By Priya Pandey and Emily Kim 

In AAPI communities, the topic of mental health has been a cultural taboo for generations. For one of the authors, Emily—who’s second generation Korean-American–it was particularly difficult to start therapy due to the lack of culturally competent mental health services. She once tried to seek support from a white therapist and was shocked with the therapist’s response to simply ignore her family’s expectations of her and “live her life doing whatever she wanted and make her family deal with it.” Deeply hurt by this  response, Emily was too frightened to seek therapy until several years later. Fortunately, the AAPI community has become more comfortable and honest recently in having conversations about mental health. Yet, our community still deeply struggles with getting the help we need because of the lack of culturally competent and accessible mental health tools, as well as the historical and modern racial trauma inflicted on the AAPI community.  

The lack of culturally competent mental health care options has dramatically decreased the likelihood that AAPI individuals will access therapy when they need it. According to Mental Health America, AAPI individuals are, “the least likely of any racial group to seek help (three times less likely than white individuals), with a 17.3 percent overall lifetime incidence of psychiatric disorders, and yet only 8.6 percent seek mental health help.” Second-generation Asian Americans who have tried therapy with white therapists have reported overall negative experiences. They have stated that with white therapists, they often feel their problems are generalized or that they are given a “black and white solution to a complex issue” that doesn’t consider cultural values.  

The unique experiences of the AAPI community have intimately shaped Asian American Pacific Islander identity across generations, ethnicities, and immigration statuses and need to be reflected in therapy practices.  Many AAPI individuals and communities report having a complicated relationship with societal infrastructures such as churches, government bodies, schools, and health care because these institutions have historically traumatized the AAPI community. Despite the passage of time, descendants of these communities continue to carry those intergenerational and unhealed traumas in the present day. Common struggles for second-generation Asian Americans often include, “family obligations based on cultural values, difficulty balancing various cultures, and facing discrimination and stereotypes such as the ‘model minority myth.’”  Within the context of the ongoing Covid-19 pandemic, AAPI members endured skyrocketing rates of poverty, discrimination, violence, and hate crimes.  

These stressors—combined with the historical, systemic trauma the AAPI community has faced—have brought to light the disparities in our health care system for AAPI individuals, particularly in our mental health system. By increasing access to culturally competent therapy practices and increasing the diversity of practitioners, we can set the AAPI community up to thrive.  Without culturally responsive mental health services, diverse behavioral providers, and non-traditional methods of healing, the AAPI community will remain disproportionately underserved. 

To address the current mental health crisis facing the AAPI community, including intergenerational issues, we must advocate for mental health resources outside of traditional Western talk therapy. For example, policymakers must recognize that other entities, such as community-based organizations (CBOs), can help support community wellbeing. Additionally, diversifying the ethnic and racial backgrounds of our behavioral and mental health expanding language access will be, particularly transformative for older AAPI folks who have limited English proficiencies. Additionally, it is important to recognize and honor that AAPI communities often use non-traditional practices of healing; for instance, traditional Indigenous healers are frequently, “religious leaders, community leaders or older family members.” With this multifaceted approach to healing and well-being we have a unique opportunity to address long-standing inequities in mental health care for the AAPI community and create a path forward where culturally competent care is the norm not the exception.  

Addressing the lack of culturally competent mental health care requires that we address the problem at all levels. Congress needs to pass legislation that equitably addresses AAPI’s mental health needs, including intervening at systemic and local levels to dismantle the structures that produce harmful outcomes like generational poverty, intergenerational and cultural trauma, racism, sexism, and ableism. To improve mental health outcomes, we must consider a person’s various identities, communities, and environments. Cultural values, familial expectations, and intergenerational trauma must remain at the center when advocating for mental health services for the AAPI community.