Barriers to seeking care

Cultural stigma

There is significant cultural stigma around mental illness in many Asian immigrant communities. Due to a history of poverty, war, and famine in many Asian countries of origin, financial security and material wealth is often prioritized over mental health considerations. Mental wellbeing is lowest on the priority list and is viewed as extraneous and even frivolous. If your grandmother survived famine, you can surely overcome your emotions! This can be quite invalidating for many people from Asian backgrounds, especially if they’re truly suffering. The lack of openness about mental health struggles can contribute to feelings of shame and inadequacy.

Family resistance

Oftentimes it is families who do not support the person seeking help for mental health. Asian parents might see it as a personal failing that their child meets criteria for a mental health diagnosis or needs treatment for psychiatric conditions. They question: what did I do wrong? and can sometimes become defensive when they feel at fault. They might criticize or invalidate the person seeking help to justify themselves and their past actions. They may feel at loss on how to help their child or loved one and thus not take appropriate action to help them. First generation immigrants and older family members themselves might also suffer from untreated mental health conditions because they never sought help for themselves. This in turn can make it harder for them to give the right support and advice.

Intergenerational trauma

Untreated mental illness in older family members can cause intergenerational trauma for younger family members. Untreated trauma and PTSD can lead to overreaction to small triggers in parents and grandparents and this reactive way of responding can be modeled to younger generations, perpetuating the behavior even if the younger generation has not experienced the initial trauma. For example, parents who have first hand experience of war might have an overreactive response to safety threats to their children and not allow them to participate in activities (like sleepovers or summer camp or going to college out-of-state) which affect their children’s ability to develop autonomy and independence.

Shame

In many Asian cultures, having a psychiatric diagnosis is shameful. One of the reasons is because there’s a lack of recognition of the full spectrum of psychiatric illness. Anyone with a mental health problems is labeled pejoratively as “crazy” so if you are seeing a psychiatrist or therapist, you are “crazy.” This discourages anyone from the community to seek help or get treatment because they do not want this label. In fact, there is a very wide range of severity in mental illness. Most humans exist somewhere on the spectrum of anxiety and depression and move along the spectrum depending on their life circumstances and level of stress. When anxiety, depression, and other psychiatric symptoms are recognized as part of the continuum of human experience, there is much more understanding and less shame.

Different value systems

Due to history of poverty, war, and famine in many Asian countries of origin, material wealth and financial prosperity is valued above all else as a survival mechanism. When someone is financially successful but suffering mentally or emotionally and they disclose this to their families or community, they risk being viewed as “ungrateful.” Their families and communities might not understand their suffering because on the surface they are doing well. Their families equate their financial security with wellbeing and is resistant to acknowledging their pain.