A new report lists multiple ways in which lawmakers and other thought leaders across the country can help Asian American communities obtain improved access to mental health services.
Nationally, about 37 percent of people of Asian descent indicate that they have poor mental health, according to a report just released by the Center for American Progress. This is defined by the Kaiser Family Foundation as having one or more of the past 30 days during which one’s mental health “wasn’t good.” Poor mental health includes depression, stress and emotional problems.
Moreover, Asians are three times less likely than Whites to seek and utilize mental health services.
Among the factors that result in such disparities is the misconception that Asian Americans are monolithic and don’t need such help, along with the pervasive Model Minority Myth that all Asians are wealthy.
The Center for American Progress report states that lawmakers should expand the collection and publication of fully disaggregated health data of the different Asian subgroups.
“Too many analyses currently rely on aggregated data that provide an incomplete picture of these diverse communities,” the report stated. “Collecting sufficiently large samples of data on Asian-American ethnic groups is difficult. However, it is essential for crafting truly responsive public policy, especially health policy.”
Because Asians come from a variety of socioeconomic backgrounds, there is a “harmful and inaccurate narrative of homogeneity” in these communities stemming largely from too little disaggregated data, the new report states.
Previous studies have found significant discrepancies among the mental health needs of different Asian populations. For example, 33 percent of Korean American adults experience symptoms of depression, compared with less than 16 percent of Chinese Americans. Among Filipino American women, 78 percent describe their mental health as excellent or very good, compared with just 45 percent of Chinese American women and 50 percent of Vietnamese American women.
Meanwhile, too many Asian Americans still lack affordable access to mental health services, the report stated.
According to survey data from the Centers for Disease Control, 1 in 3 Asian Americans who have been diagnosed with depression have not been able to see a doctor in the past year due to cost. This is particularly disconcerting because the uninsured rate of Asian Americans who aren’t elderly fell from 15 percent to only 8 percent between 2013 and 2016.
Immigration status is another barrier to accessing affordable mental health services in Asian American communities. Asian nations made up five of the top six sources of immigration between 1965 and 2015, according to the Center for American Progress report.
“Evidence suggests that improving access to coverage for immigrants can reduce disparities in prescription drug utilization and physician visits,” the report stated.
Lawmakers can craft policies to boost mental health care utilization, such as guaranteeing universal coverage, eliminating under-insurance, expanding coverage for immigrants and providing free access to mental health and substance abuse disorder services.
A third problem for Asian Americans is the language and stigmatic obstacles.
More than 35 percent of Asians in this country are limited English proficient, and 77 percent speak a language other than English at home. Consequently, Asian Americans — especially those born outside the United States — would benefit from greater language accessibility in mental health services, the report stated. But in 2012, only 18 percent of hospitals offered their medical staff a formal assessment of foreign language proficiency, and less than one-third of hospitals required medical residents to receive any interpreter services training.
To bridge the communication gap between Asian American patients and mental health service providers, it’s important for health care providers to offer professionally trained and culturally competent interpreters. Last year, U.S. Rep. Judy Chu, D-Calif., introduced legislation that would provide culturally and linguistically appropriate treatments and interventions for Asian Americans, Native Americans and Pacific Islanders.
“Policymakers should support these and other efforts to ensure that all Americans have access to the health care they need,” the Center for American Progress report stated.
Furthermore, some Asian Americans don’t seek mental health services because of social stigma. A 2010 survey revealed that the stigma surrounding disability is among the most significant obstacles to accessing such services and from seeking out civil rights protections such as the Americans with Disabilities Act.
Finally, cultural incompetency and bias among health care professionals pose additional problems, the new report states. In 2017, about 13 percent of Asian-Americans reported that they had experienced discrimination during a doctor or health clinic visit. The problem is even worse among immigrants, with 1 in 6 reporting discrimination.
“Hospitals, medical practices and universities should invest in cultural competency training,” the report stated.
The lack of diversity among mental health professionals fuels cultural incompetency in the mental health field. Asian Americans are underrepresented in the U.S. psychology workforce. For instance, Japanese Americans and Filipino Americans make up 7 percent and 19 percent of the Asian American population, respectively, but constitute less than a respective 2 percent and 4 percent of Asian applicants to U.S. medical schools.
“Colleges, universities and professional associations should do more to ensure that the medical field is building a pipeline,” the report stated.
The Center for American Progress report focused only on Asian Americans. It doesn’t include Pacific Islanders, whose data are often studied alongside people of Asian descent.
The report concluded that, “Of the millions of Asian Americans who report poor mental health status, too many face systemic barriers to treatment and are therefore unable to access vital health services. Lawmakers and members of the health community can and must do more to ensure that all Americans — regardless of ethnic or socioeconomic background — have access to the care they need.”