Presentations

Abstract

Introduction: Although Asian Americans (AAs) have historically been stereotyped as a "model minority", recent studies highlight significant mental health challenges among AAs. In particular, AA youth (ages 15-24) and elderly individuals have higher suicide rates than their peers in other racial/ethnic groups. And AAs are 50% less likely than their counterparts to seek mental health services. However, limited qualitative research has systematically explored the underlying mechanisms of mental health disparities among AAs. To address this gap, we analyzed in-depth interview data collected from a diverse sample of Asian Americans as part of a mixed-method Community Health Resources and Needs Assessment (CHRNA) of Asian Americans to inform culturally competent health services and intervention strategies.

Methods: Key-informants (N=65, including 23 Chinese, 25 Filipino and 17 Asian Indians) were recruited between April 2023 and July 2024, using purposive sampling and referrals of Asian community gate-keepers in Hampton Roads of Eastern Virginia. Screening criteria included: 1) persons of Chinese, Filipino, and Asian Indian descent; 2) ages between 18-85 years; and 3) residents of project cities in Hampton Roads. Semi-structured interviews were conducted via Zoom (in English or Chinese), lasting approximately 30-45 minutes, by trained medical students. An Amazon e-gift card ($25) was provided to compensate participants for their time. Data analysis was guided by the Health Equity Framework and grounded theory.

Results: Mental health challenges among AAs were largely associated with the upheaval of uprooting, immigration, acculturation-related stress, and experiences of anti-Asian discrimination and racism. Access to healthcare was further compromised by language barriers, high healthcare costs, and lack of health insurance coverage. Additionally, cultural stigma around mental health contributed to underreporting of problems and reluctance to seek care, driven by a desire to maintain family reputation and harmony. Notably, significant disparities existed across subgroups, with unmet mental health needs being more pronounced among Asian Indians, older individuals, those with lower education levels, and those working in blue-collar professions.

Conclusion: Findings revealed significant mental health challenges and disparities in healthcare among AAs, highlighting the need for community-based efforts to increase awareness and education, as well as systemic interventions to improve cultural competency in healthcare.