Enhance Accessibility and Reduce Barriers

Asian-Americans tend to underutilize mental health services. Physical illness is much more culturally acceptable than mental illness.  Research shows that Asian-Americans are “three times” less likely to seek mental health services.  The low utilization rates have to do with the lack of appropriate services and barriers to services, rather than lack of need for services.  In a study conducted by Leong and Lau (2001) four categories were identified as barriers to Asian-Americans in search of treatment. These categories are; cognitive barriers, affective barriers, value orientation barriers and physical/structural barriers.


Barriers to Services

Cognitive barriers refer to the culturally conception of psychosocial and mental health issues in the Asian community.  This barrier relates to how Asian-Americans view the nature of their problem and its solution. The culturally informed conceptions are demonstrated through two Confucian themes; an “orientation toward others and a sense of holism among body, mind, and spirit” (Torsch and Xueqin Ma, 2000). 


The affective barriers refer to the expression of and response to psychosocial and mental health problems. Asian-Americans are unwilling to utilize mental health services because of the “shame and stigma” associated with any type of distress.  Their cultural values impress upon them not to share personal problems with people other than family members. Asian-Americans are called to endure suffering and this is seen as a “path to maturity”.


The barriers of value orientation of the Asian culture directly conflicts with the individualist value of the American culture.  Asian-Americans put an emphasis on the interest of the family, even if it means self-sacrifice of personal goals. Communication within the Asian culture is noted for the deference to authority, thus there is an effort to be deferential and respectful to any professional.  Thus typical therapy is sometimes ineffective in working with this population.


Physical and structural barriers are related to social class and the lack of awareness of services.  Services are inaccessibility for a number of reasons, including lack of transportation, child care, and lack of adequate insurance/money.  Another barrier includes lack of appropriate cultural outreach.  Language barriers are also the reason for underutilization of services.  Research has found that Asian-Americans are more likely to receive effective services if the therapist speaks their native language.  Structural barriers include a mistrust of social services within the Asian community.


Accessibility to Services

In spite of these barriers, accessibility to services can be enhanced using a variety of   ways. One way to reach out to Asian-Americans is to provide ethnic-specific programs.  When providers are members of the same ethnic group, and staff/client have the same cultural values then barriers to services will be reduced. Other things to consider in the enhancement of services include; location of services within the community, employment of bilingual staff, cultivation and utilization of the site as a community center.  A place where services can be provided and where social and cultural festivals can take place.  It would be important to consider the availability of mental health services within medical facilities. Asian-Americans readily seek medical assistance without the stigma associated with mental health issues.   Another acceptable source of help can come through school counselors.   Importance in the Asian community is placed on the importance of academic excellence and counselors can be a source of referral regarding mental health issues.  Asian-Americans have the lowest rates of utilization of mental health services among ethnic populations.  In order for this to change mental health professionals must think outside the box to reach this population.  Use of alternative resources within the community should be considered. Cultural factors encourage the use of family, traditional healers, and informal sources of care, these factors could possibly be incorporated into more conventional treatment plans.  Emphasis should be placed on education and preventive strategies provided to all generations of the Asian-American population in regard to mental health treatment and availability of services.  The development of cultural and linguistically competent services would also be helpful in reaching the Asian-American population. With the collaboration of mental health professionals and appropriate stakeholders the problem of underutilization of services can be corrected.