Comparing Self-Reported Mental Health Data in Asian Indian Americans to National Trends

Abstract

Background: Stigma surrounding mental health issues can prevent members of the Asian Indian diaspora living in the United States (US) from seeking adequate medical attention. Asian Indian Americans (AIAs), like other immigrant groups in the US, face increased psychological distress from migration, acculturation pressures, and other social determinants that can adversely impact functioning and quality of life. We sought to determine if self-reported data regarding attitudes towards mental health issues and rates of access to mental healthcare among AIAs were unique when compared to other racial/ethnic groups within the US using the nationally representative 2015-2018 National Health Interview Surveys (NHIS). Methods: This cross-sectional study included 111,065 adults aged 18-84 years old. The data were first stratified by race. Chi-square tests of independence were performed by survey question using Python 3.10 to assess how race/ethnicity correlated with self-reported symptoms, diagnoses, and treatments of anxiety and depression. The Wilcoxon rank-sums test was then performed to determine the uniqueness of AIA responses within the US population. Results: Among 111,065 participants, 45.2% of respondents were male, 54.8% were female, 80.0% were white, 12.4% were black/African American, 1.3% were Native American, 1.2% were Asian Indian, 4.3% were other Asian, and 0.7% were other/multiple races. Race correlated with severity, symptoms, and treatment of both anxiety and depression. AIAs were most likely to self-report “never” experiencing symptoms such as nervousness (94.7%, p=0.0039), hopelessness (91.4%, p=0.010), worthlessness (94.7%, p=0.0039), and avolition (80.6%, p=0.0039) as compared to all other racial/ethnic groups at the 0.05 level of significance. AIAs were also more likely to report not receiving treatment for anxiety (95.7%, p=0.049) or depression (97.3%, p=0.049) in 2018. Conclusion: These data quantitatively indicate AIAs are less likely to self-report symptoms of anxiety and depression, and are less likely to seek treatment for the same. Given the prevalence of stigma concerning mental health in many South Asian cultures, it is essential to further investigate the nuances of how AIAs understand and advocate for their mental wellbeing. Further study is required to assess the role of stigma, overall mental health literacy, and possible success of targeted intervention with the AIA population.