Language barriers are a major obstacle to accessing mental health care for those in the US who have difficulty communicating in English. But despite increasing demand, mental health services in Asian languages are rare—and in some places, in decline, according to a new study published in JAMA Health Forum .
"Our research underscores an urgent need to strengthen the mental health infrastructure so people can access care in a language they can understand," said study author Ji Eun Chang , associate professor of public health policy and management at NYU School of Global Public Health.
Asian Americans are the fastest growing racial or ethnic group in the US. This population is less likely to seek out mental health care—in part because of the stigma associated with mental illness, but language barriers may also play a role, given that nearly one in three Asian American adults has limited English proficiency.
To understand the availability of mental health services in Asian languages, Chang and her colleagues analyzed data from 3,847 outpatient and inpatient mental health facilities across the US. Using surveys from 2015 to 2024, they looked at whether the facilities offered linguistically accessible services in nine Asian languages: Arabic, Chinese, Farsi, Hindi, Hmong, Japanese, Korean, Tagalog, and Vietnamese. They also analyzed the geographic distribution of these services and whether their availability aligned with local population needs.
In 2024, only 5.6 percent of facilities offered treatment in at least one Asian language. While non-English mental health services have expanded overall, Asian-language services peaked in 2021 (at 6.9 percent) and actually declined from 2022 to 2024.
In addition, Asian language mental health services were largely concentrated in urban areas in California and the Northeast. Rural areas lacked such services, even in counties with substantial populations of Asian language-speaking individuals with limited English proficiency.
"Rural areas are a language desert—only 0.6 percent of facilities in rural areas offer treatment in an Asian language," said Chang. "Our study points to a persistent geographic mismatch between the needs of Asian-language speaking individuals and the services offered in their communities."
While long-standing federal policies already require federally funded health care organizations to ensure "meaningful access" to their services for people with limited English proficiency, the study suggests a gap between these mandates and the current behavioral health infrastructure. According to the researchers, additional policies to increase access to linguistically concordant mental health care could help close this gap—for instance, incentivizing the hiring of providers who speak multiple languages, or increasing interpreter services using virtual or artificial intelligence-enhanced translation services.
Additional study authors include Aarya Suryavanshi and Jonathan Cantor of RAND and Sugy Choi of NYU Grossman School of Medicine.
