Agudo 1

Sean Agudo
Roxanne Balansag
Richard Wong
Professor Lee
Sociology of the Asian American
[insert due date]
Mental Health Issues and the Asian American Community
Mental health is the fundamental basis of thinking and communication skills, including
verbal and physical actions. The brain becomes the machine in which ideas and image come to
life; communication skills along with thinking and learning becomes the core of our society.
Often times, it is all to easy to dismiss the problems that may occur throughout one's lifespan. As
time goes on, the brain becomes more and more frail with old age, accentuated by psychological
trauma and damage. The mental health problems that arise are illnesses that can inhibit daily
actions or alter lifestyles of oneself, especially to loved ones. Psychological issues are real and
debilitating to one's conditions, especially among the Asian-American community. Asian Pacific
Americans (APA), also commonly denoted Asian Pacific Islanders (API), are one of the fastest
growing ethnic minorities within the United States. APAs in the US range from approximately
18 million and represent more than 100 languages and dialects from cross Asia. Two thirds of
Asian-Americans (AA) are foreign born, while up to 40% of do not speak English fluently. Most
AA live in states bordering the coast, including California, New York, Texas, and Hawaii.
Although APAs often are physically healthier than whites and other ethnic minorities, further
research proves the large disparity between mental health conditions among ethnic minorities.
Barriers such as language, lack of access to care, and cultural beliefs are among difficulties on
how influential APAs look to seek mental help. In a primarily shame-based culture, mental
health issues, often associated with weakness or fragility, is a powerful stigma in which APAs
choose not to deal with their situation.
In 2001, the Surgeon General report Mental Health: Culture, Race, and Ethnicity calls
stigma the most pervasive problem in preventing racial ethnic minority groups for seeking
mental help and substance abuse problems. Stigma in particular to Asian-Americans is an often
more critical issue among ethnic groups whose knowledge and beliefs are rooted in traditional
teachings of Confucianism, Buddhism, and Taoism, beliefs that are centered focally around
balance and stability, especially in the goal of enlightenment. Stigma is often very subtle in the
form of silence or denial, causing delayed treatment or not adhering to treatment plans. To those
who suffer from depression, bi-polar disorder, or any other mental sickness, refrain from seeking
out help due to the negative connotations and labeling that may occur during the process of
seeking help. These labels range from but are not limited to the stereotypes portrayed in media,
distortion of expectations, negative self-image, and fragility. Often the primary reason in which
mental illness is a particular issue within the Asian-American community is because of social
status that is both real and perceived. For many Asian-Americans, culturally valued aspects such
as income level, filial piety, and respect are placed at risk when mental health issues arise. The
negative cultural connotation associated with mental illness is shaped by social acceptance of
psychiatric illnesses and issues. The stigma that arises can be attributed also to general lack of
understanding or awareness of these illnesses and also from community networks of family,
friends, and professional settings. Religious and spiritual philosophies have strong influences on
Agudo 2

APA health beliefs and practices. Many times, 1 and 1.5 generations of immigrants follow the
traditional beliefs of Confucianism and Taoism, both of which adhere to minimal display of
emotion in order to maintain social and perceived status in achieving familial harmony.
Traditions upheld in Confucius and Taoist settings further avoid health figures because of
differences in Western medicine and traditional Eastern medicine. Western culture makes a
distinction between the mind and body, whereas traditional religious medicine does not. As such,
Asian cultures express more somatic pains rather than mental distress. Many APA subgroups
share common views of religious beliefs, meaning that the millions who follow these religious
beliefs also share "naturalistic theory of balance (eg. balance, body and mind, hot and cold
states)" (CITATION). Because of this, first generation immigrants deny expressing emotional
and mental pains. In this, mental illness becomes a great psychological stress factor when it does
not conform into cultural beliefs. Therefore, at times of extreme mental strain, it becomes more
acceptable to plain mental illnesses on somatic pains. Studies show that Asian-Americans
reportedly suffer more illnesses directed at the body rather than at the mind. The denial is mental
health instability also causes the under representation of medical information, further
perpetuating inaccurate health stigmas and beliefs.
