-12 were 20% more likely to attempt suicide than that of their non-Hispanic white peers. In 2018, with Asian American adults over the age of 18 – 6.3% have indicated they sought treatment in a health care facility.² That’s compared to 18.6% of their non-Hispanic white peers. And out of that only 3.6% of Asian Americans received prescription medication to help treat their mental health illnesses.³
These low numbers may look like Asian Americans do not have any mental health issues they need to seek help with, but upon further investigation, it shows that there are barriers for not only Asian Americans seeking help but also the research behind it.
There was an article written by Stanley Sue Palo of Alto University, Janice Ka Yan Cheng, and Carmel S. Saad of the University of California- Davis and Joyce P. Chu of Palo Alto University called Asian American Mental Health: A Call to Action.
In their Abstract they state:
Despite important developments in our knowledge about mental health prevalence, help-seeking behaviors, and culturally competent treatments for Asian Americans, it appears that troublingly low rates of service utilization still remain even when one accounts for the seemingly low prevalence rates among Asian Americans.
It also quoted the Department of Health and Human Services Supplement called: Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General.
AA/PIs [Asian Americans and Pacific Islanders] have lower rates of utilization compared to Whites. This underrepresentation in care is characteristic of most AA/PI groups, regardless of gender, age, and geographic location. Among those who use services, the severity of their condition is high, suggesting that they delay using services until problems become very serious. Stigma and shame are major deterrents to their utilization of services.¹
The above shows that this is a common conception that subgroups within Asian American culture are stigmatized when they seek help for mental health issues, illnesses, or substance abuse. But there is also a language barrier for those who come to the United States and have a low English-proficiency. The language barrier makes it harder for some to want to utilize and seek help. It also makes it harder for researchers to conduct their studies.
The 2010 National Survey on Drug Use and Health only conducted its interviews in English or Spanish and no interviews were conducted if the subject couldn’t speak or understand either of those languages. These situations put a limit on the number of participants in a study and can show skewed data which might lead to the underutilization of mental health facilities and the low “prevalence” of mental illness.
The Mental Health Issues:
Some of the mental health issues that occur within the Asian American communities are PTSD, depression, and anxiety. For the folks suffering from PTSD, most are mostly refugees fleeing a war-torn country at the time, and the levels of depression and/ or PTSD decrease after spending more time in the United States.4
In terms of mental health status, 62% of the respondents had PTSD and 51% had major depression in the past 12 months.5
Depression has been linked to PTSD where some majority of surveyed respondents claimed they experienced violent trauma before immigration, but 70% of those surveyed said they experienced exposure to violent trauma after resettling into the United States.
Anxiety is known to be found in Asian American men, especially to those initially coming into the country, due to lack of language proficiency. Studies have found that Asians immigrating to the United States with higher English proficiency have lower anxieties than those who do not. As time goes on and their language skills improve, their anxieties decrease.
… Nativity was strongly associated with the presence of disorders for Asian women… Nativity was associated with anxiety disorders only for 12-month prevalence. In addition, second-generation women were at high risk for lifetime and 12-month prevalence of disorders.
Nativity is defined in the Handbook of the Sociology of Mental Health (Carol S. Aneshensel, Jo C. Phelan, Alex Bierman; 2013) as “being born in, or outside of, the United States,” but it can also be the assimilation and acculturation process one takes while living in the country. To Aneshensel et al. (2013) they argue that this can have lasting psychological effects on an immigrant and it varies between regions/areas where the immigrant decides to live.
Let’s Talk About Suicide:
The percentages of suicide ideation in teens within the Asian American communities average about the same against non-Hispanic white groups, but if you split the averages up by gender, you’ll notice a higher percentage of Asian American female students (8.4% attempted vs. 2.7% in males) in between grades 9-12.6 But, the Asian American males between grades 9-12 have the highest suicide percentage (11.6% to the 5.2% in females).7
I didn’t get much information on why the percentages in Asian American teens are so high, but if I can speculate, I feel like it’s due to societal pressure to conform to cultural norms. What I did find, it was on the American Psychological Association website and there was a small section that listed off some risk factors that could include: burden on the family, experiences of discrimination, or chronic medical conditions.
Studies have also found that amongst the different age groups, elderly Asian American women are at a higher risk of suicide compared to other racial groups in the same age range. They’re still researching the reasoning behind this trend, but it could relate to nativity — like the inability to fit in with society — and/ or experiences of racism and sexism.
In addition, stereotyping Asian Americans as a model minority group is harmful because an underestimation of their rates of mental disorders may result in need-based reduction of societal attention, goods, and services.
Future Generations:
Studies have shown that as more generations grow in the United States the more likely the use of mental health facilities will occur. I’m not sure if this is also a correlation to the fact that mental health awareness has taken precedence in the past – I want to say – 5 to 8 years or maybe folks later on in generations aren’t taken in or living by culture norms brought over by their ancestors.
But this is huge in the grand scheme of things. If after all these years we can break from tradition and seek help without feeling stigmatized, then I feel like we’re heading in the right direction. It’s still a long road ahead of us, but I’m confident we will get there.
Fundraiser:
[THIS IS NOW OVER] I’ve set up a fundraising page for the National Alliance on Mental Illness (NAMI). I’m trying to raise $500!
This organization has played an important role in so many of my friends’ lives and I want to show how much I am proud of their accomplishments. I also am doing this because this organization is dedicated to making sure that mental illness isn’t a silent issue. They are promoting the idea of talking about and doing something to help those with mental illnesses find their voice.
If you’re interested in helping to reach my goal please click here and donate to this amazing organization.
Thanks for reading!
-Emi
¹ DHHS, 2001, Executive Summary, p. 14 ² SAMHSA, 2019. Results from the 2018 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 8.17B ³ SAMHSA, 2019. Results from the 2018 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 8.21B 4 Utilizing the Chinese American Psychiatric Epidemiological Study, Hwang, Chun, Takeuchi, Myers, and Siddarth (2005) 5 JAMA: Journal of the American Medical Association, 294, 571–579. Marshall, Schell, Elliott, Berthold, and Chun (2005) 6 CDC 2019. High School Youth Risk Behavior Survey Data. 7 CDC, 2019. National Center for Injury Prevention and Control. Web Based Injury Statistics Query and Reporting System (WISQARS)
Resources:
“Suicide Among Asian-Americans” American Psychology Association
“Mental and Behavioral Health – Asian Americans” Department of Health and Human Services Office of Minority Health (2019)
Asian American Mental Health: A Call to Action Stanley Sue, Janice Ka Yan Cheng, Carmel S. Saad, and Joyce P. Chu. (2012)
Handbook of the Sociology of Mental Health, 258 “Defining Nativity” edited by Carol S. Aneshensel, Jo C. Phelan, Alex Bierman (2013)