Surveying MIT Asian/American students on campus mental health resources
Respondents share the importance of cultural competence, barriers in accessing resources, and suggestions for improvement
SYD ROBINSON – THE TECH
SYD ROBINSON – THE TECH
Italicized quotes presented below were anonymously collected in our survey. The term “Asian/American” is used to include both people who identify as Asian American and Asian only, such as international students.
A significant number of us are hurting. We are MIT Asian American Initiative’s mental health team. Through these past several semesters, we’ve regularly hosted discussion circles to explore topics in a culturally safe space for Asian/Americans, touching on subjects such as imposter syndrome, body dysmorphia, and general anxiety. While we are grateful for the support that we have been able to provide one another, we can only do so much for one another while also dealing with our own mental health challenges. Time and time again, we hear from our friends, our neighbors, and our classmates about their mental health struggles, fighting countless battles without professional support.
What are the barriers at MIT that prevent Asian/American students from receiving the support they need? What can MIT do better? To gain insight on these questions, we called out to our campus’s Asian/American students via an anonymous mental health survey emailed to dorm mailing lists and Asian cultural clubs, where we collected 85 responses over the course of December 2021 and January 2022. Although this number is small in comparison to the entire Asian/American population at MIT, it is imperative that we listen to the voices of those who are struggling with the current resources in place. Here is what our respondents have to say.
Ethnic representation and cultural competence
“It’s incredibly important to me that the [mental health] professional understands my culture because a lot of the things I want to talk about are related [to] and rooted in my culture.”
A growing choir of healthcare and counseling professionals and clients are calling for more cultural competence in the clinic. To be culturally competent means that providers are continuously introspecting and building awareness on their personal biases, interactional patterns, and value systems given the culture they were brought up in. Only after a personal journey can therapists begin to approach conversations related to race with their clients, according to Dr. Helen Neville, professor of educational psychology and African American Studies at the University of Illinois. Without cultural competency, therapists may unintentionally push away the very clients they intend to support through a lack of cultural understanding or even perpetuation of microaggressions.
“Sometimes when I worked with therapists who were not of my racial or ethnic background, my concerns seemed trivial or ridiculous to them.”
The American Psychiatric Association states that Asian Americans are three times less likely to seek mental health services than Caucasians, which means it is ever-crucial that once Asian/Americans have reached the clinic, we are uplifted by mental health professionals, rather than made to feel uncomfortable.
In our survey, a large majority of respondents indicated the importance of having therapists that share their ethnic background (70%) and are culturally competent (86%). Respondents noted that cultural familiarity increases therapists’ empathy and understanding of sources of mental health issues. Asian/Americans face unique struggles, often including but not limited to: family obligations based on cultural values; difficulty balancing various cultures; and facing discrimination and stereotypes such as the “model minority” myth, which assumes innate perfection and subservience from Asian/Americans.
“I’ve come to realize that a lot of my issues have roots in my culture. I’m still working through a lot of race-related and culture-related issues from the past, and I’ve had a hard time opening up about some things in an honest way to white or non-Asian therapists. I just wasn’t able to speak as candidly about some experiences (even [to] non-Asian therapists of color). It took me a really long time to find an Asian therapist in the Boston area who was also taking appointments. I wish there were [more] Asian therapists at MIT, considering we’re not a minority race in the student body.”
Many respondents noted feeling more comfortable speaking with a therapist with a similar ethnicity, where shared experiences can increase therapists’ ability to empathize. Students do not want to deal with the burden of explaining their cultural background to their therapists, facing trivialization or misunderstanding of identity-related struggles and receiving ignorant commentary.
“Going to a predominantly white institution has caused issues like facing racism, feeling ugly, and [being] tokenized at times. I want a therapist that can help me navigate this world, and I haven’t felt comfortable opening up to white therapists because I’m afraid they will think that I am insulting them or being too sensitive.”
The unfortunate reality is that the demand for therapists of color does not meet the supply. In 2015, while 38% of the U.S. population is people of color, only 14% of psychiatrists in the U.S. are people of color, with just 5% of psychiatrists identifying as Asian. For MIT’s most recently admitted undergraduate class of 2025, 41% of students are Asian American. Out of the 28 current care providers listed on MIT Mental Health & Counseling services’ website, fewer than 15% are representative of the Asian/American community (as of January 26, 2022). Out of nine current deans at Student Support Services, none appear to be Asian/American. Even with the few Asian therapists at MIT Mental Health, some survey respondents have experienced challenges with continuity of care.
“I got super lucky this year to have an Indian-American woman therapist who was able to help me with a lot of conflicts and issues with my family that a white or non-Indian therapist would never have been able to help me with. I feel like I was finally getting better after being frustrated with white therapists before. But she left MIT because she wasn’t getting paid enough and was being given too many patients because MIT Mental Health was understaffed so she wasn’t getting to work with patients in-depth as she likes to. And because her private practice doesn’t take my insurance, now I don’t have a therapist anymore, and I feel like I'll never find anyone else as good as her at MIT Medical because she was the only person with a background that was similar to mine.”
Despite the lower prevalence of Asian therapists, given student demand, it is necessary to continue to push for representation that reflects the student body and greater cultural competence training in mental health services.
Barriers in seeking support
“I hope that everyone is able to have a therapist who doesn’t tell the patient, ‘You are ghosting me’ when a patient turns off video or really [push] the patient to answer questions when they are uncomfortable.”
Asian/American students are less likely to seek out mental health treatment than other racial groups. A study published in the Journal of Adolescent Health sampling over 43,000 university students from 2012 to 2015 also found that Asians have 64% lower odds of medication use and 51% lower odds of therapy compared to all ethnicities.