The history and complex nature of so many diverse population groups within the Asian-
American community reveals misinterpreted information recorded in the past. With so many
classification of Asian and Pacific Islander ethnic groups, homogenization is an issue in which is
not acutely addressed either. For separate groups, several other factors such as access to
healthcare, treatment, and illnesses becomes an entirely new and different set of issues. Lumping
all races together provides inaccurate and untrue information that can wrongly estimate the level
of need someone may require. As such, some subgroups of Asian origin share differences in
beliefs and values. Some Pacific Islands also offer unique perspectives of spiritual beliefs.
"Samoans believe that ailments can be caused by interpersonal conflicts", a sign of personal
failure to perform social or religious roles (CITATION). Especially unique to Pacific Islanders,
mental disorders can be attributed to one' wrongdoings in the past, spiritual forces, or personal
weakness. Rather than seeking health care professionals, APAs tend to atone for their actions in
which they attribute to their own misbehavior. Additionally, cultural ideas from one's origin
country contributes to the inability to accurately relay psychological stress. In China, symptoms
involving mental stress, fatigue, and insomnia is recognized but not officially categorize within
the "International Classification of Diseases" (CITATION). As such, any of these symptoms are
put under one umbrella word, neurasthenia, the term used to describe mechanical weakness. In
other words, the term neurasthenia becomes another word for the somatic illnesses people
experience. In this, those of Asian culture, especially from China, carry over this classification
and avoid seeking help. When even the government of China does not officially recognize these
mental illnesses, the billions that belong to that government will also likely have misconstrued
notions of mental illnesses. The idea of "saving face", the ability to shield self and family image
for the sake of respect among relative communities is crucial in setting the standards at which
Asian-Americans like to see themselves and others as. It is also responsible for those who suffer
from mental illness the inability to discuss their psychological situation in the fear of shame and
becoming social pariahs. With the widespread influence of Confucianism and Taoism, mental
illness becomes a stigma, epitomizing negatively on family value. The influence of these
qualities also stems the fear of being incompatible or unfavorable to immediate family members
Agudo 3

or future spouses; beliefs about suitability and image become intertwined with century old
beliefs. Often times, these traditional values devalue the mental and psychological stress in
which people face. It becomes more and more acceptable to deny these accumulating psychiatric
problems to save face and further deny the issues surrounding themselves. Another consequence
of homogenizing Asians into one category is the "model minority" stereotype placed upon
Asian-Americans. The generalization that Asian-Americans are the most successful of ethnic
minorities creates needed psychological distress and expectations. Although Asian-Americans on
average do high high rates of education and occupational attainment rates, this data is not
applicable to the majority of Asians. The cast and doubt cast by this inaccurate stereotype brings
about further stigma in seeking mental health. When the stereotype perpetuates the image of the
average Asian-American as the perfect example of the American way, seeking help becomes an
admission of weakness. To seek out help means to lose self image for oneself and for one's
family. In the addition to already prevalent cultural pressures, the model minority myth places
yet another barrier in inhibiting those who require help from getting it. Thus, contrary to the
stereotypes proliferated by media and society, Asian-Americans are not a group mentally
healthier than any other group. The misinterpretation of data stems from those reporting falsely
because of cultural and societal expectations.
Stigma in 1 and 1.5 generation of people is heightened by those who have immigrated
before, especially those who have come recently. Cultures that greatly value inter-family
cohesion correlates to practiced family roles. For those newly immigrated to the United States,
the process of relocation increases the mental stress at which they acclimate to American life.
Contrasting values of family in relation to the individual clash with barriers such as language,
social, and economic issues. These stresses often lead to the consumption of alcohol, substance
abuse, and other vices in an attempt to avoid clinical attention. Because these solutions are often
times temporary, these vices become other major issues in other areas of their lives. Money that
should be going towards helping patients reach psychological help is wasted; any chance towards
receiving help decreases. The shame attached to illness furthers the discrimination and prejudice
Asian-Americans impact on themselves and on others, including extreme marginalization of any
people or topics related to mental health issues.
