(November 6, 2018) Previous federal government studies have reported that 18% of Asian Americans have some form of mental distress and 3% have a serious mental illness. However, new research suggests that these rates are at least two times higher than previously reported.
Yuri Jang, Ph.D., and authors used the Asian American Quality of Life (AAQoL) survey data to report that more accurate estimates are that 44% of Asian Americans have mental distress and 6% have serious mental illness. 
While 6% may still seem like an insignificant portion of the pie, this calculates to approximately 1.2 million Asian Americans who live with serious mental illness. In addition, 28% of these 1.2 million Asian Americans perceived unmet needs for mental health services, according to the research. This measure defines those who believe that they have been denied or have no access to specific mental health services. This almost twice the national estimate for other Americans.
Individuals that used any mental health services, including specialists, doctors or religious leaders, showed up to 3.8 times higher odds of reporting perceived unmet needs, the authors report. In addition, lower education, limited English proficiency and lack of health insurance corresponded to higher odds of reporting perceived unmet needs. Across the different ethnic groups, the Chinese population reported a significantly higher rate than all other Asian groups except for the “other” category, which included Nepalese, Pakistani, Cambodian, and Japanese survey participants.
Only 37% of Asian Americans with serious mental illness reported using any mental health services. However, if you exclude religious leaders or general doctors from mental health service use, this shrinks to approximately 12%. Only 4.5% of the total mental health services used by Asian Americans with some form of mental distress or serious mental illness were provided by mental health specialists, as opposed to 18.0% by general doctors or 5.6% by religious leaders.
The researchers include religious leaders and general doctors in the analysis because of the deep stigma often associated with mental health and illness in Asian American communities. Stigma amongst Asian Americans tends to lead members of the community to seek less specialized care and frequently leads Asian Americans to seek “community mental health allies” in religious leaders.
This cultural nuance brings attention to an additional area of concern by the authors: limited English proficiency. Much of the existing national studies rely on English proficient respondents, even though approximately 21% of the total Asian American population demonstrates limited English proficiency. In fact, limited English proficiency was found as a common predictor of both mental health service use and perceived unmet needs in the analyses of AAQoL survey data—increasing both the odds that Asian Americans with serious mental illness would use mental health services and have perceived unmet needs.
The AAQoL survey was administered in 6 different Asian languages in addition to English, including Chinese, Vietnamese, Korean, Hindi, Gujarati, and Tagalog. Close to half of the participants responded using non-English versions of the survey—suggesting that the existing national data on Asian American mental health should be carefully interpreted and even more cautiously applied.
Grace Lim
Research Intern
References:
Jang, Y et al. (2018). Mental Health Service Use and Perceived Unmet Needs for Mental Health Care in Asian Americans. Community Mental Health Journal.
Lopez, G et al. (2017). Key facts about Asian Americans, a diverse and growing population. Pew Research Center.
Zong, J and J Batalova. (2015). The Limited English Proficient Population in the United States. Migration Policy Institute.