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There are many factors that go into deciding to go to therapy and/or counseling for mental health. Oftentimes, it may be difficult to view what we are experiencing as something that would require therapy and/or counseling. However, mental conditions—if left untreated—could potentially require the same amount of attention and long-term care as many chronic illnesses (World Health Organization, 2017). 

“Asian Americans are [three times] less likely to seek mental health services than other Americans” (Anxiety and Depression Association of America, 2018)—that means of the over 19 million Americans who identify as Asian American or Pacific Islander (AAPI), there are plenty of individuals who are in serious need of care and are not receiving it (Mental Health America, n.d.).

Hesitations with Therapy

Studies show that not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues are common reasons older adults do not continue therapy.  More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to seeking help (Frei, Wuthrich, 2015).

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An additional factor which makes it harder for AAPI to reach out for help is the belief that older generations experienced greater hardship, preventing people today from wanting to open up about their mental health difficulties. These individuals may hide their struggles “knowing their relatives faced something ‘more’ stressful just to survive” (Tanap, 2019).  

An example of a Japanese cultural value that could prevent the community from seeking help would be haji or feeling ashamed or guilty in wanting to ask for help.Although we may feel the need to keep such thoughts to ourselves, it is important to understand that mental illness is unique to every individual and should be treated with care regardless.

Considering Therapy

Everyone experiences obstacles or struggles of some type. This can include stress, relationship problems, anxiety, and more. Sometimes, these struggles can be managed by taking better care of oneself or talking with a supportive friend. Other times, seeking professional help may be beneficial.

There are two general factors to consider when therapy may be helpful (American Psychological Association, 2017):

  1. Is the problem distressing?
    • Do you spend time thinking about the issue every week?
    • Is the problem embarrassing so that you hide it from others?
    • Over the past few months, has the problem reduced your quality of life?
  2. Is the problem interfering with some aspect of your life?
    • Does the problem take up considerable time (i.e., more than one hour a day)?
    • Have you reduced other priorities (work, family, etc.) because of the problem?
    • Are you rearranging your lifestyle to accommodate the problem?

Answering “yes” to any of the questions above may suggest that considering therapy and/or counseling could be helpful.

Deciding to enter therapy is a very personal decision. Learning more about different types of therapy or other treatment options that are available can help individuals find support that fits best with their personality and lifestyle.

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Searching for the Right Therapist

Once you have made the decision to go to therapy,taking the time to find the right therapist will be important to get the most out of your journey. Finding a provider that showcases cultural competence—their ability to give care to patients with diverse values, beliefs, and behaviors, and to consider their social, cultural, and linguistic needs—is essential in being able to relate to the patient and provide beneficial help. (Anxiety and Depression Association of America, 2018)

Additional Keiro Resources on Mental Health


American Psychological Association. (2017). How Do I Know if I Need Therapy?  Retrieved from

Anxiety and Depression Association of America. (n.d.). Asian-Americans. Retrieved from

Mental Health America. (n.d.). Asian American/Pacific Islander Communities and Mental Health: Mental Health America. Retrieved from

Tanap, R. (2019, July 25). Why Asian-Americans And Pacific Islanders Don’t Go To Therapy. Retrieved from

World Health Organization. (2017, December 12). Mental health of older adults. Retrieved from

Frei, J. & Wuthrich, V. (2015, July). Barriers to treatment for older adults seeking psychological therapy. Retrieved from,the%20need%20to%20seek%20help.