South Asian Americans face significant mental health challenges, yet systemic barriers within the U.S. healthcare system hinder their access to appropriate care. The South Asian American population is large, with about 5.4 million South Asians living in the United States today. South Asian Americans have higher rates of depression, anxiety, and suicide than the general U.S. population but the lowest rates of seeking mental healthcare (5). Despite these alarming trends, U.S. mental health policies fail to address South Asian-specific needs due to a lack of research, cultural and linguistic barriers, and inaccessible insurance structures. This blog examines these challenges and proposes policy solutions to address these disparities.
South Asian Mental Health in the U.S.: A Political Blind Spot
South Asians are one of the fastest-growing ethnic groups in the U.S. yet remain largely invisible in mental health research. Mental health studies rarely disaggregate data on South Asians, grouping them under the broad "Asian American" label, which lumps identity-specific issues under one large group and erases disparities (1). Federal mental health initiatives dedicate little effort to studying or addressing South Asian struggles, despite suicide being a leading cause of death among South Asian youth. High rates of anxiety, depression, and PTSD—often stemming from immigration stress, racism, and family pressures—persist, yet South Asians are the least likely to seek mental health care due to stigma and systemic barriers. The Affordable Care Act expanded mental health coverage, but failed to address racial and cultural disparities. State-level mental health programs, such as Medicaid expansions, often lack language-accessible services, further limiting care for South Asian communities.
The Insurance and Access Crisis
Many South Asian immigrants are on visa-dependent healthcare plans, limiting their access to affordable therapy. Even for those with insurance, therapy and psychiatric services are often not covered, making out-of-pocket costs ($100–$250 per session) prohibitively expensive. This disproportionately affects low-income South Asians, for whom mental health services become an unattainable luxury. (4).
Lack of Culturally Competent Care
Many U.S. mental healthcare professionals lack cultural training on South Asian issues such as family honor and the “what will people say?” stigma, religious-based interpretations of mental health struggles, intergenerational trauma, migration stress, and the pressure of the "model minority" myth (2). Traditional beliefs within South Asian communities often view mental health issues as private matters, discouraging individuals from seeking external help (2). Additionally, the shortage of South Asian mental health professionals in the U.S. leaves many patients without therapists who understand their language, culture, or values.
The Political Path Forward: What Needs to Change?
The CDC and NIH have the responsibility to fund research on South Asian mental health disparities. This will be even more difficult due to the recent presidential executive orders to cut NIH fundings and federally funded research budget cuts. There is already a disparity in this research area, and with recent funding cuts, these disparities will unfortunately broaden. Mental health screenings should also be included in primary care for South Asian patients. This helps track and diagnose patients who need support in this field.
State governments should also expand Medicaid to cover therapy for visa-holders and immigrants. Mental health clinics should provide services in South Asian languages to make therapy accessible. States with large South Asian populations should fund South Asian-focused mental health programs, setting funds aside for identity-specific mental health care services.
South Asian advocacy groups should push for policy changes at the local and federal levels. There should also be training for non-South Asian therapists to understand South Asian-specific issues, just as there should be for other ethnic minority groups. We also have to break the stigma within South Asian communities through education by integrating mental health awareness into South Asian community centers, temples, mosques, and gurdwaras where multiple generations of South Asian populations can receive and share this knowledge.
Conclusion
The U.S. healthcare system’s failure to recognize South Asian mental health needs is not just a cultural problem, it’s a policy failure. Without federal and state policy interventions, South Asians will continue to suffer silently, navigating a system that wasn’t built for them. South Asian communities must demand political action, from better data collection to culturally inclusive policies, to ensure that mental health care is truly accessible for this vast population.
Reviewed by Alec Vazquez-Kanhere
Resources
[1] Okazaki S, Lee CS, Prasai A, Chang DF, Yoo N. Disaggregating the data: Diversity of COVID-19 stressors, discrimination, and mental health among Asian American communities. Front Public Health. 2022 Oct 19;10:956076. doi: 10.3389/fpubh.2022.956076. PMID: 36339147; PMCID: PMC9627279
[2] Goel NJ, Thomas B, Boutté RL, Kaur B, Mazzeo SE. "What will people say?": Mental Health Stigmatization as a Barrier to Eating Disorder Treatment-Seeking for South Asian American Women. Asian Am J Psychol. 2023 Mar;14(1):96-113. doi: 10.1037/aap0000271. Epub 2022 Jan 10. PMID: 37283957; PMCID: PMC10241369.
