Healing and Mental Health in Asian Pacific American Communities

Sumie Okazaki, PhD | May 10, 2022
An Asian American woman with long brown hair in three-quarter profile, wearing rose-color shirt and necklace, smiles and looks at camera.

Sumie Okazaki, PhD. Photo by Brandon Ruckdashel

The unrelenting news of violence and hate incidents against Asian Americans, especially here in New York City, on top of the stresses of the COVID-19 pandemic, has brought the mental health concerns of Asian Pacific Americans (APAs) into the foreground. As a scholar who specializes in Asian American mental health, never has my expertise been called into such demand.

My family immigrated from Japan to the United States in the late 1970s to follow my late father’s “American dream” as an engineering professor. Whereas our family’s middle-class status largely protected us from economic insecurities and a lack of educational opportunities, I grew up with a floating sense of racial discomfort – what the poet Cathy Park Hong so aptly describes as “minor feelings.” I discovered in college that there was a burgeoning field of Asian American psychology and I’ve made a career out of scholarship and teaching about how Asian American experiences are shaped by immigration, race, and family contexts. Yet, what has struck me the most – across various workshops, panels, addresses, and discussions about Asian American mental health that I’ve conducted with students, parents, educators, business leaders, and corporate workers in the past two years – is the recurrent remark:

“This is the first time we’re talking about race and mental health.”

How is it that it took the confluence of a global pandemic and the rapid escalation of anti-Asian hate to finally bring community conversations about the mental health of Asian Americans into the open?

Historical and Contemporary Context

Black and white contemporary photo of sign hung via taught chainlink to two wooden posts. Sign says Manzanar War Relocation Center. In distance is flat open landscape that leads to mountains

Manzanar concentration camp, California, where more than 10,000 Japanese Americans were imprisoned during WWII under Executive Order 9066. Photo: Marc Cooper

It is worth stating at the outset that there is no single Asian American or Pacific Islander experience. Our communities are made up of people from diverse national origins, pre- and post-migration histories, languages, cultural traditions, religious faiths, geopolitical entanglements with the U.S. as well as other colonizing powers, and much more. At the same time, there are shared pan-APA identities that arise out of our experiences of being racialized as Asian Americans and Pacific Islanders.

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Throughout U.S. history in times of national crises, Asian American communities have been blamed and ostracized as a foreign threat. After the Japanese attack of Pearl Harbor, Franklin D. Roosevelt signed Executive Order 9066 to authorize the exclusion, removal, and mass incarceration of 120,000 Japanese Americans from the West Coast. After September 11, many South Asian American and Muslim members of APA communities faced individual and systemic Islamophobia and discrimination. And Russell Leong’s account of Chinese restaurants in San Francisco, New York, and London being shunned during the SARS outbreak in 2003 is eerily similar to the economic damage experienced by Chinatowns in major U.S. cities – including New York City Asian-owned businesses – due to xenophobic fears during the early days of the COVID-19 outbreak.

A narrow street with many Chinese-language signs hanging vertically alongside buildings.

Pell Street in NYC’s Chinatown in Manhattan, looking west towards Doyers and Mott Streets. Photo: chensiyuan (2009)

Adding to the economic pain, the most vulnerable members of APA communities have been targeted by anti-Asian hate and violence. Collectively, APA communities have witnessed viral video accounts of Asian elders being assaulted or killed in unprovoked random street violence; the murders of six immigrant Asian women workers at Asian massage parlors in Atlanta on March 16, 2021; and AAPI frontline essential workers, including healthcare workers and delivery workers, met with racial animus and violence. From March 2020 through December 2021, Stop AAPIHate collected nearly 11,000 hate incidents against Asian Americans.

Mental Health Concerns of APAs

Masked protesters hold black and yellow printed posters that say Rise Up

The Asian American Federation’s “Rise Up Against Asian Hate” Rally in Manhattan, NYC on Feb. 27, 2021. Photo: Seungjae Seo

Given the pervasive and relentless news of anti-Asian violence, hate, and discrimination, is it any wonder that Asian Americans’ mental health concerns have been brought into sharp focus? Indeed, social scientists have documented the mental health impact of COVID-19 racism on Asian Americans. My colleagues at NYU and I surveyed 689 Asian American adults from across the U.S. in December 2020. We found that 79% of the respondents had experienced or witnessed at least one form of anti-Asian discrimination or hate that year. We also found that those who had experienced or witnessed such discrimination reported increased distress and worry.

A study by Cary Wu, Yue Qian, and Rima Wilkes that analyzed a large national survey of adult respondents revealed a sizeable race-related psychological gap, due partially to Asian Americans having experiencing increased racial discrimination. In 2020, the study found, the mental health woes of Asian Americans spiked amid a rise in anti-Asian hate crimes and pandemic-related bias. White Americans, on the other hand, were only half as likely to have encountered COVID-19-related discrimination.