Among other psychological symptoms of mental illness, alcohol consumption and
rampant gambling ranks among one of the most concerning issues to plague the APA
community. Drug addiction is considered a mental illness because addiction can modify the
brain's function in substantial ways in prioritizing new things. Compulsive behaviors override
brain behavior, consequentially resulting in harmful behavior towards themselves and others. In
fact, the Diagnostic and Statistical Manual of Mental Disorders categorizes two criteria for drug
use, drug dependence and drug abuse. Drug dependence is essentially addiction, whereas drug
abuse focuses on the negative consequences of the aftermath. Drug abuse is synonymous with
increasingly large doses to maintain the same effects. In the APA community in particular,
alcohol and methamphetamine dependence is especially high, "approximately 10%"
(CITATION). Pathological gambling varies, considered an addiction, varies, but is also
particularly high. Likewise within other sub-ethnic groups, alcohol and drug usage vary. In a
study conducted by the Substance Abuse and Mental Health Services Administration
(SAMHSA), "62 percent of Japanese Americans 52 percent of Korean Americans used alcohol
over the last month as compared to about 25 percent of Filipinos, Chinese, and Vietnamese"
Agudo 4

(CITATION). These cultural trends undoubtedly have impacts on public health as well,
including driving under the influence, as reported by the Department of Justice from the Los
Angeles county (CITATION). Furthermore, those who constantly drink experience low self-
esteem and depressive symptoms associated with the gradual development of addiction and
mental illnesses. For some of those who drink to much, domestic abuse related to alcohol
consumption is common "especially among Vietnamese and Hmong immigrants" (CITATION).
In particular, the APA community show trends of methamphetamine abuse and drug dependence.
This phenomenon may be attributed towards the geographical settings of where these APA live.
Recent increase in using methamphetamine may be associated with areas along the route of drug
trades, especially in Hawaii. This route enables those who live in the area significantly easier
access to these illicit drugs. Consequences of drug abuse, especially in a hard drug like
methamphetamine results in fractured families, and thus communities. The exceedingly high
addiction value of this drug indites mental and psychological stress from the drawbacks of
withdrawal. On a lesser scale, nicotine usage is significantly less harmful and addictive, but more
widely used. Tobacco usage in Asian countries is already substantially high; Asian countries,
such as China and India are among the "largest producer[s] and consumers of tobacco in the
world" (CITATION). Although data shows that nicotine usage and dependence has lowered over
the past few decades, nicotine usage is particularly vulnerable within the Asian-American
community. Immigrants who newly arrive carry many aspects of tobacco usage from their
respective countries. Alongside with alcohol and drug use, pathological gambling is another
issue troubling the AAPI community. University of California Los Angeles Gambling Studies
Program revealed that in a survey taken in a Los Angeles Casino in 2006, "30 percent of casino
patrons surveyed identified as AAPI" (CITATION). When gambling population of one casino
constitutes nearly a third of the area, it speaks volumes over the widespread influence of
gambling in other ares as well. While mental health issues may affect the rate of gambling
among Asian American communities, "problem gambling" is probably largely a cultural trend.
Consequences of pathological gambling very often result in guilt and shame. More importantly,
money, gained or loss, have an unprecedented impact on the gambler's family and community.
As with other mental illnesses, drug abuse and gambling dependence carries its own set
of issues as well. The differences between drug usage treatment and other mental illnesses are
minor, but with different reasons. As with other mental illnesses and the people who suffer from
them, drug patients are also just as less likely to seek treatment. In terms of drug abuse treatment,
there are "little differences between AAPI and non-AAPI substance abusers", revealing the
emphasis to find solutions in breaking cultural barriers to treat patients. Similar culturally
barriers that prevent other mental illnesses are prevalent still; stigma and familial image is
consistently a subject of vital importance.
For many, the step in self-acknowledgment is often too debilitating in their image to
themselves and to others. The concept of shame and loss of face in the Asian community is wide
and diverse, spreading across many subgroups of cultural beliefs. The protection of family
reputation becomes significantly more vital over help-seeking behaviors. Those with
psychological disorders deny their situation or otherwise keep silence. The issue of stigma
becomes a much more complicated phenomenon because it is deeply rooted within Asian values.
Those who carry traditional values and beliefs often take the ideologies of their countries with
them, perpetuating the phenomenon of stigma. Furthermore, in a study conducted by Enomoto
Agudo 5

Chun in his analysis of health care issues among Asian-Americans, stigma was not just a patient
issue; it transcended to those who held medical authority, particularly in older Chinese
physicians (CITATION). Physicians, among nurses and other medical specialists were more
inclined in redirecting their Chinese patients to community health centers of Asian origin rather
than directly treating that came to them first. On further analysis, the same stigma resistance
experienced by patients correlated with medical health professional and their own
misconceptions about mental health within a culture.
