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Mental Health Stigma Among Asian American, Pacific Islander Employees: What Providers, Employers Can Do

By Bipin Mistry, MD, Chief Medical Officer, Alight Solutions

The U.S. was already facing a mental health crisis—and dealing with mental health stigma— well before the COVID-19 pandemic. In 2019, more than 19% of adults experienced mental illness.

Today, however, we all know the situation has intensified. In fact, recent data shows 45% of adults have experienced mental illness due to the pandemic—that’s nearly 1 in 2 Americans who have been personally touched by this issue.

Yet despite increased awareness, education, and widespread media coverage in recent years, mental health stigma is pervasive among the general population and in the workplace.

Among Asian American and Pacific Islander (AAPI) employees, in particular,—a workforce that is 20 times larger than it was 60 years ago—data shows multiple barriers prevent people from seeking help for mental health issues, or even acknowledging them.

In fact, Asian Americans and Pacific Islanders are the least likely of any racial/ethnic group to seek help and only 23% of adults in this group with a mental illness received treatment.

Cultural norms, personal belief systems and values, and preconceived notions about stress, anxiety, and mental health run deep, and getting help is often viewed as a sign of weakness.

While mental health has been on the list as an organizational priority since the start of the pandemic, and is beginning to be recognized as just as important as physical health, it’s an area where there is still much more to be done by employers.

Employers must shift their perspectives and view mental health services and innovative solutions that drive engagement in these hard-to-reach employee groups as something that’s not a-nice-to-have, but instead a vital part of their overall benefits strategy.

"In fact, Asian Americans and Pacific Islanders are the least likely of any racial/ethnic group to seek help and only 23% of adults in this group with a mental illness received treatment."

Asian Americans and Pacific Islanders Face High Levels of Stress & Anxiety Compounded By Unique Issues

Between the war in Ukraine, COVID-19, inflation and financial worries, work stress, life changes, parenting, and a myriad other factors, Americans are facing unprecedented levels of stress, a recent poll by the American Psychological Association found.

For those in the Asian American and Pacific Islander community however, stress and anxiety are magnified by other issues


  • Ethnic and Racial Tension—and an Increase in Hate Crimes

    According to an April 2021 study in The Lancet, racist anti-Asian incidents and rhetoric have increased by 150% during the pandemic.

    Data from Stop AAPI Hate also found 10,905 hate incidents against Asian American and Pacific Islanders were reported between March 19, 2020, and December 31, 2021.

  • Remote Work

    The move to working from home is likely also a contributing factor to high rates of stress and anxiety for employees who didn’t have caregiver support during COVID-19, and for those who lived with extended family.

    Nearly one-third of Asian Americans live in a multigenerational family household and a 2021 report from Generations United found that 75% of people say the living arrangement contributes to stress among family members.

According to an April 2021 study in The Lancet, racist anti-Asian incidents and rhetoric have increased by 150% during the pandemic.

The Model Minority Myth

The model minority myth, which suggests AAPI employees are smarter and more hardworking than other groups, has led many to internalize these stereotypes and put undue pressure on themselves to succeed, which in turn can lead to stress and anxiety.

The proliferation of this myth also hides the mental health issues these people face, a 2021 study found.

Stress and Anxiety Affecting Work Performance

Increasing rates of stress, anxiety, and mental health issues can negatively impact work performance, leading to procrastination, missed deadlines, errors, absenteeism, and turnover.

In fact, according to a 2021 report by Mind Share Partners:

  • 68% of millennials and 81% of Gen Zers left their jobs for mental health reasons, both voluntarily and involuntarily.
  • 91% of employees say that their company’s culture should support mental health.

A Reluctance to Seek Mental Help

Despite increased awareness, education, and employer initiatives, mental health stigma in the workplace persists.

According to a national poll by the American Psychiatric Association:

  • Approximately 50% of employees say they’re not comfortable talking about mental health with coworkers and supervisors.
  • More than one-third worry about retaliation or being let go from their jobs if they seek help.

Plus, while Employee Assistance Programs (EAPs) are usually a part of employee benefit offerings, they’re highly underutilized, in part, because of the stigma that surrounds them.

According to the Society for Human Resource Management (SHRM):

Among Asian Americans and Pacific Islander employees however, faith and religious beliefs, cultural norms, personal values, and language barriers may play a role.

Not only are they the least likely to seek help among other groups, but during COVID-19, they were significantly less likely than whites to use telehealth, a recent study in the Journal Of General Internal Medicine found.

Mental health disorders are often viewed as a sign of weakness and many people are apprehensive to seek help due to shame, embarrassment, or of being seen as “crazy.”

These beliefs may be even more prevalent among males.

A lack of cultural competency, racial bias, and fewer mental health providers of AAPI descent may also play a role

How Healthcare Providers, Employers Can Provide Mental Health Support for Their AAPI Employees

In recent years, there have been some inroads to address mental health stigma in the AAPI community.

In 2021, U.S. Congresswoman Judy Chu reintroduced the Stop Mental Health Stigma in Our Communities Act, which would provide outreach and education strategies.

Healthcare providers—and primary care physicians, in particular—have an important role to play to reduce mental health stigma and provide support.

For starters, they need more awareness about culture norms.

It’s also important that they open the lines of communications with their patients, and ask about stress and mental health, since patients may present with a concern or symptoms that have stress and anxiety as underlying symptoms and patients may not be likely to talk with their providers due to stigma.

Additionally, providers can send reminders about checking in about mental health and provide educational materials in the waiting room and at check-in.

Providers should also assess patients for emerging issues such as substance use.

A 2019 report from Substance Abuse and Mental Health Services Administration found that 1 in 7 Asian/Native Hawaiians and Other Pacific Islanders have a substance use disorder.

Employers also have a significant role to play in addressing stress and mental health issues.

For example, health benefit communications can be tailored with images and information that reflect diversity, target these employees, and address their unique needs.

It’s also important for employers to understand the cultural barriers to accessing care and asking for help that exist, and to find ways to have people engage in EAP and behavioral health offerings.

Employees need to know that these services are confidential, and that no stigma or judgment exists.

Healthcare Navigation Solutions Encourage Mental Health Support

In recent years, there have been an influx of digital health and app-based solutions meant to address mental health stigma and improve access to services—and it’s a good start.

Yet employers who are looking for more innovative solutions to address mental health stigma, stress, and attrition among their AAPI employees should look to healthcare navigation solutions.

With Alight Total Guidance, our hyper-personalization campaigns use behavior-driven insights that nudge employees to seek care, follow evidence-based treatment protocols, and make it easier to access confidential mental health services which encourages people to engage.

With healthcare navigation, we can guide them to seek appropriate, culturally sensitive care.

Furthermore, our Clinical Collaboration Center, the newest enhancement to Total Guidance, allows our Medical Ally team to stay connected to clinical teams at point solutions and health plan partners long after a referral has been made to monitor an employee’s progress and proactively help them stay engaged as their journey continues.

Our Med Ally team is trained to de-stigmatize mental health issues and provide behavioral health support for everything from anxiety and ADHD to depression and substance use disorders (SUDs), including finding available in-patient facilities. They screen every participant for anxiety and depression as well, regardless of what they present with.

We separate facts from feelings and get to know people’s preferences, barriers, risk factors, and support systems.

Bipin Mistry, MD
Bipin Mistry, MD
By Bipin Mistry, MD

Bipin Mistry, MD is Chief Medical Officer at Alight Solutions. He is board-certified in Internal Medicine and obtained his medical degree at Kings College School of Medicine and Dentistry, University of London and an MBA from Babson College. He is passionate about value-based care and issues connected to the advancement of health equity.

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