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by Peter Gee
Mental health care remains an essential yet underutilized resource for Asian Americans, Native Hawaiians, and Pacific Islanders (AA/NHPIs), who report the lowest rates of mental health service utilization and help-seeking behaviors among all racial and ethnic groups in the United States.[1] Disaggregated data highlights concerning disparities, particularly in the Nikkei community, which experiences elevated rates of suicide ideation and a heightened need for emotional and mental health support.[2]
Older Asian Americans face compounded challenges, including housing and economic insecurity, social isolation, caregiver stress, and the long-term effects of untreated mental health conditions. These issues are further exacerbated by systemic gaps in California’s public mental health systems, such as “inadequate infrastructure for older adult mental health services, inconsistent outreach efforts, and a lack of workforce training in geriatric mental health care.”[3] Research shows that by age 75, nearly half of all Americans will have experienced a diagnosable mental health disorder, often manifesting as chronic conditions or dementia in later life. For older AA/NHPIs, these challenges are intensified by pervasive discrimination—50% report regular encounters with discrimination, and 20% have experienced hate incidents or crimes—adding significant strain to their mental health and overall well-being.[4]
Culturally Sensitive Approaches to Mental Health
Based on Little Tokyo Service Center’s (LTSC) extensive experience serving older adults, addressing these mental health needs requires a comprehensive, culturally sensitive approach tailored to the unique characteristics of the community. Bilingual and bicultural mental health professionals, such as licensed therapists and case managers, play a critical role in building trust and fostering meaningful engagement. LTSC employs staff fluent in Japanese, Korean, and English to provide therapy and case management that resonates culturally. By integrating mental health services with social support, housing assistance, and healthcare navigation, LTSC ensures clients receive holistic and coordinated care. For instance, LTSC’s value-based care model addresses underlying social determinants of health—such as housing insecurity and limited health care access—that intersect with mental health challenges. Collaboration with community organizations, like Keiro, enhances this continuum of care, strengthening the support network for older adults.
Addressing Roadblocks and Stigma
Despite these efforts, significant barriers hinder the provision and accessibility of mental health services for older adults in the Nikkei community. Mental health stigma remains a pervasive issue, with many older adults hesitant to seek help due to fear of shame or burdening their families. Culturally tailored outreach and education are vital to reducing stigma and encouraging help-seeking behaviors.
There is a critical shortage of culturally competent, bilingual mental health providers for the AA/NHPI community, compounded by treatment models that inadequately address the community’s unique needs. With a social services team of over 30 bilingual Japanese- and Korean-speaking clinicians and case managers, LTSC is part of a small network of community-based organizations addressing behavioral health service gaps in Los Angeles County.
A Transformative Partnership
Financial insecurity further limits access to care; however, LTSC’s partnership with Keiro enables the organization to provide free mental health services to older adults in the Nikkei community. Together, LTSC and Keiro address these challenges by integrating evidence-based therapy with bilingual case management in a culturally sensitive framework.
“Our partnership with Keiro continues to be transformative for the Nikkei community,” said Erich Nakano, Executive Director at LTSC. “Together, we’re addressing urgent needs and breaking down barriers to mental health care while fostering resilience and well-being for our seniors and their families.” This approach not only reduces stigma but also empowers seniors to achieve stability and engage meaningfully in their care.
“The mental health support we receive from Keiro gives clinicians at LTSC flexibility to meet clients where they’re at,” added Ayumi Omoto, LCSW, co-lead of mental health at LTSC. “Without a doubt, we have seen an increase in mental health needs among our Nikkei older adults. The partnership empowers clinicians to provide tailored, culturally sensitive care that addresses not only immediate mental health concerns but also the underlying factors contributing to them, such as housing, health care access, and family dynamics.”
The partnership’s measurable outcomes—including reductions in depression and anxiety symptoms and increased social connectedness—highlight the importance of community-based solutions. By fostering resilience and well-being in the Nikkei community, LTSC and Keiro exemplify how culturally responsive care can break barriers and improve mental health outcomes for older adults.
About the Author
Peter Gee, RN, MPP, is the Director of Service Programs at Little Tokyo Service Center. He has over 15 years of leadership experience at human service and community development organizations in New York City.
About Little Tokyo Service Center (LTSC):
For over 40 years, Little Tokyo Service Center (LTSC) has provided a safety net of social welfare and community development services to empower people and communities in need. Starting with its home in Little Tokyo, LTSC preserves and strengthens the unique ethnic communities of the Southern California region where people, culture and collective future matter. www.LTSC.org
Sources
[1] Substance Abuse and Mental Health Services Administration, Racial/ Ethnic Differences in Mental Health Service Use among Adults. HHS Publication No. SMA-15-4906. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
[2] Shih, Howard, Ryan Vinh, Karthick Ramakrishnan, Beth Tamayose, Todd Hughes, and Ninez Ponce. The Health, Mental Health, and Social Service Needs of Asian Americans and Pacific Islanders in California. Riverside, CA: AAPI Data, 2022. http://aapidata.com/reports
[3] Kietzman, K. G., Dupuy, D., Damron-Rodriguez, J., Palimaru, A., del Pino, H. E., & Frank, J. C. (2018). Older Californians and the Mental Health Services Act: Is an older adult system of care supported? UCLA Center for Health Policy Research. https://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1710
[4] Tan, C., Lo, F., Ocampo, C., Galán, M., & Ponce, N. A. (2024). Piecing the puzzle of AANHPI mental health: A community analysis of mental health experiences of Asian Americans, Native Hawaiians, and Pacific Islanders in California. AAPI Data & UCLA Center for Health Policy Research.
[5] Substance Abuse and Mental Health Services Administration, Racial/ Ethnic Differences in Mental Health Service Use among Adults. HHS Publication No. SMA-15-4906. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
[6] Shih, Howard, Ryan Vinh, Karthick Ramakrishnan, Beth Tamayose, Todd Hughes, and Ninez Ponce. The Health, Mental Health, and Social Service Needs of Asian Americans and Pacific Islanders in California. Riverside, CA: AAPI Data, 2022. http://aapidata.com/reports