May is Asian Pacific Islander Awareness Month

Asian Pacific Islander (API) Awareness Month, officially known as Asian American and Pacific Islander Heritage Month (AAPIHM), is celebrated annually in the United States during the month of May. This month honors the historical, cultural, and societal contributions of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) to the nation. It also highlights the rich diversity, resilience, and achievements of the API community while raising awareness about the barriers they continue to face. 

The origins of AAPIHM trace back to the late 1970s. In 1978, President Jimmy Carter signed a joint congressional resolution to mark the first 10 days of May as Asian/Pacific American Heritage Week. AAPIHM honors the diverse cultures and histories of over 50 ethnic groups from Asia (e.g., Chinese, Indian, Korean, Filipino, Vietnamese, and more) and the Pacific Islands (e.g., Native Hawaiians, Samoans, Tongans, Fijians, and others). These communities collectively represent a wide range of languages, traditions, religions, and stories. 

These groups have significantly contributed to the U.S. across various fields, enriching the nation’s culture, economy, and history, all while facing discrimination and challenges throughout U.S. history. 

In terms of mental health, within Asian American culture, there is an emphasis placed on familial values, such as honoring family hierarchy and coping in silence to ensure family privacy. A majority view mental health illness and treatment as disruptive to the social group, leading to a multitude of internalized struggles (Yang et al., 2020).  

 While a variety of reasons contribute to the gap in mental health service use amongst Asian Americans, research shows the main contributors are lack of bilingual clinicians and clinicians who demonstrate cultural humility (Augsberger et al., 2015). Research also shows retention rates for therapeutic services are shockingly low, with “over 80% of [participants] who did seek services” dropping out between four to eight sessions (Augsberger et al., 2015). The question then remains: how can Asian Americans not only be encouraged to seek mental health services without shame but also effectively be seen on a cultural level? 

 Consider the following perspectives regarding Asian American clients:  

• “Saving face” is a fundamental cultural value that is not only about saving one’s own face, but that of others.  

• The “collectivist view” seeks harmony above all and rejects group conflict.  

• It is better to keep silent and let problems resolve within the family rather than seek outside resources.  

• Racialized expectations and stereotypes heighten the tensions felt intrapersonally and interpersonally for Asian American families. 

• Cultural norms are dynamic, adaptive, and shaped by assimilation.  

• Strong fear of judgment and stigma also stem from generational trauma experienced in the home country and/or life in America.  

• There are generational differences that cause mental health use discrepancies when seeking services.   

• Asian cultures already have unique models of healing that have supported them for centuries (i.e. Chinese herbal medicine, acupuncture, meditation, etc.) that have a more holistic view of the mind-body connection. 

Stigma plays a role both inside and outside the therapy room. The lack of Asian American therapists/clinicians in the mental health field is apparent. According to a study done in 2021, only 11.3 percent of therapists in America were Asian, while 72.6 percent were white (Shrestha, 2023). A main contributor is the stigmatized view of mental health in the Asian American community. Traditional values within Asian cultures teach individuals to tolerate difficulties, never complain to others, and consider it taboo to pursue a career in the mental health field.  

On the client side, Asian Americans use mental health services at a lower rate compared to the general population (Derr, 2015). Mental health difficulties are viewed as an individual issue, and talking openly about these issues is discouraged. In addition, a significant barrier that contributes to the low utilization rate for mental health services within the community is the lack of cultural values acknowledged in the therapy room. This lack of recognition leads to a disconnect between the therapist and client, making the client less likely to return to therapy services or even begin services.  

 However, there appears to be some hope with the use of Solution Focused Brief Therapy (SFBT) with Asian American clients. One of the more recent studies by Cheung and Jan (2017) emphasizes that SFBT “actively draws on the cultural resources and strengths of the client in their clinical work.” Given its collaborative, client-oriented, and strength-based framework, SFBT allows the therapist to follow the client’s needs and see the benefits of how their cultural values play into their experiences more closely. SFBT emphasizes measurable goals that appeal to most Asian American clients and their value of pragmatism (Cheung & Jahn, 2017).  

Clinicians could also blend or bridge the distance between Western and Eastern healthcare practices by exploring and providing resources for alternative healing and medicinal practices. Having a working knowledge of acupuncture and Chinese herbal medicine clinics may help the therapist be more sensitive to the client’s particular needs and meet them where they are while attuning to the mind-body connection that Asian American clients and their families may value. 

As clinicians, we must advocate for our clients and push for more community mental health services and outreach programs that support the Asian American community as a whole. With this advocacy comes education and more self-of-the-therapist work to help our future Asian American clients feel safe and seen in the therapy room.  

References 

Augsberger, A., Yeung, A., Dougher, M., & Hahm, H. C. (2015). Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Services Research, 15(1), 1-11. 

Cheung, C., & Jahn, S. (2017). Closing the acculturation gap. The Family Journal. 25. 170-178.  

Derr A. S. (2016). Mental health service use among immigrants in the United States: A systematic review. Psychiatric Services, 67(3), 265–274.
 

Shrestha, S. (2023, April 19). Challenges Asian American and Pacific Islander youth face in accessing mental health services. Public Health Institute; Public Health Institute.
 

Yang, K. G., Rodgers, C. R. R., Lee, E., & Lê Cook, B. (2020). Disparities in mental healthcare utilization and perceived need among Asian Americans: 2012–2016. Psychiatric Services, 71(1), 21–27.