Mind Matters: Mental Health in South Asian Americans

A recent article in India West reported that a higher percentage of South Asian Americans, especially between the ages of 15 and 24, had been found to exhibit depressive symptoms and a higher rate of suicide among young South Asian American women compared to the general US population. Likewise, studies have spoken of how South Asian immigrants have high rates of mental health disorders that go unaddressed.

Asian American Connect

Other studies have shown that immigrants from South Asia to the USA and their children face numerous mental health challenges.

“This could be on account of acculturation, that is cultural or psychological changes that occur as a result of prolonged first-hand contact between two different belief systems or cultures. Stress predominantly originates from their attempts to incorporate ‘American’ traits in their own culture. This eventually shows up as a cultural conflict. Multiple other factors contribute to this stress, including alienation and separation from their families and loved ones, language barriers preventing true socialization, uncertainty around their immigration status, financial stressors, as well as in certain cases, overt or perceived discrimination, and more generally, barriers to cultural integration,” says Dr. Priyanka Thukral Mahajan, Consultant Psychiatrist, Masina Hospital.

Conflict Concerns

Eventually, this cultural conflict leads to uncertainty around belonging. This is particularly more visible in the workplace. The effects of prolonged acculturation and discrimination result in a wide spectrum of psychological disorders over time. These include depression (primarily due to isolation, financial stress), somatization (i.e., self-interpretation of mental health symptoms as physical symptoms and not seeking help), anxiety (again on account of alienation), substance abuse disorders, especially alcohol.

“Such disorders have a dark underbelly, as they are one of the key reasons for increasing rates of suicides among South Asian immigrants in America. The tragedy is that all the above is neither widely known nor acknowledged. The issue is accentuated further by the challenges associated with seeking help from mental health professionals in the form of psychological counseling. If one gets into the weeds of the issue, one realizes that such immigrants have limited means of confiding their feelings with mental health professionals in the USA, given cultural barriers and differences. It is difficult for professional mental health professionals to understand their feelings and challenges, correlate with their culture and truly empathize with them,” adds Mahajan.

Ethnicity Woes

South Asian countries have been right in the center of the pandemic conversation throughout. Though the impact for South Asian Americans is even more convoluted. At the height of the pandemic, last year xenophobia gripped multiple countries and this community bore much of the backlash for no fault of their own. The lingering effects continue in a lot of pockets. The impact that it would have had on their mental health would be enormous.

“Personal stories shared by individuals across the world via my online counseling sessions gave me an insight into the South Asian American community and their fears. The last 14 months, we have seen an increased prevalence of nonpsychotic depression, pre-anxiety, somatic concerns, alcohol-related disorders, and insomnia in general. Parents worried about their children’s safety have given rise to psychological symptoms correlated more with physical complaints of fatigue and pain in older adults. This was directly related to social media use, misinformation, xenophobia, and social distancing. The resulting isolation made a lot of people see the bad rather than the good in a community. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination,” says Sahiba Sethi, Counseling Psychologist, Ummeed Healing.

Apps as a Tool

Apps are just a click away, so are easy to access.

“And some may already be socially isolated and experiencing loneliness which can worsen mental health. COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke,” says Nabhit Kapur, Founder President of PeacfulMind Foundation.

Apps help people connect in their native languages to a therapist who understands their culture and can empathize with their situation. Some of these apps are powered in the background by Artificial Intelligence.

“These apps help such immigrant patients deal with their mental health issues in a much better way. Their biggest advantage is the patient’s perceived lack of being judged by a third person, resulting in lower stigma towards using them as against meeting a mental health professional in person. This stigma is a huge barrier especially in the South Asian community given the cultural background. A key issue with such apps, however, is in certain instances the patients may not feel truly connected with the device, which can result in a decline in their usage over time. A recently launched app for this purpose is SAMHIN (South Asian Mental Health Initiative and Network). Another one that has been in existence for a longer duration is SASMHA (South Asian Sexual and Mental Alliance). These apps can help connect people who need psychological counseling, with various platforms, to seek support and find mental peace,” says Mahajan.

COVID Angle

Statistics reveal that only 23% of non-Americans in the USA seek mental health, against the 40% of Americans born in the USA. Patients from such communities find it arduous to find a mental health professional from their own community, who can understand their situation and truly support them. Covid-19 pandemic has further worsened the above dynamic. As is very well known, the sheer incidence of mental health issues has gone up significantly through this pandemic due to heightened financial insecurity, lack of social contact. For the immigrants, seeking medical help in these times has become even more challenging.

Prakriti Poddar, Global Head for Mental Health at Round Glass, Managing Trustee Poddar Foundation says, “a 2018 study found out that stress related to acculturation, trauma, and discrimination has been linked with depression, anxiety and substance abuse among South Asian Americans. Also, the COVID-19 pandemic has affected South Asian American communities by increasing stress and anxiety levels in terms of health concerns and issues such as employment and housing. Due to the uptick in violence and hate against the South Asian American community, racism has also severely impacted the mental health of the community.”

Breaking Taboos

In India, it is an uphill task to change perceptions related to mental health predominantly due to the stigma associated with it. The challenge lies in creating the right kind of awareness about mental health problems and encouraging people to seek the right kind of help from mental health professionals.

“Mental health crisis can be attributed to the outbreak of Covid-19 and resultant loneliness, isolation, fear of loss of life, financial insecurity, job cuts, salary cuts, and overall economic uncertainty. The common mental health issues associated with the COVID-19 pandemic are stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear reported among Indians. Stress, anxiety, and depression have been closely related with the COVID-19 pandemic,” says Dr. Aparna Methil, Vice-President, Operations, Mpower. Mental health issues faced by South Asian immigrants in the USA are immense and one of the ways to tackle the challenge is to take the help of technology. After all wellness in a click matters the most.

Mental Health App List

Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.