Equity in Mental Health Month: A Q&A with JED Advisory Board Member Helen Hsu

July is known as BIPOC Mental Health Month, National Minority Mental Health Awareness Month, and at JED, Equity in Mental Health Month. Regardless of title, we recognize that the youth within communities of color face unique challenges yet have minimal access to culturally competent mental health resources.

JED Advisory Board Member Helen Hsu, PsyD, speaks with us about what can be done to implement better equity in mental health.

1. What disparities are we still seeing in access to mental health services? Why do you think that is?

The key access barriers for mental health overall are affordability and health insurance coverage, minors who need services but do not want parents to know, and difficulties finding therapists who practice with appropriate cultural humility and have the skills for supporting intersecting identities and needs. Also, the pandemic has particularly intensified the dearth of available therapists overall.

2. What systemic factors contribute to inequities in mental health? How are various communities affected, uniquely, by these factors? What can be done?

Mental health is multifactorial. A lot has been published about genetic factors and early childhood life experiences; however, one aspect of mental health that is particularly relevant for BIPOC people is that there is a mental health toll of experiencing stress from microaggressions and/or racial traumas. An important aspect of coping with and healing from systemic problems is to access supports that are beyond individual interventions.

3. According to the American Psychological Association (APA), Asian Americans and Pacific Islanders (AAPI) are three times less likely to seek mental health services than their white counterparts. What do you think are the reasons behind this? 

Immigrant or refugee families often don’t trust, or are not familiar with, confidentiality laws. For example: When I worked in K-12 schools, South Asian immigrant parents would often refuse recommendations for counseling because they mistakenly believed it would negatively impact college applications or that everything about counseling would be on school records. Many became supportive of mental health care once they better understood the parameters for confidentiality. Unfortunately, many AAPI individuals have reported harmful and invalidating experiences when seeking treatment from professionals that do not understand cultural values and family or cultural dynamics. For example: Western “individualistic values” therapists might advise a communal values client to “just cut off” family members or speak about the AAPI client’s family values in an ignorant or invalidating manner.

4. What can mental health professionals on college campuses do to provide more culturally responsive services? 

Campus mental health professionals and entire communities should proactively address racial trauma. Mental health professionals and staff should make efforts to increase cultural awareness and skills with a clear commitment to increase training, outreach, and engagement, as well as bringing on cultural clinical experts.

Helen H. Hsu, PsyD, is a former President of the Asian American Psychological Association. She is a bilingual (Mandarin) staff psychologist and lecturer at Stanford University. Hsu began her career in campus youth mental health serving public schools in the cities of Oakland and Fremont, CA. She has been a clinical supervisor, consultant, and trainer since 2001. Hsu completed a three-year term on the American Psychological Association (APA) Committee on Lesbian, Gay, Bisexual, and Transgender Concerns and is current Chair of the APA Minority Fellowship Program Training Advisory Committee. Her work focuses upon culturally responsive campus mental health services, grief and bereavement support, and mentoring and developing culturally responsive leaders in psychology.