Asian American Mental Health: Treating a Diverse Population at a Crossroads.

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Date: Aug. 2021
From: Psychiatric Times(Vol. 38, Issue 8)
Publisher: Intellisphere, LLC
Document Type: Article
Length: 2,507 words
Lexile Measure: 1470L

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REPREHENSIBLE REGRESSED SENTIMENTS

First Yellow Peril

Now model minority

Back to viral slum

--FRANK CLARK, MD

The shocking Atlanta mass shooting in March 2021 that resulted in the deaths of 6 Asian American women brought the nation's attention to the rise in anti-Asian violence since the advent of the COVID-19 pandemic. The increase in hate speech, property damage, and brutal attacks, coupled with the negative mental health impact of quarantine isolation, has led to an increase in feelings of anxiety and distress among Asian Americans. (1-3) With this confluence of stressors, we anticipate more Asian Americans will present for psychiatric care. Given the shortage of psychiatrists with expertise in working with Asian American patients, (4) it seems timely for us to share some insights on both acute and longer-term issues facing Asian Americans.

Before we begin, a caveat: Asian Americans are an incredibly diverse group, representing more than 20 countries of origin and hundreds of languages and cultures. The needs of immigrants differ from those of American-born Asians. There are wide differences in socioeconomic status, insurance status, educational background, age, and degree of acculturation. Although 3 case presentations are inadequate to capture the diversity of this population, the cases are used to illustrate some of the issues with enhanced nuance and depth.

CASE 1

"Ms Cho" is a 37-year-old married professional Korean American woman with a history of major depressive disorder (MDD) and generalized anxiety disorder (GAD). Although she has been on a long-term stable dose of sertraline, her mood and anxiety have gradually worsened in recent months, and she reports feeling inexplicably "overwhelmed." She finds herself struggling to keep up with work demands. Her psychiatrist, "Dr Williams," who is not Asian, asks if this feeling has anything to do with the recent rise of anti-Asian violence. Ms Cho thinks for a moment, then nods. She discloses that she is constantly worried about the physical safety of her parents and her 2 school-aged children. She is also having intense memories of being bullied when she was in grade school. She finds herself thinking about these incidents, now with an adult's perspective, and realizing the long-term impact these incidents have had on her life.

Anti-Asian racism in the United States began with the arrival of the first Asian immigrants in the 1850s. Frequently seen by Whites as "uncivilized, unclean, filthy beyond all conception," (5) Asians were labeled the "Yellow Peril" and "perpetual foreigners." Over the subsequent 75 years, legislation such as the Exclusion Act (1882), Immigration Act (1917), and Johnson-Reed Act (1924) was passed to severely restrict immigration from Asian countries and to make those who did immigrate ineligible for citizenship.

In 1965, the United States relaxed immigration restrictions from Asia, and a second wave of more affluent, highly skilled Asians immigrated to this country. Perception of Asian Americans shifted from revulsion to admiration, as Asian immigrants attained educational and professional success. Asian Americans came to be known as a model minority, with success attributed to aspects of Asian culture, as...

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Gale Document Number: GALE|A676443358