In another study conducted by the National Latino Asian-American Study organization,
Asian-Americans who reached out and sought out a medical professional were satisfied, and in
fact, surprised. In order to reach out to a psychological community in need of help, education
must be made a priority to teach those who feel ashamed or stigmatized not to be. Many first
generation immigrants as well as even second and third generation Asian-Americans are simply
not aware of the resources they have at hand. For many Asian-American cultures, mental
illnesses are seen as somatic illnesses, and traditional medicine is sought after as a solution. Most
APAs trust in traditional medicine as an acceptable form of intervention, including, but not
limited to acupuncture, massages, herbal medicine, and dietary therapy. The belief that seeking
help from public health domains is comparably frowned upon; traditional medicine is common
and widely accepted. Studies analyzing health within Asian (particularly Chinese) cultures reveal
that those suffering from severe symptoms of larger illnesses or disease find themselves in an
unfavorable position easily solved if addressed earlier (CITATION). Some APA members also
associate accepting the help of mental health agencies an admission of weakness. For a culture so
acclimated with shame and guilt, seeking outside help becomes a last resort for families that
value traditional ways. Often times, those who are afflicted with mental illnesses feel lonely and
trapped within themselves, fearing judgment if they were to reach out for help. General lack of
awareness is also a factor in how little the APA community employs mental health institutions.
Western practices are not as familiar with special APA issues find further problems in the
disparity of those who offer help and those who look to seek it. Especially for those in tight-knit
communities, those who experience unsatisfactory or unpleasant treatment will often relay their
experience in their communal organization. In this, many APA communities distrust public
institutions such as government funded public healthcare and human service agencies because of
personal bias and other barriers. Further specialized education may be necessary in helping
medical professional work with those in Asian backgrounds to feel better acclimated in a helping
environment. And because Asian-Americans do not actively seek out help, medical communities
need to especially stretch out to Asian-American cultural centers such as schools, churches, and
other community gatherings. Like Red Cross or LGBT organizations, similar groups for Asian-
Americans would be prominent in alleviating the stigma and shame from mental health
disorders.
When understanding the growing demands of mental health issues within Asian-
American culture, being familiar with acculturation is essential. Acculturation, the process of
adapting to new world views and cultures is especially important to new immigrants, especially
refugees from countries suffering from political strife. For those who come from least developed
countries, the transition from their known lifestyle to new ones can often be stressful both
physically and mentally. The main differences between immigrants and refugees is largely found
in the process of arrival to their desired country. Refugees often have no motivation to leave
Agudo 6

other than fear, whether it be political or social. Time for preparation is rare so many of those
who leave have no real set plan in emotion; as such, refugees who flee to different countries have
no material assets. Furthermore, resettlement is a long and arduous process of paperwork. For
immigrants, everything is the complete opposite; those who leave their country have goals in
mind and take their possessions with them on their journeys. They are mentally prepared and
ready to leave. For high-need communities in the Asian-American refugee population, Pacific
Islanders from Laos, Cambodia, and especially Vietnam make up the majority of refugees within
the United States. For this population of people, mental health needs are often more severe,
indicated by the history of mental disorders within refugees (CITATION). Refugees that newly
arrive or whom have arrived previously for a number of years share many similar characteristics.
For one, the relationship between poverty, poor mental health, and acquirement of mental
treatment is clear. As such, many many Asian-Americans, specifically Pacific Islanders, are
homeless, making professional psychological treatment a luxury (CITATION). The exposure of
violence and bloodshed caused by political strife, especially in Cambodia during the reign of Pol
Pot in the mid to late 1970's has created a generation of people still dealing with their mental
trauma. Almost half of Cambodia's population was wiped out through mass starvation, rampant
disease, and execution. The combination of relocation and acculturation is naturally exceedingly
traumatizing to the refugees who arrive without prior knowledge. Waves of Cambodian and
Laotian refugees who survived Pol Pot's holocaust came to America was usually next to nothing.
In addition to their lack of method to sustain themselves, they were most vulnerable to post-
traumatic stress disorder associated with the mass murders of their friends, families, and peers.
