Asians are a diverse group of people and come from a variety of religious and cultural backgrounds and speak different languages. They are also the ones who underutilize psychiatric or psychological services and preventive health screenings. This may be because Asian communities identify mental health as something an individual must have control over and therefore, take care of on their own rather than seeking outside help. Other reasons may be negative reactions from family or society, losing face, failure of mental health professionals to modify practices based on culture. Let’s explore what keeps Asians fearful of therapeutic alliances.
Shame
One of the most common reasons why Asians refuse to go to therapy is the issue of shame in asking for help. Traditionally, Asians place significant emphasis on appearances of “normal functioning” and consider family to be of highest importance. Therefore, they prefer to respond to mental health crises with denial or attempt to handle the problem within the family itself, without wanting to bring the influence of an ‘outsider’. The shame stems from a failure of the family to solve the situations and is considered as losing face. This leads to the suppression of distress in both the patient and the family and they have difficulty in opening up and discussing history, symptoms and consequences in therapy.
Mistrust of Western Medicine
The concept of therapy is fairly of Western origin and there exists a general level of mistrust among Asians about the efficacy of Western medicine. They believe that Western treatment always seems to have poor outcomes while overlooking the fact that when Asians present to treatment, their conditions are severe enough for any intervention to lead to satisfactory results.
Anticipated Utility
Anticipated utility refers to the perceived usefulness or lack thereof regarding seeking services from a counselor. Individuals who refuse to seek counseling services for psychological concerns are those who have lower expectations about the benefits of these services. These people feel uncertain about how helpful therapy can be for them and hence, refrain from seeking help, sometimes even in times of extreme distress.
Stigma
Stigma has played a major role in an individual’s decision to either seek or fully participate in mental health care. There are two types of stigma: self-stigma and social stigma. Self-stigma is associated with the application of stereotypes to oneself, resulting in diminished views about personal worth, compounded by feelings of shame and low efficacy. Asians who are prone to this type of stigma have negative attitudes towards help-seeking from psychiatrists and therefore, avoid engaging in any therapeutic alliances. Social stigma is defined as the fear that others will judge a person negatively if she or he sought help for a problem. The social stigma attached to seeking professional help is one of the most significant barriers to mental health treatment. A history of seeking help for mental health concerns leads people, particularly belonging to the Asian descent, to label an individual as more awkward, cold, defensive, dependent, insecure, sad, and unsociable; view the individual as less in control of his/her emotions and describe an individual as weak or disturbed.
Social Norms
The implicit standards of those close to the individual affect their help-seeking attitudes. If important people in a person’s life see counseling as a negative event, then she or he may be less likely to seek help for fear of exposure and loss of social standing. Since people usually talk to members of their social circle before seeking help, their attitudes play an influential role in how an individual defines and acts upon distressing symptoms.
Fear of Emotion
A fear of discussing painful emotions in counseling is another one of the reasons why people from Asian descent refuse to seek therapy. Even after enrolling in therapy, these individuals often withhold their emotions and are afraid to express distressing feelings verbally, thereby leading to dissatisfying outcomes and strengthening their beliefs about Western medicine. Those who lack emotional management skills or are overly concerned about the potential risks (being judged, misunderstood or ignored) attached to a counselor also display reduced help-seeking behavior.
Despite increasing mental health awareness worldwide, help-seeking among Asians continues to be shaped by deeply ingrained cultural beliefs, stigma, and systemic mismatches between service providers and clients. To truly bridge the gap, mental health services must take cultural nuances seriously—adapting language, approach, and methods to reflect the values and realities of Asian communities. Only then can therapy feel like a safe, trustworthy, and effective space for healing.
Photo Credits:
First image: freepik
Second image: freepik
References
Tseng, W. S. (2004). Culture and psychotherapy: Asian perspectives. Journal of mental health, 13(2), 151-161.
Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of counseling & development, 85(4), 410-422.
Wynaden, D., Chapman, R., Orb, A., McGowan, S., Zeeman, Z., & Yeak, S. (2005). Factors that influence Asian communities’ access to mental health care. International journal of mental health nursing, 14(2), 88-95.
Sakshi
About the author
Sakshi is a clinical psychologist with a deep passion for understanding human behavior, a strong drive for research, and a keen eye for psychological intricacies. Committed to continuous learning, she seeks to explore every facet of psychology, from theory to practice, to better support and empower individuals. With a curiosity that fuels her pursuit of knowledge, she strives to bridge the gap between research and real-world applications, making psychology more accessible and impactful.
Recently Added
Ally Lobanova is the visionary founder of Signature Events, renowned for crafting exceptional and personalized experiences. With a rich background in global …
Shikha S. Lamba is a jewelry designer and poet living in Hong Kong. She is the co-editor of an online magazine, Coffee …
Afroditi is a Greek-born mother in Hong Kong, and a passionate voice for normalizing infertility discussions. After leaving her banking career, she …