The United States is a melting pot of cultures, races and ethnicities. While that has many advantages, the medical community cannot always keep up with and accommodate the differences that reveal themselves in such an environment. Different cultures provide unique challenges regarding treatment and diagnosis. The Asian American population is one that presents some of these challenges and in the last several decades as the population has grown, treatment plans and specialized facilities have been established and developed in order to help this community. Many of these facilities have become more specialized, offering representatives for Korean, Japanese, Chinese, and Khmer patients, just as a few examples. These differences require not only a variation on treatment from a psychological perspective, but can also change biological requirements and dosage needs for medication. For these and other numerous reasons, the medical community has developed to understand the specific needs of Asian American patients, and offer them the care and treatment that they need.
Waiting to Seek Help
According to the article “Mental Health Issues for Asian Americans,” from Psychiatric Services, Asian Americans have always had low admission rates to state hospitals for mental health issues. “Earlier researchers suggested that the low utilization rates might reflect low rates of psychopathology among Asians” (Lin & Cheung, 1999). However, further study of this phenomenon revealed that members of the community who were finally admitted for hospitalization had conditions which were “…significantly more severe and chronic than those of patients of other cultural backgrounds and consequently required more intensive treatment and longer hospitalization or outpatient care.” This reluctance to seek help for mental health is backed by preliminary data from the National Latino and Asian American Study (NLAAS) survey (APA.org). These facts together indicate that instead of being immune to behavioral health issues, the Asian American community does not seek treatment until their health has degenerated and all other options have been exhausted.
Confusing the Mental with The Physical
While the clinics and programs developed to assist Asian Americans have made a measurable positive impact on mental health among the population, the article points out that “…service barriers to the overall mental health system and low utilization of services continue to be major issues, both in the public and the private sectors.” One major problem is that Asian American patients often focus on physical symptoms in favor of psychological ones, even when they are conscious of both. Cheung returned to Hong Kong for further study of this phenomenon and found that it was consistent: “…although patients typically focused on their somatic complaints when visiting a physician, they were often fully aware of their emotional problems as well as stresses derived from social relationships that might be related to their emotional as well as somatic symptoms” (1999). Based on these findings, she suggested that most patients selectively presented their symptoms according to what they perceived as appropriate and tended to focus only on somatic suffering while in health care settings.
A study done with Vietnamese refugees backed up Cheung’s study. This study found that when participants were asked about their physical and mental health in general they only reported the physical. “However, their response to the Cornell Medical Index showed extremely high mean psychological as well as somatic scores, indicating that when they were asked specifically, they did not have difficulty reporting psychological symptoms” (1999).
Lin and Cheung explain that one main reason for this disconnect is the Eastern versus Western philosophies of body and mind.
“The Western view that emphasizes the separateness of the two has roots in the Greek philosophies…This…model not only has provided the foundation of modern medicine, but also has exerted profound influences on practically every aspect of modern Western life, including how distress is expressed. In diametric opposition to this perspective, Asian traditions have always regarded body and mind as one. Despite Western influences, most contemporary Asians continue to adhere to such a unitary model, which consciously or unconsciously permeates all aspects of their lives, including language and help-seeking preferences… This tendency, added to a natural tendency to be reticent about emotions that may be linked to a person’s private life, may result in the exclusive reporting of somatic symptoms” (1999).
As a result, mental health professionals working with Asian American patients should consider “…not focusing predominantly on the psychological side of the patient’s suffering, but to present a formulation compatible with the patient’s cultural orientations” (1999).
Another article about Asian American health, titled “A Call to Action”, offers a comprehensive list of innovations to the state of Asian American-specific health care. Some of these include greater research where there is inadequate sampling, especially regarding mental disorders which are more prevalent in certain Asian American subgroups: “suicide among Asian American older women and PTSD in Southeast Asian refugees…” The authors offer ideas on how to modify research, as well as recommending community-level or cross-disciplinary collaborations in order to establish solutions to some of the biggest barriers facing Asian Americans. These include “[a] delay in recognizing symptoms and seeking help, stigma and shame over using services, lack of financial resources, non-Western conceptions of health and treatment, use of alternative resources, and lack of language-proficient providers” (Sue, Cheng, Saad, & Chu, 2012).
The Asian American community is certainly getting better care than ever before, with more uniquely suited professionals and research into how to address and care for this population. However, there is still plenty of work to be done as treatment and research both become more specific and more widely established.
Lin, K., & Cheung, F. (1999). Mental Health Issues for Asian Americans. PS Psychiatric Services, 50(6), 774-780. doi:10.1176/ps.50.6.774
Meyers, L. (n.d.). Asian-American mental health. PsycEXTRA Dataset. doi:10.1037/e460192006-034
Sue, S., Cheng, J. K., Saad, C. S., & Chu, J. P. (2012). Asian American mental health: A call to action. American Psychologist, 67(7), 532-544. doi:10.1037/a0028900