There Are Not Enough Asian Therapists

Asian Americans need mental health services but cannot find fellow Asian Americans therapists. This is a problem.

Ihen I sought therapy in the past, I tried to find a fellow Asian American female therapist. While there were many female therapists available in my area, I didn’t come across a single Asian American female therapist. All four of the therapists I have used over the last four years are Caucasian. When I stopped to think about it though, it was not a surprise at all that it was difficult to find an Asian American therapist.

A quick search for therapists on a mental health professionals directory revealed there are very few Asian American therapists compared to therapists of other ethnicities in several major cities in the United States. On the directory, run by the startup Zencare which aims to smooth the process of connecting to an online therapist, zero of the therapists in the directory for Seattle were Asian. 2% of therapists in the directory for Boston were Asian and it was 4% in New York City. Even though New York City fared the best among the three cities, it only had 16 female Asian therapists and 3 male therapists.

The lack of options in Asian American therapists means it may be more difficult for Asian Americans to get the specialized mental health care they need to face their family, personal, and relationship issues. It can be difficult if you are seeking therapy to articulate a struggle they are facing, or to realize that the issue they have is actually a common issue faced by many of their ethnicity and gender. Having a therapist who has gone through similar challenges and understands your culture on a nuanced level allows the therapist to tailor their advice specifically to your needs.

When the statistics regarding mental health need and services availability is compared, it becomes clear that is a significant gap between the prevalence of mental distress among the Asian American population and a lack of educational and professional resources to address mental health needs of this community. Not only that, there is no evidence that a pipeline of future resources such as Asian American therapists exists. This means the current gap in need and resources is unlikely to change in the near future without intervention. This is a real problem for the Asian American community that needs to be addressed.

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The gap between mental health needs and help

Studies comparing the percentage of Asian Americans indicating they experienced mental distress recently and the number of these respondents who took action to seek mental health resources show a wide gap. There is also a significant difference between the need for mental health services and accommodation of those needs between ethnic groups with Asian Americans scoring poorly. A 2019 study, led by Yuri Jang at the USC Edward R. Roybal Institute of Aging and Suzanne Dworak-Peck School of Social Work, found the following:

• 44% of Asian American surveyed indicated they experienced mental distress compared to 18% in the U.S. general population.
• 88% of Asians Americans who have a serious mental illness had not been treated by a mental health specialist compared to 40% of non-Hispanic whites in the same situation.

The study did not dive into the length of time in which the respondents were suffering from mental distress. It is safe to say many suffer with prolonged mental distress or mental illness for many months and years before seeking treatment. According to Joel Young, M.D., untreated mental illness over the long term can lead to symptoms as minor as unexplained aches and pains and as extreme as homelessness and suicide. It is unfortunate that so many in the Asian American population are going through life without proper guidance for their mental challenges when some resources (albeit not an adequate amount) do exist to help them.

COVID-19 makes the problem worse

The coronavirus pandemic is making the lack of mental health resources for Asian Americans even more dire. Asian Americans make up 17% of the medical workforce of doctors and nurses at the frontline fighting to save lives amid the pandemic. The psychological burden on doctors who are overwhelmed with patients, undersupplied with personal protective equipment (PPE), and feeling hopeless after watching patients slip through their hands because of the lack of ventilators, is an emotionally traumatizing event. It has even driven some doctors to take their own lives. Doctors around the world, Asian and otherwise, need psychological support during and after the coronavirus pandemic.

In addition, Asian Americans are facing increased racism due to suspicions that they have a higher likelihood of carrying the virus. They have been subject to racist comments, threats, and physical assault. Asian Americans have always faced discrimination in the United States, even before the Chinese Exclusion Act of 1882, but the coronavirus pandemic has provided another excuse for open discrimination against Asian Americans. Discrimination leaves scars, often unconsciously, for many years. Therapy can help victims process these events and continue with their life. Luckily, more Asian Americans are finding their voice and calling out discrimination.

But aren’t there many Asian doctors?

There are plenty of Asian doctors, dentists, and surgeons, but not many Asian psychiatrists, psychologists, and therapists. One of the main reasons why so few Asian American licensed mental health professional exists is because a profession in mental health is not looked upon as prestigious the same way a career as a doctor, lawyer, or engineer is. Indeed, certain Asian cultures do not regard mental health issues as a real problem requiring treatment, according to a 2002 study on the cultural factors influencing the mental health of Asian Americans. The lack of Asian Americans choosing to pursue careers in the field of mental health services means there will not be anymore Asian American therapists available for future generations as there are today.

Not many Asian Americans seek therapy when they need it

Asian Americans do not tend to use therapy services even when it’s available. They have a tendency to refuse to acknowledge mental health issues when the topic is brought up in conversation, and many refuse to acknowledge the fact that they may have a serious mental health issue themselves. Many Asian cultural values do not lend themselves to the open discussion of mental health issues or encourage the seeking of modern psychotherapeutic services, which is seen as a Western practice.

The age old Asian customs of secrecy, silence, and shame, according to psychotherapist Sam Louie who specializes in Asian and multicultural issues, prevents many from being able to speak to their family and friends about the mental challenges they are facing. In addition, Asian culture emphasizes collective family decision-making, meaning one member may choose to not seek therapy if other members of the family do not think it is necessary. Even when the subject of mental distress is broached, family members may encourage the individual to seek traditional remedies such as herbs and acupuncture.

The lack of qualified Asian American therapists who speak the local language and look like their clientele is another reason for the low number of mental health services utilization by Asian Americans. Many Asian Americans, especially those above fifty, are not fluent in English. They require a therapist fluent in their local dialect to be able to effectively communicate during therapy. Asian Americans may also feel uncomfortable speaking with a therapist of a different ethnic group for fear of being misunderstood which deters them from seeking help. It makes a big difference in comfort level when the therapist is of the same ethnicity as the patient.

Increasing access to mental health services

One of the most effective steps to address the stigma of mental health is by discussing the topic more openly and often on social media, in movies, magazines, books, and among family and friends. Talking and reading about the subject helps to normalize it. “One of the best methods for reducing stigma is through informing,” says Geetha Jayaram, M.D. When I have brought up the topic of therapy with my friends, most have been curious about it. Some have even admitted to me that they have been considering therapy for themselves but still have some questions about it. They would probably like to see people of their own ethnicity and gender as well.

Raising awareness of the existence of mental health issues and available resources for Asian Americans seeking therapy is another effective strategy to combat the problem. Many do not recognize the symptoms of mental illness or think what they are witnessing is just an annoyance instead of a sign of chronic mental distress. Educational resources in local dialects to train individuals to recognize mental illness and support materials on how to intervene when a case of mental illness is identified are vital components of mental health resources. Congresswoman Judy Chu of California, herself a former clinical psychologist, introduced legislation in her district of Los Angeles to provide outreach and educational services regarding mental health among Asian Americans in her district in 2017.

The lack of understanding, availability, and utilization of mental health resources in Asian American community is a real problem that needs to be recognized and tackled with robust and sustainable programs. Aside from the occasion extreme case of suicide committed by a young Asian American student which makes the news, most cases of mental illness are invisible in Asian American communities. Just because it cannot be seen by the naked eye though, does not mean that it is not occurring everyday behind the front doors of houses all along the streets of Asian enclaves in the United States. The more Asian Americans themselves understand there is a problem, the more motivation there will be to create resources to address it.

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