Barriers to Psychological Help Seeking in Asian American Youth: A Qualitative Exploration in Schools, New York, 2015-2016

In contrast to the model-minority myth, which conceptualizes Asian American youth as more educationally successful, respectful of teachers, hardworking, and cooperative that other ethnic minority youth (Chang and Sue, 2003), research has demonstrated that Asian American youth are at an increased risk for depression and suicide than their White or Black counterparts (Sen, 2004). Specifically, Asian American females aged 15-24 have the highest rate of completed suicides (14.1%) compared to other racial and ethnic groups (e.g., White 9.3%, Black 3.3%, and Hispanic 7.4%). Asian males of the same age group have the second highest rate of suicide deaths (12.7%) compared to other racial/ethnic group males (e.g., White 17.5%, Black 6.7%, and Hispanic 10%) (CDC 2008). In addition to these specific mental health problems, these youth face additional culturally-specific concerns, including racial discrimination (Lee et al., 2009). Despite such needs, Asian Americans underutilize traditional mental health services (Abe-Kim et al., 2007). Compared to youth (aged 18 or younger) from other racial or ethnic groups, Asian American youth are less likely than White, Black, or Hispanic children to actually receive mental health care (Ku and Matani, 2000). Additionally, research has demonstrated that Asian American youth also tend to underutilize mental health services in school settings (Amaral, Geierstanger, Soleimanpour, and Brindis, 2011; Anyon, Ong, and Whitaker, 2014; Walker, Kerns, Lyon, Bruns, and Cosgrove, 2010), despite the delivery of mental health services in schools seemingly overcoming certain structural barriers to seeking and obtaining mental health services, including transportation, insurance coverage, and cost (Cauce et al., 2002). Using exploratory focus groups, this qualitative study sought to explore perceptions of barriers to seeking school-based mental health services among first- and second-generation Asian youth of immigrant origin (33 participants in 7 focus groups). The specific research questions were: What are the sources of stress that may contribute to mental health concerns among Asian and Asian American youth, and what are their perceptions of barriers to mental health service use?