Mental Health: Southeast Asian Americans

I was curious to know about the state and quality of mental health services available to Asian Americans, specifically the Southeast Asian American communities here in the U.S.

Despite the notion of Asian Americans as the “model minority”, studies show that “not all Asian Americans are as uniformly educated, acculturated, and financially successful as the myth of the “model minority” would suggest.” Source: http://www.cacf.org/mythsfacts/index.html

In the course of research, I came across The Southeast Asia Resource Action Center (SEARAC), a national organization “advancing the interests of Cambodian, Laotian, and Vietnamese Americans through leadership development, capacity building, and community empowerment.”

People from the Southeast Asian countries of Cambodia, Laos, and Vietnam constitute the largest group of refugees ever to build new lives in the United States. Nearly all Southeast Asian Americans — whose main ethnic groups are Cambodian, Hmong (from the northern mountains of Laos), Lao, and Vietnamese — entered the U.S. as refugees or as relatives of refugees at various times after the end of the Vietnam War. They began to relocate to this country in 1975, when the American-supported South Vietnamese government succumbed to the military pressures of their Communist neighbors to the north. In that same year, the Communist Pathet Lao defeated the US-supported government in Laos, and in 1976 the US-supported Cambodian government was toppled by the infamous Khmer Rouge. Southeast Asian arrivals to this country increased dramatically in the late 1970s and 1980s, with the influx of Vietnamese “boat people,” the flight across the Mekong River of hundreds of thousands of Hmong and Lao refugees from Laos, and the escape of hundreds of thousands of Cambodians from the Khmer Rouge government in Cambodia. Current estimates are that 1,342,532 Southeast Asian refugees entered the United States between 1975 and 1998.

Source: http://www.searac.org/commun.html

Another excellent resource is the Suicide Prevention Resource Center (SPRC).
In “Suicide Among Asian American/Pacific Islanders”, the Suicide Prevention Resource Center (SPRC) shared the following:

General Statistics
The Centers for Disease Control and Prevention report that, between 1999 and 2004, in the Asian American and Pacific Islander population:

• The suicide rate was 5.40 per 100,000, approximately half the overall U.S. rate of 10.75 per 100,000.¹
• The highest rate, 27.43 per 100,000, was found among adult males 85 and older.²
• Suicide ranked as the 8th leading cause of death for all ages (compared to 11th for the overall US population).³
• During the 1980s, the Asian and Pacific Islander population more than doubled in the U.S., making it the fastest growing racial/ethnic group, followed by Hispanics. Three fourths of the Asian and Pacific Islander population growth has been due to immigration. This rapid growth is predicted to continue, with another doubling by 2009.⁴
• Elderly Asian American/Pacific Islander women have higher rates of suicide than whites or blacks. For women aged 75 and older, the suicide rate for Asian Americans/Pacific Islanders was 7.95 per 100,000, compared to the white rate of 4.18 and the black rate of 1.18.⁵

Youth Statistics

• In the 12 months preceding the Youth Risk Behavior Survey, Asian American and Pacific Islander high school students were as likely as their black, Hispanic, and white counterparts to have attempted suicide.⁶
• Suicide ranked as the second leading cause of death for those ages 15 to 24 years old.⁷

Mental Health Considerations

• One study found that Asian Americans and Pacific Islanders are significantly less likely than Caucasians to mention their mental health concerns to:
  1. a friend or relative (12% vs. 25%),
  2. a mental health professional (4% vs. 26%),
  3. or a physician (2% vs. 13%).⁸
• Asian Americans do not access mental health treatment as much as other racial/ethnic groups do, perhaps due to strong stigma related to mental illness. Emotional problems are viewed as shameful and distressing and this may limit help-seeking behaviors. Asian Americans also tend to rely on family to handle problems.⁹
• Asian American concern about negatively affecting their social network and expectations of low effectiveness keep them from seeking help.¹⁰

Ethnic and Cultural Considerations

• For nearly half of Asian Americans and Pacific Islanders, access to the mental health care system is limited due to their lack of English proficiency and to a shortage of providers with appropriate language skills.¹¹
• Many Asian American and Pacific Islander cultures view the psychological and physical as highly interconnected, unlike the common view in Western cultures. Asian Americans and Pacific Islanders may be more likely to express emotional distress through physical problems and to believe that physical problems cause emotional disturbances.¹²
• In Asian Americans, suicide risk increases with age. Some explanations for the increase are related to difficulties adapting to the U.S. culture. Elders are not treated with the level of respect of their native cultures and may feel burdensome. Many Asian American men who are in the U.S. without their families are isolated not just from family but also culture.¹³

See references at http://www.sprc.org/library/asian.pi.facts.pdf.

Finally, the third resource I discovered was “Mental Health: Culture, Race, and Ethnicity (A Supplement to Mental Health: A Report of the Surgeon General), 2001.”

Many Southeast Asian refugees are at risk for post-traumatic stress disorder (PTSD) associated with the trauma they experienced before they immigrated to the United States…

Studies document high rates of mental disorders among these refugees. A large community sample of Southeast Asian refugees in the United States (Chung & Kagawa-Singer, 1993) found that premigration trauma events and refugee camp experiences were significant predictors of psychological distress even five years or more after migration. Significant subgroup differences were also found. Cambodians reported the highest levels of distress, Laotians were next, then Vietnamese. Studies of Southeast Asian refugees receiving mental health care uniformly find high rates of PTSD. One study found 70 percent met diagnostic criterion for the disorder, with Mien from the highlands of Laos and Cambodians having the highest rates (Kinzie et al., 1990; Carlson & Rosser-Hogan, 1991; Moore & Boehnlein, 1991).

See references at http://www.surgeongeneral.gov/library/mentalhealth/cre/sma-01-3613.pdf.