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May 31, 2023

Ask the expert: Asian American communities face barriers in search of better mental health

“Ask the expert” articles provide information and insights from MSU scientists, researchers and scholars about national and global issues, complex research and general-interest subjects based on their areas of academic expertise and study. They may feature historical information, background, research findings or offer tips.  

May is Asian American and Pacific Islander, or AAPI, Heritage Month as well as Mental Health Awareness Month. As a cultural psychiatrist who works with underrepresented communities, Farha Abbasi recognizes the interconnectivity of both.

Farha Abbasi

Abassi is an assistant professor in the Department of Psychiatry at Michigan State University’s College of Osteopathic Medicine and serves as chair of the Mayor’s Mental Health Task Force in Lansing, Michigan. Below, she discusses the unique challenges AAPI communities face.

What do you think is the most critical issue regarding mental health as it relates to Asian Americans right now?

Stigma surrounding mental illnesses remains the biggest barrier in the access of timely care. On one hand, we have a disproportionate increase in disease burden, but the utilization rates of resources are the lowest in Asian communities. There is extremely limited mental health literacy. Then, we have a dearth of culturally appropriate resources. 

Unfortunately, another way stigma works is that we do not have enough people of color trained in these specialties. The mental health workforce of color is forced to carry a heavy burden leading to high burn out and compassionate fatigue. 

Young Asian Americans have the highest rates of suicide compared to peers. Why is this happening, and what is being done about it?

What is being done about it is extraordinarily little in the face of the problem. We are not tackling mental health seriously in these communities.

The why is more complicated. Some of these are very patriarchal societies — there is a lot of pressure on women and girls, especially when it comes to intergenerational trauma. The women carry the burden of war, displacement, immigration, employment and childbearing.

There’s lot of deeply ingrained issues like perfectionism, eating disorders and post-traumatic stress disorder. We pay a huge price to be “the model minority”: Children are treated like trophies, not humans. They cannot fail or falter. 

What issues do you see in AAPI communities that you might not see in other communities?

American society is a very independent, individualistic society where the pursuit of happiness is self-centered, whereas in Asian culture it is translated as taking care of your parents, your kids and your family. When we are told to be selfless, we forget; we become less of ourselves. We also know now that this intergenerational trauma does not just exist in the mind, it exists in the body as well. We now know even to the point that your genetics change, and the next generation can be more prone to multiple diseases and cancer. 

I am now focusing more on intergenerational trauma, which we have never acknowledged and is deeply impacting our youth. The immigration trauma, refugee trauma, Vietnam War, Hiroshima . . . we need to recognize how these events have impacted the present generation of Asians and their role in America. These are complex issues with multiple layers of untreated trauma.  

And now, there is also the growing xenophobia in the country and an increase in hate crimes that has created the fear of being a victim of violence.  

What are some steps to make progress in promoting mental health among underrepresented groups, particularly in AAPI communities? 

In my work with the Muslim community, we focused on four pillars, which are applicable to all groups. My first goal always is creating awareness: what is mental health, why is it needed, why is it important and why do we need to invest? The second is acceptance: that when we cite statistics and say “one in four in America . . .” — that includes us. It includes South Asians, Muslims, all faith communities, Latinos — it includes everyone.   

And then comes access. Now that we know that we are depressed, anxious and/or have bipolar disorder, what do we do next? Where do we go? How do we navigate care? Access also becomes a struggle due to the cultural differences, language barriers, lack of culturally appropriate care or culturally trained workforce, fear of being misunderstood. So, why would anyone contact a provider if they feel like they will not be understood? 

That is why the fourth pillar is advocacy. The people making these policies do not know much about these vulnerable populations. That is where the disconnect happens and the trust deficit in the system comes in. How do you bridge that gap? We need to be in these spaces to ensure policies reflect “nothing about us without us” and are designed and implemented with representative members at the table.

We need to be more politically conscious and engaged. We need to be familiar with what bills are out there and how they are going to affect us. 

Tell me more about our work on this issue.

There is a saying: “You cannot boil an ocean.” One person cannot do every part of this work, so I find allies and stakeholders who are doing similar work and connect so we can augment each other’s work. 

One important thing we have done in the community is bring faith leaders into this conversation. During MSU’s 15th anniversary Muslim Mental Health Conference, we trained 50 imams in first aid mental health by offering scholarships and providing transportation to bring them to the table.

There is a lot of work being done in the Muslim community now, but when I started this work, research was not being translated or impacting everyday people. There were no initiatives to engage at the street level. This annual conference has played a huge role in bridging this gap.

Currently, we have — for the first time in the history of the residency program — six residents working closely with Asian communities. For example, there’s one Hmong resident who is doing lot of Mental health awareness in the Hmong community here in Michigan.

What would you like people to know, to think about? 

We really need to talk about the consequences of not dealing with mental health issues and the effects it is having on communities across our country. We need to shatter this silence and have our voices heard. We have a mental health crisis on our hands, and visibility is viability.

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