May is Asian American and Pacific Islander Heritage Month and is a time to celebrate the vast contributions of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) people toward the arts, sciences, government, education, and more. May is also National Mental Health Awareness Month and brings to the forefront the unique mental health challenges within the AANHPI community.

To underscore the critical need for dialogue, research, and dedicated support, some states, local governments, and organizations nationwide designate May 10 as AANHPI Mental Health Day. This dual observance not only honors the rich heritage and achievements of the AANHPI community but also shines a spotlight on the essential services required to address the complex mental health needs of some of its most vulnerable members—those who become entangled in the criminal justice system. This work includes understanding who within the AANHPI community is being served by criminal justice or behavioral health programs; what culturally responsive services could be offered; and what cultural issues might pose barriers to critical mental and substance use disorder treatment and services.

Diversity and Mental Health Outcomes for AANHPI

Individuals from the AANHPI population represent a diverse group. National Asian American Pacific Islander Mental Health Association (NAAPIMHA) Deputy Director Krystle Canare states, “The AANHPI community is not a monolith. We represent more than 50 countries of origin and 80 ethnic groups, identify with various spiritual beliefs and religions, have very different migration stories, and speak more than 2,000 languages and dialects. Most of these languages are distinct, have differing linguistic roots, and can vary by neighborhood, region, religion, class, caste, and more.” Although tailoring programs for this level of diversity may be impracticable, criminal justice and behavioral health agencies can take steps to reduce harmful generalizations and improve service responsivity, such as expanding intake forms to “include at least the six largest [AANHPI] subgroups.”

U.S. Census Bureau’s American Community Survey Definitions

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including people who identify as Asian Indian, Chinese, Filipino, Korean, Japanese, Vietnamese, Pakistani, Cambodian, Hmong, Thai, Bengali, Mien, etc.

Native Hawaiian and Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including people who identify as Chamorro, Samoan, Palauan, Tahitian, Chuukese, Pohnpeian, Saipanese, Yapese, etc.

Krystle Canare

Krystle Canare

In addition to ethnic and cultural diversity, the AANHPI population faces a diverse array of mental health challenges, including suicide risk. AANHPI people experienced the most significant percentage increase in suicide deaths of the five major races between 2021 and 2022, with Native Hawaiian and Other Pacific Islander people experiencing a rate threefold higher than Asian American individuals. While suicide is a predominant cause of death among AANHPI people aged 15 to 34, both gender and ethnicity play a role. The Substance Abuse and Mental Health Services Administration, in a snapshot brief, noted significantly higher suicide rates among Guamanian men than women, but this pattern does not hold in Western Samoa, where suicide rates do not differ by gender. Based on this finding, agencies should be encouraged to explore strategies to improve cultural responsivity for people identified as part of the AANHPI population.

Service Needs and Culturally Informed Responses

AANHPI diversity underscores the need for culturally responsive support tailored to their unique needs. The AANHPI community has one of the lowest utilization rates of behavioral health services. In 2022, two-thirds of the estimated 2.8 million AANHPI people who met the criteria for any mental illness did not receive mental health treatment. This is partly attributable to systemic factors such as cost of care, limited insurance, and the behavioral workforce shortage in this country. Moreover, research findings indicate that people of color prefer and have more trust in healthcare providers who share their race. Many individuals in the AANHPI community do not have this option. Most psychologists in the United States identify as White; only .03 percent identify as Native Hawaiian or Pacific Islander and 3.28 percent as Asian.

In response, organizations such as the Asian Prisoner Support Committee (APSC) have adapted their programs to provide essential support that is accessible, engaging, and mindful of culture. For example, virtual appointments are now available for those who want to participate in the Restoring Our True Selves (ROOTS) program, a weekly class for incarcerated Asian American and Pacific Islander people, among other eligible participants, that is shaped to support understanding about immigration/refugee history, intergenerational trauma, leadership development, and reentry planning. For organizations like APSC and others to be effective, trust-building, destigmatization, and implementation of trauma-informed practices are important to meeting the needs of those from the AANHPI community who become involved with the criminal justice system.

Eddie Zheng

Eddy Zheng

Cultural Shame and Other Barriers to Mental Health Treatment Engagement

Eddy Zheng, president and founder of the New Breath Foundation, explains, “Cultural shame is disempowering and invisiblizing. We as a people do not talk about issues that diminish respect or lose face, and mainstream society prefers to think of us as a model minority. For example, throughout my incarceration of 14 years, my family never revealed where I was.”

Dr. Pata Suyemoto

Dr. Pata Suyemoto

Shame may play a role in preventing treatment engagement for mental health services within the AANHPI community. However, the power of sharing stories, such as talk story in Hawaiian culture or kwentuhan in Filipino culture, promotes healing and honors the nuanced experience of individuals. Dr. Pata Suyemoto, director of the National Asian American Pacific Islander Empowerment Network and incoming executive

director of NAAPIMHA, who has shared her story many times, notes, “I have much respect for anyone who shares their story, whether in healing circles or spaces beyond our community. The more we communicate what works for us, the more readily we’ll garner support for policies that increase access to culturally relevant services.”

Referring to his time being incarcerated, Zheng reports, “I was considered ‘other’ because I am neither White, Black, nor Hispanic. There [were]

no culturally competent services for ‘others,’ particularly those who [didn’t] fall within stereotypical expectations.” Zheng advocates for services that address the intergenerational, first-hand, and vicarious traumas that the AANHPI community has experienced and continues to encounter. “When you have an opportunity to learn, you have an opportunity for healing,” he observes. There is a shift happening, and some barriers are being removed, according to Zheng, who says, “I am encouraged by ethnic studies curricula, prioritization of language access and support in health services, and the efforts of the upcoming [AANHPI] generation to be more inclusive and to reframe the narrative around seeking support.”

Conclusion

Asian American and Pacific Islander Heritage Month and National Mental Health Awareness Month are an opportunity for communities and systems to understand and improve mental health services for the AANHPI community. Information on specific subgroups within the AANHPI population that are being served can help providers tailor culturally responsive services, which may increase engagement in treatment. Collaborating with local organizations such as the New Breath Foundation and APSC can inform the broader context in which individuals navigate the criminal justice system and improve services.

Additional Resources