A study by the University of Maryland School of Public Health found that common reasons for hesitance to seek treatment include stigma of being perceived as weak or ungrateful (particularly for those of refugee or asylum-seeking backgrounds), lack of awareness of resources, fear of worrying parents, lack of culturally competent professionals, and cost. The study observed that it is taboo to discuss mental health in many Asian cultures and can be perceived as disrespecting spiritual beliefs, leading people to “hide, neglect, or deny symptoms rather than seek help.”
When surveying the Asian/American community at MIT, we asked respondents what prevents them from seeking support on-campus:
Time and effort: Many respondents mentioned a lack of time and/or energy to reach out or that it is not a priority.
Inaccessibility of setting up an appointment: Currently, the only way to schedule an initial appointment is through a phone call, which can be inconvenient and is a barrier to those with social anxiety.
Long wait times: Many reported either experiencing firsthand or hearing from others about the long wait times to get an appointment, sometimes exceeding a month.
Distrust of professionals: Multiple students felt rushed to start medication, leading to general distrust of professional support. Others reported doubt surrounding the effectiveness of treatment, some stemming from negative past experiences with therapists.
Cost and confidentiality: Many reported being unsure about whether insurance covers the bill or not. Multiple also reported cost as an issue, likely stemming from misinformation surrounding insurance policies. Additionally, confidentiality is a significant concern, including mandatory reporting law and visibility of insurance bills.
Stigma and lack of perceived need: Multiple students reported feeling weak or experiencing difficulty acknowledging that they need help.
Difficulty with teletherapy: Common challenges of teletherapy include difficulty in finding a private space to take sessions, which is especially an issue for students with roommates.
“I’ve heard wait times can be really long. [But] also the stigma that seeking help for mental health means that you’re weak.”
“I felt that stereotypes were being projected onto me due to being East Asian. When I hesitated to go on medication for a multitude of reasons, one being my parents’ valid distrust of Western medicine, my psychiatrist would only focus on whether or not I had talked to my parents, rather than ask if other factors were bothering me.”
When it comes to seeking mental health, the process should be as accessible and low-effort as possible. Students facing mental health challenges already struggle to set up appointments; this struggle is further compounded for Asian/American students due to stigma surrounding mental health and distrust of professionals.
Bettering mental health support on campus
“I hope that MIT administration and those with power will listen to our desperate call to improve mental health resources for students. This means putting in the money.”
This survey is far from the first time that MIT students have called for improved mental health resources. To probe the most pertinent and pressing needs, we asked respondents about how MIT can better support their mental health. In this section, 38% of respondents demanded that more money be invested in mental health resources, with specific calls to expand availability, reduce wait times, and increase therapist salaries to promote retention. Additionally, many students requested that MIT hire more Asian (or other non-white) counselors in order to provide better care for marginalized groups.
“Please get more therapists, preferably more non-white therapists too.”
Numerous respondents pressed for an easier way to set up appointments, such as an online portal or text-based scheduling system. Citing personal and second-hand experiences, several students described waiting up to a month to secure an appointment, only to receive a phone call from MIT Mental Health while in class or another inconvenient setting where they may not be comfortable setting up a mental health appointment. Moreover, even after the first appointment is scheduled, therapists sometimes do not even show up. A phone-free scheduling system would mitigate the exasperation faced by many students trying to schedule a first appointment, lowering a major barrier to seeking support.
Students called for better advertising of available mental health resources and information regarding common concerns (such as confidentiality, cost, expectation of low appointment frequency), more effective guidance towards internal and external therapy options, and the creation of more resources for neurodivergent students. These as well as the aforementioned changes (increasing the availability of appointments and therapists of color, and creating a streamlined, phone-free scheduling system) are all necessary steps towards better supporting the mental health of not only Asian/American students, but every member of the MIT community.
“We are constantly referred to MIT Mental Health as a beacon of hope for our problems by administrators and faculty whenever we are struggling. This was the case after the massage parlor shootings in 2021. But many of us face immense barriers [to] even getting an appointment and the consistent, basic care that we need.”
Call to action
By probing the most pressing problems and pertinent solutions, we aim to amplify the collective voice of Asian/American students as we call out to MIT to improve mental health support for all.
To summarize, a majority of respondents expressed the following sentiments: a) more therapists (preferably Asian and POC) should be hired, as ethnic representation and cultural competency are important for their therapy experience; b) inconvenience and unresponsiveness are experienced when placing appointments by phone, and lack of follow-up or attendance of therapists are large concerns — instead, an online scheduling portal is desired; and c) respondents feel distrust, exasperation, and impatience when dealing with MIT’s mental health support services.
We acknowledge and appreciate the efforts of MIT’s mental health resources to improve support for its students thus far, including currently recruiting and interviewing clinicians, keeping in mind diverse backgrounds and cultural competency. MIT Medical has previously hired a director of diversity, equity and inclusion and appointed clinicians with experience in multicultural outreach in accordance with the MIT Black Students’ Union and Black Graduate Student Association’s 2015 recommendations. These BSU/BGSA recommendations also spurred the genesis of anti-oppression training in MIT counseling services and a graduate Black women’s support group, laying the groundwork for a more equitable campus. However, as clearly demonstrated through the results of this survey, there is more work to be done. Our community is suffering, and we need change now.
“More therapists need to be hired, specifically POC and women/non-binary folks so that people with marginalized identities feel comfortable reaching out to these resources in the first place. I hope our call is not ignored, as it has been time and again.”
This article was written by Alana Chandler ’22, Jason Li ’24, and Elaine Wu ’22, members of the MIT Asian American Initiative, a student-run organization for Asian American advocacy, allyship, and civic engagement. Contact them at aai-exec@mit.edu or on their Instagram @mit.aai.