Although a small portion of the refugees could speak English, most did not. As such, linguistic
and economic barriers barred those who needed help from receiving any at all. Studies document
the unusually high rates of mental disorder among Cambodian and Laotian refugees living in the
United States (CITATION). Even after 5 years since fleeing their countries, trauma events still
continue to pervade everyday life events, leaving many debilitated and unable to perform more
complex tasks. Prominent subgroup responses to trauma differed as well. For Cambodians,
PTSD, depression, and distrust ranked among the highest in the psychological symptoms towards
mental breakdowns. Southeast Asian refugees generally share the same statistics in levels of
psychological distress. In another study conducted by a Southeast Asian mental hospital in
Minnesota, "clinical diagnoses...from a symptom checklist" revealed " 73 percent had major
depression, 43 percent had post-traumatic stress disorder, and 6 percent had anxiety and somatic
disorders" (CITATION). In the same study, a random community sample of 124 Cambodian
men were anonymously surveyed for their psychological well-being. The sample of men
revealed that "45 percent had PTSD, 81 percent experiencing five or more symptoms, and 51
percent suffering from depression" (CITATION). Even before war traumas experienced in
Cambodian, trauma of starvation and torture were among the psychological symptoms reported.
Many of these people surveyed are/were parents as well, reporting extreme distress in losing
their children in the Pol Pot killing fields. Parents are still reluctant to express their "deep
worrying sadness" to others, revealing how powerful the stigma of seeking psychological help.
Even for younger generations of Cambodian and Laotian children, psychological distress is
obvious in their personal experiences. Refugee youth suffered from mild symptoms of PTSD,
and like their older counterparts, were found with symptoms of depression. In a study of
Cambodian adolescents who survived and fled the killing fields of Pol Pot reported "41 percent
Agudo 7

depression-related symptoms even after 10 years after the events" (CITATION). For youth, these
problems are also associated with greater consequences in their future lives. The inability to
make friends or find spouses will contribute to the decline in Cambodian/Laotian populations
within the United States. Clearly, psychological and mental health issues have a greater impact
than the symptoms of depression and loneliness may visibly show.
Even for those who try to access health care, major disparities become apparent when
providing safe and effective mental health care to the APA community. Public health clinics or
centers that are both culturally understanding and helpful are often unavailable or difficult to
access. In a nation in which the population of growing Asian-American and Pacific Islanders is
steadily growing, mental health care systems are limited in the help that can be offered. With
over 100 dialects in the APA community, finding efficient providers is a major difficulty that is
often overseen. In general, minorities often have less access and opportunity to reach mental
health services. And when help is received, treatment is generally in poorer quality, as it is
relative to income level and medical insurance. For minorities and Asian-Americans especially,
exclusive prominence is placed upon racial bias and treatment concerning prejudice and race.
Data collected from the National Latino Asian-American Study revealed that for Asian-
Americans who suffered from depression, 69% of those people did not try to seek out help.
Compared to other ethnic minorities, Asian-Americans sought out help on average about 15%
less. Many times, lack of linguistic ability inhibits the extent of help in which medical companies
and professionals can offer. General lack of knowledge and sensitivity of the the issue are
cultural nuances that deter many from seeking the help that is necessary. In the 2001 Surgeon
General Report concerning ethnic minorities and medical treatment, a studied show that for
every 100,000 Asian-Americans in need of help, only an average of about 70 health providers or
medical professional were culturally competent. And because of the widespread diversity of
Asian communities, languages and the many dialects of those languages become a huge
hindrance in the interpretation and translation of common language. The disparity and
availability of bilingual services remains a gap between healthcare received and healthcare
deterred. Furthermore, rates of Medicaid coverage for Chinese-Americans, Korean- Americans,
and Filipino-Americans is significantly lower than that of Whites. Although this phenomenon
may be explained by economic reasons, linguistic mistakes concerning health insurance deters
people away from it. Lack of medical insurance also remains a barrier to many APA's, especially
for refugees from countries such as Laos and Vietnam who have experienced political turmoil
and post-traumatic stress order. Different subgroups also had varying amount of people carrying
medical insurance; "34 percent of Korean Americans have no health insurance, whereas 20
percent of Chinese-Americans and Filipino Americans lack such insurance" (CITATION). Even
for Asian-Americans who belong in the same income brackets as Whites, medical insurance
coverage is still lower, evidence of the lack in utilization of medical resources. This disparity is
also further evidence of the issues that stretch beyond economic problems. For APAs under or
next to the poverty line, most small businesses and minimum wage jobs do not offer medical
insurance necessary to them. For those who do receive medical benefits from their employer, it is
often not enough to cover the expensive fees of medical facilities. Insurance coverage among
APA's also varies among subgroups of ethnicity, but nationally in the United States, about "21
percent of AAPIs lack health insurance" (CITATION). Immigration statuses, especially for those
who are not legal citizens are often deterred from accessing care from the fear of legal
Agudo 8

punishment or otherwise, jeopardizing citizenship applications. The Department of Homeland
Security office of Immigration Statistics cites that the "largest number of undocumented
individuals come from the US", among which Filipinos, Indians, Koreans, and Chinese are at the
top (CITATION). In a broader sense, mental health treatment reception is special and relative to
the minorities' historical and modern day struggles. Historical treatment often has an indirect
correlation with one's social, economic, and political status in the United States, thus affecting
their mental states. Additionally, those who already suffer from mental health illnesses,
developed or genetic, mistrust larger health organizations, contributing to the perpetuation of
distrust and the communities they are part in. The barriers that are evident within social and
economic situations becomes part of the cumulative problem in the growing issue of the
reluctance to receiving health care.
