Influence of Cultural Values and Integrational Acculturation Differences on the Behavioral Health Treatment of Asian American Immigrant Children in the COVID-19 Era

This is the authors' abstract. We don't add key points for this paper.

B ehavioral health service delivery to children of Asian American immigrant families requires attention to the unique interplay between traditional cultural values, family-oriented dynamics, and acculturation processes.Native-born children, also referred to as second-and third-generation immigrants, often face ethnicity-based stressors in both familial and societal contexts that can manifest in intergenerational conflict.To provide culturally competent behavioral health care for the children of Asian American immigrant families, clinicians must attend to the centrality of cultural values and address the heightened importance of parents, extended family, and caregivers within this group in supportive psychological and educational interventions.As with most American families, Asian American immigrant families operate through the belief practices of their matriarchs and patriarchs.Traditional Asian collectivist values place precedence in family solidarity over the goals of the individual.The children of these families, who are often native born and acculturate in the United States to a greater degree, may learn but not adopt and/or retain these values to the same extent as their parents.Resultant intergenerational culture differences predict psychological symptoms and are associated with interfamily conflict, which can translate to clinical challenges for healthcare providers who serve this population.In this perspective, attention to this concept as an often-important part of making a successful referral for treatment is emphasized as key to recommendations for delivering behavioral health services for children of Asian origin.Recent events provide important context for revisiting this concept.Amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, national organizations have documented concerning increases in reported anti-Asian discrimination and hate crimes. 1 Mass media coverage has highlighted disturbing acts of violence perpetrated against Asian Americans, primarily women and older adults, and victims of recent mass shootings in Atlanta, Georgia 2,3 and Dallas, Texas 4 were found to be of majority Asian descent.A growing body of literature suggests that these and other COVID-era events have contributed to health disparities and increased psychiatric and psychosocial burden in Asian American populations, especially among native-born youth. [5][6]][7][8][9][10][11] In response, policy leaders and community groups have increasingly called for improved mental health services targeted to Asian American and Pacific Islander (AAPI) individuals. 12,13lthough the future trajectory of anti-Asian bias is unclear, we believe that the provision of high-quality, comprehensive care to AAPI patients is urgently important.Referring primary care physicians, psychiatrists, and other treating behavioral health providers should consider the impacts of Asian American cultural characteristics on clinical management and be aware of the potentially exacerbating effects of COVID-19.To this end, we identify and provide suggestions for addressing the unique behavioral health challenges faced by children of Asian American immigrants.Our discussion is informed by years of clinical work on an inner-city inpatient child and adolescent psychiatry unit, including during the pandemic, which serves an ethnically and socioeconomically diverse set of children and adolescents, including AAPI youth from immigrant families.We additionally incorporate the lived experiences of four authors who identify as immigrant and/or native-born AAPI women.