Understanding Culture to Address Mental Health in the AANHPI Community

Asian Americans and South Asian populations are understudied in most mental health-related research, ranging from epidemiological reports on youth suicide, risk factors for mental illness to treatment options.

Mental health providers are making efforts to change this by better understanding the challenges Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth face and offering culturally informed interventions. Apurva Bhatt, MD, child, adolescent, and adult psychiatrist at Stanford Medicine Children’s Health, highlights the importance of practicing cultural humility and improving support for the community’s youth.

What impact does culture have on the mental health crisis in the AANHPI community?

Studies have shown that Asians are less likely to access mental health treatment compared to white individuals, highlighting a disparity in perceived need and access for culturally informed mental health services.

The way mental health is framed within a culture plays a role in how individuals perceive and talk about their experiences, and can contribute to stigma and shame, which can discourage some from seeking help. Cultural framing of mental illness also influences the mental health treatment journey, including who one might reach out to first regarding these experiences and what treatments will be pursued, with typically culturally acceptable options being sought out first. Additionally, acculturative stress, which is the psychological impact of adapting to a new culture, can increase the risk of developing mental illness. Acculturative stress can involve experiencing cultural conflict (where the cultural values of the original culture conflict with the new culture), language barriers, and discrimination.

On the other hand, when someone feels well-rooted in their culture and participates in the community in a way that promotes a sense of belonging, this can be a protective factor against developing some psychiatric disorders. Living in a community that embraces diverse cultures can reduce acculturative stress and lower the risk of developing mental health disorders.

What are some of the barriers to care for AANHPI youth? How can clinicians help break those barriers down?

There is still a significant lack of culturally informed youth mental health care programs nationwide. Many Asian American and South Asian youth avoid seeking care due to stigma, and when they do, they often encounter clinicians who lack experience in navigating the intersection of mental health, culture, and family dynamic factors that influence care.

Clinicians can address these barriers by practicing cultural humility and continuously improving their cultural understanding to provide more effective, informed care. Creating environments where individuals feel comfortable and understood is crucial. That includes ensuring that children and teens are working with providers who look like them and understand their background. Mental health care professionals can enhance workforce diversity by offering early exposure to mental health careers, along with training and mentorship opportunities, to help bring in individuals from diverse backgrounds into the field.

What is being done at Stanford Medicine to address these issues?

Working in the AANHPI community is crucial to breaking down barriers. Stanford’s CHIPAO, or Communication Health Interactive for Parents of Adolescents and Others, provides a more hands-on way for parents to learn how to communicate with their children. There are also specialty clinics at Stanford Medicine where we have providers of diverse cultural backgrounds to provide interdisciplinary, culturally informed mental health care.

What needs to be done at an industry-level to better address mental health issues in the AANHPI community?

Our field is making progress, but there is still a lot of work to be done. First is ensuring adequate funding of culturally informed youth mental health programs and funding training programs that recruit individuals from diverse backgrounds to improve the youth mental health workforce shortage. Second, consulting youth and individuals with lived experience of mental illness through advisory groups can be very helpful in designing appropriate and timely solutions. The allcove centers are an excellent example of how youth advisory groups can guide mental health solutions for their peers. Recently, I’ve also been hearing from youth that they want more interventions and mental health education directed at parents and caregivers to help them understand that mental health is treatable and where individuals can access care.

What recommendations do you have for clinicians who are treating AANHPI youth?

The most important thing that clinicians can do is practice cultural humility and continually expand their understanding of different cultures, values, beliefs, and how these different factors impact an individual and family’s understanding of mental health experiences and treatment approaches. Clinicians can then use shared decision making and work together with the shared goal of helping the young person feel better.

Read More: Dr. Bhatt discusses how to support AANHPI youth and their families in a Psychiatric Times article.