Asian American/Pacific Islanders

Asian Americans and Pacific Islanders are diverse in ethnicity and in their cultural and historical experiences. There are many Asian Americans and Pacific Islanders who have lived in the U.S. for several generations, but there also are a high number of recent immigrants who contribute to a great diversity in language and culture among this group. Asian Americans and Pacific Islanders are often portrayed as the model minority. For many, this is true; however, reports also indicate that half of all Asian Americans and Pacific Islanders have difficulty accessing mental health services because of economic barriers, social and cultural differences, language disparities, and the lack of culturally competent providers.

Among all ethnicities, Asian Americans and Pacific Islanders are the least likely to seek help for mental disorders. Asian cultural values of self-reliance and reservation and fear of shaming the family keep many from seeking assistance with emotional problems.

Rate of Mental Disorders
A study has not yet been conducted to determine the rate of mental disorders among Asian Americans and Pacific Islanders. However, researchers have examined mental-health problems by measuring the prevalence of symptoms. In these studies, Asian Americans appear to have an increased risk of depression with Chinese Americans reporting the highest lifetime prevalence rate of depression.

Symptoms of social anxiety, social phobias, and trauma-related disorders also occur at high rates among Asian Americans, especially among second-generation Asian Americans. This may be attributed to conflict caused by their strong identification with mainstream culture.

Some studies have indicated that Asian Americans who use mental-health services are more severely ill than other groups. Evidence suggests this is because many Asian Americans delay seeking treatment because of the stigma associated with using mental-health services and cultural and linguistic barriers to access.

Mental Health Issues
Despite being viewed as a model community, Asian Americans and Pacific Islanders face many of the same mental health problems as other groups. Evidence shows high rates of addiction, gambling, and family violence among some groups of Asian Americans and Pacific Islanders compared to the general population.

Substance Abuse
While Asian Americans overall had the lowest rate of drug use among all groups, the illicit drug use rate for Pacific Islanders, in contrast, is 9.1 percent higher than any other ethnic or racial group. In addition, treatment admissions for stimulant abuse among Asian Americans and Pacific Islanders are nearly four times higher than total admissions for this condition.

Gambling
Asian Americans show high rates of gambling disorders compared to the general population. For example, about five percent of the general population suffers from a gambling addiction, but in the Chinese-American community, 20 percent are problem gamblers. Southeast Asian Americans have the highest lifetime prevalence of pathological gamblingâ€”one study reported that 59 percent of Southeast Asian refugees were pathological gamblers.

Domestic Violence
Until recently, Asian Americans and Pacific Islanders were thought to have lower than normal incidents of domestic violence. One study dispelled that notion by finding that 38 percent of Asian Americans surveyed knew a woman who had been injured by a partner. Family violence may be tolerated to maintain the family, avoid conflict, and avoid dishonorâ€”this is especially true in the Cambodian and Vietnamese communities.

Culture-Bound Syndromes
In addition to Western psychiatric disorders, Asian Americans also may experience culture-bound syndromes, such as shenjing shuairuo and hwa-byung. These syndromes may draw upon Asian patientsâ€™ mind-body connection. In many Asian cultures, the mentally ill are so stigmatized that sufferers may experience their anxieties as physical aches and pains.

SHENJING SHUAIRUO, or neurasthenia, is a mental disorder triggered by stress. The symptoms include sensations of pain or numbness, chronic fatigue, weakness, anxiety, and fainting. Neurasthenia is an acceptable medical diagnosis because it conveys distress without the stigma associated with a psychiatric diagnosis.

HWA-BYUNG, or â€œfire-illness,â€ is a Korean folk illness. Sufferers report such symptoms as a heavy feeling in the chest, sleeplessness, hot flushes, cold flushes, and blurred vision. It is thought that hwa-byung might serve to provide sufferers with a way to conceptualize and resolve emotional distress.

Youth
While little is known about the mental-health needs of Asian American and Pacific Islander youth, studies that examine mental symptoms indicate that there are high rates of depression, anxiety, and suicide among this group. The conflict between traditional family values and mainstream culture may cause additional stress and exacerbate anxiety for some Asian youth.

Older Asian Americans and Pacific Islanders
Four small-sample studies have examined the mental well-being of older Asian Americans. One study found that older Asian-American women have the highest suicide rate of all women aged 65 and older, and the suicide rate among elderly Chinese-American women is 10 times higher than the rate among white elderly women. Older Asian Americans also show a greater prevalence of dementia than the general population.

High-Need Groups
Many Asian Americans are at risk for post-traumatic stress disorder because of trauma suffered before immigration. During the 1970s, Southeast-Asian refugees fled war-torn countries and the ravages of the cruel dictatorships. National trauma and repeated exposure to catastrophic events, such as combat, forcible detainment, and torture, as well as the stressors associated with relocation, continue to affect the emotional health of many Southeast-Asian refugees.

Conclusion
With the proper treatment, most symptoms of mental illnesses can be controlled. If the possibility of mental illness is a concern for you or someone you care about, there is no shame in seeking treatment. Mental health information is available in many Asian languages and can be obtained through your physician, a clinic, or online. Culturally and linguistically competent mental-health professionals also are available and can be reached by contacting your physician and asking for a referral.
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