South Asian Mental Health

1 in 5 South Asians in the United States report experiencing a mood or anxiety disorder in their lifetime, with women reporting higher levels of distress than men. Obviously, these numbers, in general, are vastly underreported, as South Asians often express greater stigma toward mental illness than other groups. Stigma toward mental illness is a major barrier to getting a diagnosis or help.

South Asians commonly experience psychological distress as physical symptoms. Mental health problems may manifest as somatic, such as sleep troubles, bodily pains, headaches, fatigue, and stomach problems. When this occurs, it increases the likelihood of being undiagnosed and untreated since mainstream models of medical treatment may focus attention on physical symptoms instead of potential underlying causes, including systemic, familial, social-emotional, and historical.

Medical and mental health professionals must address the following areas in addition to presented physical symptoms. Issues that impact the mental health of South Asians may include:

Stereotyped Roles
The “model minority” myth is a microaggression known as “ascription of intelligence,” where one assigns intelligence to a person of color on the basis of their race. South Asian students are often perceived to be nerdy, academically rigorous, and driven to pursue fields in medicine, science, and technology. At home, a student earning less than stellar grades may be regarded as lazy or incompetent by family members, rather than needing support or accommodations.

The Perpetual Foreigner
This occurs when someone is assumed to be foreign, exotic, different. Some questions that perpetuate this stereotype include “Where are you from?” “Where are you really from?” “Your name is too hard to pronounce so I’m going to call you Sam,” and “How do you say (or write) _____ in your language?”

South Asian clients often tell me that they cringed in school when called upon, hearing their name mispronounced repeatedly. Others report that they could not eat their lunch in front of others without comments from peers about their “weird food.” Ramadan and fasting can be a challenge for Muslim students, particularly when faced with the social aspects of school lunch, participation in sports, and gym class. For South Asian girls/women in particular, the experience of fetishism is not uncommon. For example, in college, this writer was frequently asked questions about the Kama Sutra on dates, or inquiries about harems. When these occurrences become commonplace, feelings of isolation and loneliness may occur in routinely being treated as an outsider.

Trauma
First-generation immigrants, particularly from global conflict areas, may experience trauma. This trauma can be passed down to their children and subsequent generations. South Asians with a history in the US may have compounded trauma due to racial discrimination. Of note, South Asian parents are frequently unlikely to speak up or address bullying of their children in the school system or in social settings. This may include a lack of awareness, lack of access to resources, and a desire to be under the radar.

Stigma
According to statistics by the American Psychological Association, South Asian Americans are the least likely racial group to take actions on their mental health and are more likely to reach out to friends and family, if at all. Lack of knowledge or stereotypes regarding mental health, learning disabilities, and psychiatric disorders contributes to this dearth in treatment.

Expectations
Criticizing appearance, comparing successes, chores and family obligations, and an emphasis on academic and financial success create an often unrealistic set of expectations. Children of first-generation immigrants may also be expected to serve as cultural and linguistic liaisons for older family members in addition to frequently serving as a caregiver for younger children, all while attending school.

Religious intolerance
Religious minorities, for example Muslims and Sikhs, are often discriminated against for their appearance and beliefs, bearing the brunt of racial profiling due to Islamophobia. Some clients report being called a terrorist ‘in jest.’ There is also religious intolerance between groups, such as Muslims and Hindus; Ahmadi Muslims and Sunnis, and Sikh-Hindu conflict which carries forward to US immigrants.

Lack of data
Empirically validated research studies on mental disorders have historically not included participants of South Asian descent. For example, there are no large studies on bipolar disorder or schizophrenia which included significant samples of South Asian patients/participants. In addition, psychology and mental health concerns are rarely discussed in families, places of worship, and medical offices. See Cultural Competency with Muslim Parents.

Embolden Psychology is dedicated to culturally competent practice, social justice, and psychoeducation.

References, Dr. Siddique in:
Siddique, H: The Meaning of Difference, sixth edition (2011). Rosenblum, K.E. and Travis, T. C. (Editors), McGraw-Hill.
Mental health and stress among South Asians. Journal of Immigrant and Minority Health (2019), volume 21.

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