1. Less likely to report challenges
   1. Asian Americans are less likely to report mental health challenges or exhibit suicidal behaviors than the general population, but these numbers have been increasing in teens and young adults over the last decade.
2. Least likely to seek treatment
   1. Asian Americans are the least likely to seek treatment for mental health conditions for reasons including stigma around discussing mental health struggles, limited knowledge of available resources, lack of insurance coverage that includes mental health treatment parity, and a lack of culturally responsive care.
3. Show struggles and culturally competent care
   1. Storylines can shine a spotlight on growing mental health concerns among Asian American youth and help overcome barriers to help-seeking by showing conversations about emotional struggles and depicting Asian American individuals accessing culturally responsive care. 

This section was written in partnership with CAPE and input from Dr. Michi Fu.

Storytelling Tips

Diversify Representation

• Include positive representation of Asian American individuals in storylines. Broadening overall representation of Asian American characters, cast members, and storylines can help combat feelings of isolation, depression, and loneliness. Highlight intersectionality and differences, showing that Asian Americans are not a monolith.
• When representing Asian American characters with mental health issues, including side characters, ensure their story extends beyond their emotional struggles. For instance, if the character is a Vietnam War refugee suffering from PTSD, that should not be their only story/characteristic. 
• Recognize diversity within the Asian American community. Find an expert advisor who can help ensure your story reflects the nuance of your character or cast member’s specific identity.

Show Conversations About Mental Health and Help-Seeking

• Show conversations about mental health happening openly and in a way that resonates with Asian American audience members. 
• Seeing positive, open dialogue about mental health may help empower some Asian American individuals — especially teens and young adults — who feel they cannot talk about their mental health and who, as a result, underutilize mental health services.
• Show these conversations happening with family as well as other sources of support like friends, guidance counselors, teachers, general health practitioners, coaches, etc. 

Spotlight Support from Friends and Family

• Show how Asian American individuals can reach out to friends and family members as a first step toward help-seeking.
• Studies show that Asian American individuals are more likely to talk to friends and family members than mental health professionals. Seeing stories of supportive loved ones in entertainment media can help viewers take a productive first step on the path toward feeling better and getting professional help if needed.

Depict Effective, Realistic Help-Seeking and Treatment

• Show Asian American characters getting effective treatment from professionals who have the experience and training to understand and support their needs.
• Seeing Asian American characters or cast members seeking help and receiving culturally competent care can be a powerful tool for encouraging viewers to get support. One way to depict culturally competent care is to show Asian American mental health professionals on-screen providing effective treatment to Asian American cast members or characters. 
• Be realistic about the practical and cultural barriers to seeking help so viewers can better relate to the storyline. These include the inability to pay for therapy/mental health services, belief from family that mental health struggles are not “real,” inability to find professional help, stigma, etc.

Represent the Complex Causes of Mental Health Challenges

• Depict the realities of generational trauma and its impact on mental health. Past wars and conflicts in Asian American origin countries may not seem relevant to the mental health of younger members of these cultural groups, but generational trauma can be a powerful influence and storytelling can spotlight this mental health factor and ways to cope with it. Work with advisors from the Asian American community to better understand how to represent the impact of that trauma and discrimination toward people struggling with their mental health.

Snapshot

Asian Americans are defined as Americans with origins in East Asia, Southeast Asia, or South Asia. It’s important to note that the Asian American community encompasses a very broad and diverse group of individuals with distinct experiences and factors that can impact their mental health—such as the transgenerational or intergenerational trauma faced by those who survived wars and/or genocide, or the anxiety felt by the children of first-generation immigrants to reconcile their cultural heritage with American life.

In general, individuals who identify as Asian American are slightly less likely to report experiencing mental health challenges than the general population, and they’re also less likely to seek help for their struggles. There have been concerning increases in the prevalence of mental health conditions and suicidal behaviors in Asian American teens and young adults over the last decade. The lack of studies done on mental health in Asian American communities contributes toward difficulties developing effective policies and treatment programs to support this population. 

A number of factors negatively impact Asian American mental health, including: 

• The model minority myth, which is a stereotype that ascribes intelligence, skills and related expectations to Asian people. This can stifle individualism and create damaging pressures and expectations, contribute to the perception that things are “not that bad” for the Asian American community, and results in fewer appropriate resources being allocated to Asian American communities in need.
• The perpetual foreigner stereotype, which occurs when someone is assumed to be foreign born or to not be fluent in English because of their background or appearance. An individual can experience increased feelings of isolation and loneliness by being treated as an outsider based solely on race. This stereotype is the root of much of the violence against the Asian American community, and the fear of this violence can further affect mental health.
• Trauma, particularly in individuals and families from conflict areas, can be passed down to children and subsequent generations. Events like the Vietnam War, the Cambodian genocide, and Japanese incarceration have contributed to intergenerational trauma in Asian American communities. 
• Some common religions practiced by Asian Americans, like Hinduism, Buddhism, Sikhism, and Islam, are often misunderstood and discriminated against in the United States. These perceptions and mistreatments can increase one’s likelihood of experiencing mental health challenges like depression and anxiety. 
• Bullying can have a harmful effect on mental health among young people. While fewer Asian American students report being bullied compared to white, Black, or Hispanic students, more Asian American victims of bullying report being bullied because of their race. Furthermore, the alarming spike in hate incidents have complicated the experience of Asian Americans during the pandemic.

Asian Americans also experience cultural barriers to help-seeking. Previous studies have shown that traditional Eastern cultures tend to have a higher “external locus of control,” or a mindset that emphasizes compliance with authority and acceptance of fate, compared to Western cultures, which have a higher “internal locus of control” and more motivation to seek outside help. As a result, members of the Asian American community may experience guilt or shame around mental health struggles and choose to endure those struggles independently rather than reach out for help. Likewise, research indicates that stigma is a cultural barrier unique to Asians that can prevent or delay help-seeking, which can have consequences for treatment prognosis.

Additionally, Asian Americans who are first- or second-generation immigrants may not be familiar with available mental health resources, one reason being the lack of bilingual mental health services as well as  the need for greater collaboration between formal mental health care systems and community resources that reach immigrant communities. 

Facts and Stats

Of the 6.1% (20+ million) Americans who identify as AAPI (Asian American and Pacific Islanders), nearly 15% reported mental health conditions in the past year. 

AAPI are 3 times less likely to seek mental health services than whites. This makes them the racial group least likely to seek mental health services. 

Only 3.6% of Asian Americans received prescription medications for mental health conditions versus 15.4% of whites. 

Suicidal thoughts, plans, and attempts rose among AAPI young adults over the last decade (while still lower than the overall U.S. population). Suicide was the leading cause of death among Asian Americans ages 15 to 24 in 2017.

While statistics suggest lower misuse of substances and lower need for substance use treatment, Asian Americans are also less likely to receive treatment when it’s needed. Likewise, Asians may experience barriers for other addiction issues, such as gambling and internet addiction.