Author: Clare Jocelyn Mangubat
Compared to other Latinx/Hispanic, White/Caucasian, and Black/African American adolescents, Asian American adolescents experience higher levels of anxiety and reach the clinical threshold more frequently (Brice et al., 2015). They may be under pressure due to the Model Minority Myth (i.e., notion that Asians in general are more successful than other minorities) (Qin, 2008; Chao, Chiu, & Lee, 2010) and stressful parental interactions. These interactions may be especially salient during adolescence, when one’s desire for independence is intensified with the American sense of individualism (Buki, Ma, Strom, & Strom, 2003). While Asian American adolescents are at a great risk for poor mental health, many do not receive treatment. Only about 8.6% of Asian Americans received services or resources for mental health, which is less than almost 18% of the general population in the United States (Spencer, Chen, Gee, Fabian, & Takeuchi, 2010). While these statistics are not specific to adolescents, they intimate that Asian American adolescents may accordingly seek treatment less often. Knowing how Asian Americans adolescents are susceptible to anxiety can inform healthcare professionals to educate parents on the importance of mental health and encourage healthcare professionals to de-stigmatize mental illness among Asian families.
Social Environment: Model Minority Myth, Parents, Peers
Various social pressures to succeed from the Model Minority Myth and from parents (Lee et al., 2009) may provoke anxiety among Asian American adolescents. When people adopt the idea that a specific group naturally performs better than other groups, individuals from that “model” group may internalize strong societal pressures to achieve more than their peers. When Asian parents set extraordinary standards for their children’s performance in school, they might frequently remind their children about their high expectations and regularly check in about grades. In turn, Asian American adolescents may ruminate about disappointing their parents. The constant, societal burden to excel paired with incessant, quotidian reminders to meet parental standards may push Asian American adolescents to excessively worry about performance in school, in extracurricular activities, and at home.
The social environment at home may also induce anxiety among Asian American adolescents. Specifically, the acculturation gap between parents and adolescents can lead to familial conflicts (Ying, 1999). Asian American adolescents may stress about having different values than their parents, not having as much autonomy as their peers, and believing that their parents do not understand them. Qin (2008) found that distressed Chinese immigrant adolescents had strict parents who imposed a hierarchy at home and valued education performance. While this study did not evaluate all Asian households, strict hierarchies at home and traditional values of education commonly found in Asian households may induce stress.
Social environment shaped by the peers of Asian American adolescents is another factor that may engender anxiety. Asian American young adults reported that discrimination, especially during high school, was a considerable cause of stress (Lee et al., 2009). When in an academic environment where peers show prejudice against them, Asian American adolescents may constantly worry about the next acts of discrimination against them. They may not feel like they can be themselves if classmates are making comments about their looks, their behaviors, and their culture. Juan and Alvarez (2010) found that discrimination was related to poorer adjustment in terms of anxiety, which was intensified by family conflict.
Healthcare Access: Cultural Barriers
Cultural barriers to healthcare access can contribute to the maintenance of anxiety among Asian American adolescents. In Asian culture, it is believed that individuals control their mental health. Therefore, mental illness is often regarded as something that can be fixed by oneself, without the need for medical and professional help (Lee et. al, 2009). This understanding of mental illness encumbers Asian American adolescents from seeking treatment for their anxiety. Not only may they believe that they are responsible for minimizing their own anxiety, but it can be that their parents believe that as well. Even if Asian American adolescents disclose their mental health problems with their parents, their parents may not encourage them to go to a professional to alleviate their anxiety. This lack of encouragement to seek help may contribute to the high percentage of Asian American adolescents with anxiety and low percentage receiving treatment.
In Asian culture, there is also stigma around mental illness and treatment (Augsberger, Yeung, Dougher, & Hahm, 2015), such that treatment should be the last option if even contemplated at all (Akutsu, Castillo, & Snowden, 2007). While Asian American adolescents might not be told explicitly that their mental health doesn’t matter, their mental health is not prioritized compared to other concerns like grades and physical health. When mental health problems arise, they might not know what to do or who to turn to because these problems aren’t talked about in their culture.
There also may be a scarcity of mental health professionals who can provide culturally appropriate care (Lee et al., 2009). Being paired with a provider who does not completely understand one’s situation could weaken the patient-provider relationship. This is because Asian American adolescents may not trust their provider enough to disclose everything that they are feeling and experiencing. As a result, they may not trust their provider’s recommendations.
Implications for Healthcare Professionals
Lee et. al (2009) posits that the number of mental health professionals who are linguistically and culturally competent should grow and that parents should be educated on mental health. Healthcare professionals can become aware of Asian culture, the societal and family pressure placed on Asian immigrant adolescents, and family conflicts that may be common among immigrants. This may strengthen their capability of identifying and treating Asian American adolescents with anxiety. Healthcare professionals can also educate parents on the importance of mental health. They can be a key role in de-stigmatizing mental illness among Asian immigrant families. This may inspire parents to care about their children’s mental health and be open to talking about the subject.
Conclusion
Asian immigrant adolescents’ risk for anxiety may be attributable to social environment and health care access. Social environment is not only shaped by familial and peer interactions but by overarching racial stereotypes. Stigma in Asian culture influences access to treatment. Therefore, it is important that healthcare professionals are aware of the social determinants of health that provoke and maintain anxiety in order to have a general idea of what to expect when caring for Asian American adolescents. This strong foundation can be individualized based on each patient’s situation in order to provide specific, competent care. This knowledge can also motivate healthcare professionals to educate Asian parents on the importance of mental health and de-stigmatize illness among Asian families.
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