According to a report from the National Center for Biotechnology Information, culture shapes the expression and recognition of psychiatric problems. Western culture makes a distinction between the mind and body, but many Asian cultures do not. Therefore, it has long been hypothesized that Asians express more somatic symptoms of distress than white Americans. The influence of the teachings and philosophies of a Confucian, collectivist tradition discourages open displays of emotions, in order to maintain social and familial harmony or to avoid exposure of personal weakness. Mental illness is highly stigmatizing in many Asian cultures. In these societies, mental illness reflects poorly on one’s family lineage and can influence others’ beliefs about how suitable someone is for marriage if he or she comes from a family with a history of mental illness. Thus, either consciously or unconsciously, Asians are thought to deny the experience and expression of emotions. 

To better understand the Asian American experience, one should know the basic demos. According to a recent US Census Bureau report:

  • There are 19 million people in the United States who identify as Asian/Pacific Islander, up from 11 million people just fifteen years earlier.  6 million live in California, followed by 1.7 million who live in New York.
  • Among Asian Americans, 6.2 million are of Chinese descent, 3.9 million of Filipino descent, and 3.3 million of Indian descent, followed by 1.9 million of Vietnamese descent, 1.8 million of Korean descent, and 1.3 million of Japanese descent.
  • In 2012, 13 percent of Asian Americans lived below the poverty level, and 15 percent were without health insurance.  21 percent of Pacific Islanders lived below the poverty level, and 18 percent were uninsured.
  • 51 percent of Asian Americans have at least a Bachelor’s Degree, compared to 29 percent of all Americans, and 15 percent of Pacific Islanders.
  • 270,000 Asians are veterans, one-third of them over the age of 65. More than 32,000 Pacific Islanders (including Hawaiians) are also veterans.

And of this Asian-American demo, fewer Asian Americans report mental health issues than their white peers. Having said that:

  18.9 percent of Asian American high school students report considering suicide, versus 15.5 percent of whites.

  10.8 percent of Asian American high school students report having attempted suicide, versus 6.2 percent of whites.

  Asian American high school females are twice as likely (15 percent) to have attempted suicide than males (7 percent).

  Suicide death rates are 30 percent higher for 15 to 24-year-old Asian American females than they are for white females (5.3 versus 4.0). 

  Suicide death rates for 65+ year old Asian American females are higher than they are for white females (4.8 to 4.5).

Some quick figures from the US Department of Health and Human Services’ Office of Minority Health breaks down Asian American stats like this:

  • Suicide was the 9th leading cause of death for Asian Americans, and the 10th leading cause of death for White Americans, in 2014.1
  • Southeast Asian refugees are at risk for post-traumatic stress disorder (PTSD) associated with trauma experienced before and after immigration to the U.S. One study found that 70% of Southeast Asian refugees receiving mental health care were diagnosed with PTSD.2
  • For Asian Americans, the rate of serious psychological distress increases with lower levels of income, as it does in most other ethnic populations.
  • The overall suicide rate for Asian Americans is half that of the White population.

According to the Asian American Psychological Association:

Asian ethnic groups (i.e., Korean Americans, Filipino Americans, Japanese Americans) have been found to have higher levels of problem drinking than other Asian ethnic groups.

7.1% of Asian American adolescents between the ages 12–17 reported having used alcohol in the past month in the United States.

According to SAMHSA (2013), while the numbers suggest a lower use of substances, Asian American Pacific Islanders are less likely to receive treatment when they need it.

Rates of past month drug use were lower among Asian adults than national averages (3.4 vs 7.9%)

Nearly 14% of Asian Americans or Pacific Islanders who were 18 to 25 years of age needed substance use treatment compared with 21.5% of persons from other racial or ethnic groups.

Other stats include these from SAMHSA:

  • Among people ages 12 and up, the rate of illegal drug use in the last month was 4.1% among Asian Americans and 15.6% among Native Hawaiians or other Pacific Islanders.
  • The rate of binge alcohol use was lowest among Asian Americans ages 12 and up (14.5%). The binge alcohol use rate was 18.3% among Native Hawaiian or other Pacific Islanders.
  • The past-month binge alcohol use rate for youth ages 12 to 20 was 6.7% for Asian Americans, compared with the national average of 13.8%.
  • The rate of substance dependence or abuse was 4.5% for Asian Americans and 10% for Native Hawaiians or other Pacific Islanders.

In 2014, the percentage of Asian Americans ages 18 and up reporting a past-year mental illness was 13.1%, and 3.1% of Asian Americans and 1.2% of Native Hawaiian or other Pacific Islanders ages 18 and older had serious thoughts of suicide, compared to the national average of 3.9%.

Treatment also comes with its own issues:

  • Language barriers make it difficult for Asian Americans to access mental health services. Discussing mental health concerns is considered taboo in many Asian cultures. Because of this, Asian Americans tend to dismiss, deny, or neglect their symptoms. 
  • Lack of awareness of the resources and services that are available, as well as the stigma surrounding mental health issues, are the biggest deterrents in seeking professional help.
  • Most young Asian Americans tend to seek out support from personal networks such as close friends, family members, and religious community members rather than seek professional help for their mental health concerns. 

Historically, Asian Americans have had challenges in accessing health care and insurance. To whit:

  • Nearly 1 out of 2 Asian Americans will have difficulty accessing mental health treatment because they do not speak English or cannot find services that meet their language needs. 
  • Prior to the passage of the Affordable Care Act, 15 percent of Asian Americans, and 18 percent of Pacific Islanders lacked health insurance. 
  • Relative to other U.S. populations, Asian Americans are 3 times less likely to seek mental health services. 

According to data from the National Latino and Asian American Study, as a group, Asian Americans have lower rates of mental illness than whites but seek treatment less often but it can differ within communities. For example, while Vietnamese Americans had similar rates of mental illness as the other Asian-American groups, they were much more likely to seek help.

Stress can form in other ways too; ways unique to the immigrant experience. For example, immigrant parents have expectations that their children are both obedient and appreciative of sacrifices made by them when they left their native country. Because of America’s culture is somewhat different, these children might assimilate faster than their parents expected (or wanted) which creates conflicts which, in turn, can then increase the risk of mental health problems.

Ultimately, Asian-Americans – especially males – need to learn that seeking help for any mental health illness including addiction is not a sign of weakness but, indeed, is a step in the right direction on the road to recovery.