Additionally, in the comparison of Asian-Americans to any other ethnic minority, studies
begin to show that those suffering from mental illnesses seek out help when it is comparably
more severe. In the Los Angeles County, mental health clinics and hospitals alike report that
Asian-Americans attend hospitals significantly lower relatively to the general population. Again,
Chinese-Americans, Korean-Americans, and Filipino-Americans ranked the lowest in medical
attendance. The disparity was not just innate in merely age or gender differences, but in almost
every sub-category of people. Old and young alike, veterans and non-veterans, etc showed a
significant disparity still in medical treatment reception. In fact, people who blamed their mental
illnesses on somatic reasons sought religious or traditional treatment. In a study conducted by the
Chinese American Psychiatric Epidemiological Study organization, "less than 6 percent of
[Asian-Americans] saw a mental health professional and 8 percent saw a minister or
priest"(CITATION). In this, one can clearly see the overbearing influences of the same stigma
and traditional influences at hand in the Asian-American community. Compared to Whites,
especially, Asian-Americans are much less likely to convey their problems to friends or family
members. Explanations for the phenomenon of why Asian-American communities only seek out
medical health care when it becomes too unbearable are because "Asian-Americans are reluctant
to use mental health care, so they seek care only when they have severe illness" or when
"disturbed [family] members become unmanageable". Furthermore, severity of the situation
becomes only a fraction of the problem in consideration of other factors such as cultural values,
stigma, and rejection of Western medicine. Instead, many Asian-Americans are under
represented in hospital or clinical settings because they seek alternative medicines. From dietary
supplements to herb treatments, alternative medicine is much higher in Asian-American and
Pacific Islander communities than compared to Whites or other non-Asian ethnic minorities.
Focusing on high population Asian-American centers, rates begin to show the high usage of
alternative medicine. Chinatown in New York City finds that "43 percent of people had used
Chinese therapies within one week of visit" and "95 percent of Chinese immigrants in Houston
and Los Angeles used home remedies and self-treatments, including dietary and other
approaches" (CITATION). Aside from just Chinese immigrants, other sub-ethnic groups use
indigenous alternative medicine. When traditional medicine has existed in China, Vietnam, etc.
for thousands of years, it is undeniable that many consider it to be good alternates for Western
medicine in which many mistrust. Traditional Eastern medicine is wide and impactful in South
East Asia, especially in places likes India; its far reaching influences and beliefs have
undoubtedly carried over in Western settings. Often times, many of those who practice Western
Agudo 9

medicine simply do not understand the cultural impact in which immigrants or Asian-Americans
place on traditional medicine, and as such, have contentions with those they treat. Again, cultural
competence has and still is a large pervading issue as an obstacle to receiving treatment.
