CACF - Coalition for Asian American Children + Families

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New CACF Policy Brief Finds Language and Cultural Barriers Prevent Access to Mental Health Care

NEW YORK (November 3, 2022) --In a new policy brief titled Collective Healing: Moving Towards A More Community-Centered Approach to AAPI Mental Health Care, the Coalition for Asian American Children and Families (CACF) details the myriad of ways the conventional mental health care system leaves New York City’s Asian American and Pacific Islander (AAPI) communities behind when it comes to accessing care. Language barriers, a lack of culturally accessible practitioners, and limited options for un- or underinsured patients all contribute to a mental health care landscape that is inaccessible to community members seeking care.

The ongoing impact of the COVID-19 pandemic and related economic instability and public safety concerns make improving AAPI access to mental health care more necessary than ever. In order to address this increased need for mental health care, CACF and our members provide a list of recommendations that include the following:

  • Invest funds and resources into AAPI-led and -serving CBOs that provide conventional mental health services to the AAPI community in NYC. CBOs have been crucial in providing both linguistically accessible and culturally responsive conventional mental health care as they have established longitudinal relationships with the communities they serve. These direct connections allow them to respond to the diverse mental health needs of their AAPI community members. Therefore, the city and state government must prioritize funding these AAPI-led and -serving CBOs.

  • Revise the licensure and/or educational requirements of mental health students and practitioners to include cultural responsiveness. Culturally responsive training must be a central priority for the mental health field, starting from the education of students intending to obtain licensure as practitioners. 

  • Create more opportunities to increase the number of mental health practitioners that speak the languages of the communities they serve and for those most impacted in our communities to enter the mental health field.  In order to create a more culturally responsive workforce, policy and funding must be used to not only encourage individuals to stay in the mental health field, but also to break down barriers that make it difficult for people from marginalized backgrounds to enter the field.

  • Support and uplift holistic mental health care approaches. As systemic barriers to treatment continue to exacerbate community members’ hesitancy and access to seek conventional mental health care services, it is critical to support and raise awareness for holistic care options that can provide a larger range of culturally responsive care to our AAPI community.

  • Prioritize the disaggregation of mental health data to better account for the diversity in ethnic identities within the AAPI population. Most current data collected by city and state agencies lumps all of our diverse groups together as a single entity, thereby masking substantial diversity (ancestry and language) and various disparities in our community. Disaggregation of mental health data would break down the data into more granular ethnic and language subcategories that will help identify the specific mental health needs in our community that have historically gone unseen and unaddressed by lawmakers and government agencies.

“Even when members of our communities actively seek out mental health care options and treatments, the obstacles they face often feel insurmountable. This brief makes clear that our community-based organizations need to be able to hire bilingual counselors and social workers while also increasing programming options geared towards AAPI youth and seniors – two of our community’s most vulnerable groups – in particular,” said CACF’s Co-Executive Directors Anita Gundanna and Vanessa Leung. “Perhaps most important of all, we must expand access to health insurance and call for the expansion of mental health coverage by insurance plans so that all New Yorkers regardless of their income can access the care they need.”

CACF’s Health Policy Coordinator Medha Ghosh notes that community-based organizations often see the disconnect between the mental health resources available and the needs of the residents their organizations serve. 

“This brief provides community insight into the ways our mental health care system can better support the AAPI communities' unique needs. Often, the discussion around AAPI mental health issues focuses on the prevalence of stigma towards mental health within the community. By centering the conversation around stigma, it puts the onus on the AAPI community rather than the conventional mental health care system that has failed to meet the needs of our community,” said Ghosh. “There must be an investment in ensuring conventional mental health care is more linguistically accessible and culturally responsive for the AAPI community. In addition, holistic forms of mental health care that already exist in the AAPI community (such as reiki, acupuncture, and healing circles) and have been shown to have a positive impact on mental wellbeing should also be uplifted and supported.”

The profiles recommendations included in Collective Healing: Moving Towards A More Community-Centered Approach to AAPI Mental Health Care were created with the vital support of 19 CACF’s partner organizations whose staff work in the community each day.

"Eighty percent of the individuals and families who turn to us for their mental health needs are better served in a language other than English,” said Kaushal Challa, Chief Executive Officer of the Charles B. Wang Community Health Center. “Improving that language access is key to serving them effectively, particularly in light of the COVID-19 pandemic and the rise of Anti-Asian incidents. CDC's recommendations for increased access to linguistically and culturally responsive care are an important step toward improving mental health outcomes for the AAPI community in New York.”

"Linguistic and cultural sensitivity is very crucial while providing mental health services. Trust plays a key role in forging a therapeutic relationship, especially in immigrant communities who are not always comfortable seeking mental health services in a traditional hospital-based setting,” said Mary Archana Fernandez, Director of Family Support Services at the South Asian Council of Social Services (SACSS). AAPI-led and -serving organizations understand the specific cultural and linguistic needs of the communities that they serve and are able to provide mental health services in non-traditional settings." 

"Creating this Executive Summary on AAPI Mental Health needs and recommendations is so vital and necessary for our community. By naming these key priorities, we can see the health disparities that are very layered and intersectional,” said Khamarin Nhann, Campaign Director at Mekong NYC.  “CBOs, community advocates, health care professionals have been at the forefront in addressing the root causes of failure in systems, institutions, inadequate resources and funding. Let this be an organizing tool to continue to advocate for all communities' needs." 

“At the KCS Mental Health Clinic, our clinicians use approaches to mental health that are community focused and require advocacy and education. We have to address heightened mental health issues using more intensive approaches due to the complex and unique needs of the Korean community,” said Yuna Youn, Director, Mental Health Clinic at Korean Community Services of Metropolitan New York (KCS). “Data disaggregation shows that the average rate of suicide among AAPIs was 5.4 per 100,000, similar to the city wide-rate, however for the Korean population it was 13.4 from 2008-2017. Korean seniors have also been one of the most impacted groups during the rise of anti-Asian violence. Because the Korean community is smaller than some other ethnic groups, there are only language lines instead of Korean-speaking providers for emergency services. When an organization like KCS is only one of a handful of places monolingual Koreans can turn to, we want to advocate for equitable resources and funding while also supporting other ethnic CBOs' advocacy for their community's unique needs.”    

"Apicha Community Health Center provides primary care, mental health, and support services in an integrated approach,” said Jun Matsuyoshi, Director of Behavioral Health Services at Apicha Community Health Center. “Mental health services seek to help patients with depression and other diagnoses. Additionally, mental health providers help patients to adhere to medical treatment, since medical issues often impact patients’ mental status. We have two clinics. Our Jackson Heights clinic serves patients of all ages and has dental services; providers at this location speak Spanish, Bangla, Hindi, and other languages. Mental health staff coordinate on an ongoing basis with primary care and support services."

For more information or to be connected to any of the survey’s authors or partner organizations, please contact Lakshmi Gandhi at lgandhi@cacf.org. To read the full brief, head here.