Of course, even without the urgency of pandemic-related stress and anti-Asian hate, APA communities have long experienced stressors linked to poorer mental health. Like other immigrants, APA immigrants are challenged by acculturative stress, or the stress of adjusting to a new environment in which you may not know the language, the social norms, and other unwritten rules of how to survive and thrive in a new context. Acculturation is particularly difficult for immigrants who are without the support of kin and friends who remain in their native countries. Some APAs worry about uncertain futures in the U.S. due to a lack of U.S. citizenship or permanent residency, while others contend with pre-migration trauma and family separation. APA children face bullying in schools and APA adults face limited opportunities in workplaces due to racism.

Though the increased mental health needs of APAs are now clear, cultural and structural forces continue to keep APA community members from openly discussing and addressing their mental health concerns. Due to cultural stigma, too many APAs view mental illness as a sign of weakness and a source of shame, preventing them from seeking professional help. There is also a dire shortage of culturally-affirming bilingual mental health care professionals for APA communities. The unmet mental health needs of APAs in New York City has been long recognized, and a local group of Asian American mental health professionals, the New York Coalition for Asian American Mental Health, has been advocating for greater resources.

What Helps?

A group of protesters in purple and sweatshirts holds signs that say CACF and sand on city hall steps. In foreground are two women behind a CACF sign.

Coalition for Asian American Children and Families co-executive directors Anita Gundanna and Vanessa Leungco calling for an equitable City budget at May 5 rally on the steps of City Hall. Photo: John Eng

Despite the enormity of unmet mental health concerns of APAs, I am hopeful about the changes taking place for many reasons.

First and foremost is the increased visibility of Asian Pacific Americans who are speaking up publicly, giving voice to those who remain unseen and unheard. Local pan-Asian American nonprofit organizations such as the Asian American Federation and the Coalition for Asian American Children and Families have been working tirelessly for decades, and continue to be strong coalitional voices for the community. The Asian American Federation has also unveiled a new online resource, a Mental Health Directory of local service providers and organizations that can deliver services in various Asian languages.

Second, the professional sector and academia have generated a wealth of resources to identify and fill the knowledge gaps, gathering timely data and conducting research on such issues as the impact of COVID-19 on APA populations. One local example is the NYU Center for the Study of Asian American Health, which has collaborated on a needs assessment of Native Hawaiian and Pacific Islander communities. Nationally, the Asian American Psychological Association has gathered mental health resources to respond to COVID-19 and anti-Asian racism.

Third, many workplaces and educational spaces are creating more spaces for APAs and others to talk about race, racism, stress, and mental health – openly, and not just during the APA Heritage month.

A brightly colored graphic illustration of a woman with long black hair, earrings looking at viewer. Text says: I am not your scapegoat. The large image is on side of bus shelter on a New York City avenue. Tall buildings and traffic are in background.

Bus Stop: One of the hundreds of works in “I Still Believe in Our City,” a public art campaign artist and activist Amanda Phingbodhipakkiya created during her NYC Commission on Human Rights residency that reclaimed space in NYC neighborhoods where anti-Asian bias incidents have occurred. After the March 2021 shootings in Atlanta, this portrait appeared on the cover of TIME magazine. Photo: MK Luff

I am also heartened by the efforts of artists who contribute to the community’s radical healing. Amanda Phingbodhipakkiya, a local Thai-Indonesian American artist, has produced brilliant large-scale public artworks that grace our public buildings, bus stops, and subway stations with messages combatting xenophobia and hate. My friend and a psychology colleague, Professor Richard M. Lee, teamed up with his cartoonist brother, Martin Lee, to produce The Other Ones,” a daily comic strip that addresses race and racism. The Chinatown Art Brigade is an intergenerational collective of Asian American and Asian diasporic identifying artists, scholars, and organizers anchored in New York City’s Chinatown, making work that centers art, culture, and community in response to gentrification and displacement. And there are many additional grassroots civic engagement, advocacy, and cross-race coalition efforts led by activist groups working tirelessly to dismantle racism and promote resilience and wellness. 

Five colorful comic panels. One says They say Ask Questions. I ask, why don't you teach us about he 1882 Chinese Exclusion Act. I get send to the office. Good Grief. Four other panels are related and say. I met another Asia American in school today. Cool. Except he said He's Chinese...not Asian American. Huh? Yeah...he hasn't grasped how racism works.

“The Other Ones” comic strip by brothers Prof. Richard M. Lee and Martin Lee

As my research team and I continue to analyze the data we collected during the first year of the pandemic, our preliminary results suggest that Asian American adults were engaging in all forms of activism and solidarity workfrom educating self and others about racism, having difficult dialogues with family, friends, and colleagues, to voting, signing petitions, and participating in protests—not just on behalf of Asian Americans and immigrants but also on behalf of Black people. Although it took the tragedy of a global pandemic and virulent anti-Asian racism to bring many APAs to talk openly about mental health “for the first time,” I am confident these conversations and actions will continue.

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For more content concerning this month’s column, visit our highlights of Asian Pacific American Heritage Month and Mental Health Awareness Month.