When actually given mental treatment, outcomes between different ethnic minorities and
Whites become apparent as well. Because of the general stigma that is associated with mental
health care in the Asian-American communities, clinics find that Asian-American patients have a
less likelihood of improving when compared to a White patient. When treating the same
symptoms, "Asian-American clients were either similar to, or poorer than those for Whites"
(CITATION). Because Asian-Americans sometime deny their illnesses or symptoms, many
patients are misdiagnosed for their own issues, receiving treatment that is otherwise ineffective
or incompatible. When Asian-American clients were matched with similarly culturally
compatible medical providers, results were significantly better. From increased treatment time to
linguistic matches, patients become more open and responsive, thus easing the negative cultural
stigma surrounding help. In a study conducted at Santa Clara County and San Francisco County
community health centers, "Asian-American children who attended Asian-oriented mental health
centers in Los Angeles received more care and functioned better at the end of care than Asian-
American children who attended mainstream centers" (CITATION). From these reports, it is
obvious how crucial and necessary it is to provide culturally compatible providers to not just
Asian-Americans, but of other ethnic minorities as well. The differences between generic
mainstream hospitals and smaller health centers/clinics were small but significant. In this Asian
oriented venues, tea is often served by bilingual providers and health care professionals, placing
clients in a comfortable and more familiar settings compared to regular hospitals. In this,
treatment becomes pragmatic and therapeutic. By understanding the personal needs of one's
culture and origin, being Asian-American oriented health centers can provide the appropriate
care required for their patients. In lieu of the extreme stigma and shame felt by Asian-American
communities for getting treatment, intervention is often necessary much earlier. Education
becomes a much more vital subject at hand and a tool in counteracting further mental harm. The
fact that many Asian-Americans do not seek mental help earlier is a clear sign in which
communities need to reach out further beyond usual communities. If Asian-Americans become
more open and responsive to their own cultures, then new programs are required to promote and
spread the voice of the issue of mental illness within the Asian-American community. Taking the
step towards bi-cultural training and understanding acculturation will be exceedingly vital in
promoting the overall well being of Asian-American people.
With every year, the population of Asian-Americans and Pacific Islanders rapidly rises as
a response to the social, economic, and political benefits people may find when immigrating to
the United States. As these trends continue to steadily occur, it is not surprising that many
fluctuation between rates of sub-groups of ethnic minorities may occur. Different types of
immigrants from different countries of origins will experience subjective experiences of social
and mental health problems than others may encounter. For example, the variability of Southeast
Asian immigrants are the prime example demonstrating the differences between subgroups. For
one, dramatically higher rates of poverty and mental trauma and illness are apparent compared to
many other Asian-American immigrants, wealth being one significant factor. Although the
strengths of family cohesion, educational achievements, motivation for upward mobility, and
willingness to work hard are strong merits within the majority of Asian cultures, the strengths
Agudo 10

they bring about are potential risks. This wide range of diversity is a problem maker as well;
often, cultural values are at constant contention with one another. Distinct barriers are
categorized within several problems, each constituting their own set of issues; these include the
obstacle of language, the stigma of seeking help, familial expectations, amongst other cultural
factors. When more than a millennium of known information is mixed in together in a cultural
mixing pot realized by the United States, mental illness becomes one of the many diverse and
inherent problems that plague the community. Although mental illness and the obstacles from
receiving treatment is not as widely known as other issues in Asian-American culture, the issue
is nonetheless harmful. In particular, when the issue is not widely voiced, those who begin to
look for treatment are often too late in seeking help. When looking at the overall picture of
Asian-American culture and community in relationship to mental illness, several things become
clear. Knowledge of mental health needs of Asian-Americans only scratches the surface of many
more underlying issues of this relationship. Very few studies address how severe mental health
illnesses are to Pacific Islander groups, as they are so various and assorted. The many
fluctuations of experiences between each separate group becomes difficult to accurately
categorize, and as such, much scholarly work is a generalization of the Asian-American race.
Chinese-Americans, Japanese-Americans, and Southeast-Asians are much more documented and
studied because of their large representation as the significant majority in Asian-American
communities. This generalization is often inaccurate in the specific problems each subgroup
deals with. Symptoms of PTSD and depression are much more likely to be found among
Southeast-Asian communities, regardless of differentiating factors, whereas Chinese-Americans,
Japanese-Americans, and Hmong-Americans are strongly influenced by their financial levels in
their access to medical help. The availability of services need to quickly adapt and change to
better help those who lack English proficiency by offering medical providers with the
appropriate language skills. As times marches forward, the requirement for medical services
catered to Asian-Americans need to grow to accommodate to the ever-expanding population of
immigrants and American citizens of Asian descent. And although mental health awareness has
substantially increased in the advent of the internet and social media, much more focus upon
quelling the negative connotations of stigma surrounding Asian-American communities will be
required in the coming future.