The Generational Difference: Why Asian Americans Face Barriers to Mental Health Support

Written by: Theo Chen | Edited by: Nathan Hahn

As an Asian American growing up with immigrant parents, it is well known that the words “I love you” were hardly exchanged. It is in the wordless actions and sacrifices—the bowls of cut fruit that appeared by your table, and the bedroom without a speck of dust despite your absence for college—that really express this unspoken and unconditional form of love. In this mute exchange, you feel that to work your hardest to succeed is the only way to repay their gestures.

I am depressed.

However strong familial love can be, within the community, these three delicate words are spoken just as sparingly. 

Asian Americans are the fastest-growing population in the United States, and they face significant unmet mental health needs. Despite growing awareness of mental health across college campuses and healthcare settings, Asian Americans remain among the least likely to seek mental health services, even when experiencing significant distress. 

According to the U.S. Surgeon General’s report and recent CDC data, Asian Americans are up to three times less likely than other racial groups to access mental health services, despite reporting comparable or higher levels of psychological distress. This underutilization persists across age groups, income levels, and educational backgrounds, rooting out these factors as confounding variables. 

Why Asian Americans?
This disparity isn’t just a matter of stigma—it’s a complex intersection of cultural values, societal expectations, and immigration experiences. In many Asian cultures, family is the primary source of emotional support. While this can foster resilience, it can also create pressure to maintain harmony and avoid burdening others. Mental health struggles may be seen as personal weaknesses or threats to family reputation, leading individuals to suppress mental symptoms. The concept of honor serves as a double-edged sword. It encourages children to assume familial responsibilities, but to that end, avoid mental health struggles that could bring down the family name. The avoidance of shame and stigma is a huge deterrent for mental health acknowledgement within the community and results in somatization, the expression of emotional distress as physical symptoms. Somatization is common and can mask underlying mental health conditions.

Not only did the CDC report that Asian Americans were less likely than other ethnic populations to seek out mental health support, but it also found that  “Many participants perceived that being ‘1.5 or 2nd generation immigrants’ was a strong contributor to stress in their lives.” 

Impact of the Model Minority Myth
Since the 1848 influx of Asian immigrants to the United States, like all minorities, Asian immigrants faced resistance to assimilation and acceptance in America. After the voiding of the Chinese Exclusion Act and other discriminatory policies, the compliant and earnest values of Asian immigrants earned them the title of “Model Minority”. However, this isn’t always remarkable. The model minority myth (MMM) falsely portrays Asian Americans as universally successful, academically gifted, emotionally resilient, and economically stable. While seemingly positive, this stereotype invalidates struggles around mental health. 

The public view of Asian Americans through the model minority myth pressures Asian Americans to feel compelled to live up to the “successful immigrant” narrative. This leads to internalized pressure, fear of failure, and reluctance to express vulnerability. According to a 2024 review from the University of Michigan, internalizing the MMM is linked to higher levels of anxiety, depression, and identity conflict. Many report feeling “too well-off to be unwell,” a phrase that captures how the MMM invalidates their pain.

The model minority myth isn’t just a stereotype—it’s a barrier to healing. Closely tied are the values immigrant parents instill in their children. At the generational threshold of assimilation, parents instill a belief that mental health is not a priority. For many Asian American families, especially recent immigrants, mental health care may not align with traditional healing practices or survival priorities. The “immigrant mindset” often involves mental health-related challenges and beliefs that stem from a history of trauma, scarcity, and cultural stigma, leading to a reluctance to discuss or seek help for mental health issues. This mindset prioritizes survival, security, and providing for the family, viewing mental well-being as secondary to achieving tangible success and security. 

What can you do?
Addressing this requires building bridges by starting intimate conversations, connecting mental to physical health, and challenging the stigma through culturally sensitive approaches. As future healthcare professionals, we must recognize that mental health disparities are not just clinical — they’re cultural and structural. Approaching these issues may be increasing access to bilingual and bicultural providers, normalizing mental health conversations in Asian American communities, and integrating cultural humility into medical education and practice. Acknowledging the difficulties that were conquered from an immigrant’s journey and the torn identity that multi-generation Asian Americans face is a great place to start.

As this new Asian American identity is forming, regardless of our ethnic background, we play a role in its perception. By understanding the unique barriers Asian Americans face, we can begin to build bridges between cultural values and clinical care, ensuring that no one has to choose between family loyalty and personal healing.

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