Asian-American Mental Health

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“Asian Mental Health” is a timely and important article by Stanley Sue and his colleagues, just published in the October 2012 edition of American Psychologist. This is one of three articles recently written that address mental health disparities occurring in cultural groups.

Ten years ago the U.S. Surgeon General wrote a report Mental Health: Culture, Race, and Ethnicity: A Report of the Surgeon General. This report addressed areas of need regarding mental health among Asian Americans. The report noted Asian subgroup differences in Asian subgroups. For example, there was a higher prevalence of PTSD among Southeast Asian refugees. Interestingly, some studies showed overall lower prevalence of Asian-Americans compared to other groups.

The article by Sue and colleagues revisits the knowledge generated in the past ten years in order to assess further the need for mental-health services among Asian-Americans. They conclude that cultural biases in symptom reporting make it difficult to draw exact conclusions about the state of Asian-American Mental Health.

One problem identified is the limited English proficiency and lack of language service providers. Another was the question about whether mental-health prevalence among Asian Americans is affected when the definition of a mental disorder varies across cultural groups. The 2001 report by the Surgeon General confirmed that there are varying levels of disorders, symptom expressions, and culture-bound symptoms.

The authors warn that there may be an insidious process occurring because Western definitions of mental health may be teaching the rest of the world “to think like Americans.” Such a process might alter how mental illness is expressed in other cultures. Witness the increase of a small cluster of mental health disorders—depression, PTSD, and anorexia—that are spreading across non-Western cultures.

Sue and colleagues conclude that “what is clear from the extensive evidence pointing to the under-served needs of Asian Americans is that new innovations are needed to reach a greater proportion of Asian Americans with mental disorders.”

They conclude: “One may be tempted to raise the question of whether services should be the focus of attention, if indeed, Asian Americans have low rates of mental disorders and low service utilization rates. Our position is that because of methodological and concepual issues, the prevalence of mental disorders among Asian Americans is still and open question that must be further examined.”

Two specific areas of need involve suicide among elder Asian-American women and PTSD in Southeast Asia refugees. Finally, “community-level or cross-disciplinary collaborations may be necessary to effectively reach Asian Americans who are reluctant to seek specialty mental health care.”

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