"Kids can’t be depressed; you have everything you need."
"Therapy is for people with serious mental disorders—you’re normal."
These were the words I heard from close family members and other adults in my culture when I expressed my desire to see a therapist at the age of 12.
When my parents separated, my world had shattered. And as an only child, I struggled to process this sudden shift in my life. While divorce is considered to be common in some cultures, South Asia has one of the lowest divorce rates globally. Specifically, in Indian culture, strong stigma around divorce and deeply rooted traditional values contributed to a divorce rate of only 1%. This also makes children of divorce rare and their struggles isolating.
As I endured my emotions in silence, I became the target of both family and societal pressures. Around this time, I had also migrated from Kuwait to India, where I previously lived until the age of 10. The abrupt change of environment, combined with my parents’ separation, created an emotional turmoil that no adult around me seemed to understand. And at the age of 13, I finally decided I wanted to attend therapy.
I went to five sessions in total, but each one felt eerily the same. My psychiatrist repeated the same phrase every time; "Don’t involve yourself in adult problems." That one statement made everything I had shared—my pain, my confusion, my desperate attempt to make sense of my life—feel irrelevant. But how could I not be involved? It was my parents, my family, my life.
It did not take me long to understand that my experience wasn’t just about one unhelpful therapist. It was a reflection of a larger issue—how cultural stigma shapes the way mental health is perceived and treated. Even professionals were influenced by societal norms and held preconceived notions about who deserved therapy, including what struggles were deemed worthy of attention.
My experience was not unique—many children in immigrant communities face similar invalidation when seeking help. The stigma surrounding mental health is deeply ingrained, not only within families but also in the very institutions meant to offer support. This raises the question: Why is mental health so misunderstood in certain cultures, and how does this stigma prevent people, especially youth, from getting the care they need.
WHAT IS MENTAL HEALTH STIGMA?
Mental health stigma refers to negative attitudes, beliefs, and discriminatory behaviors directed towards individuals with mental health conditions. Stigma surrounding depression and other mental illnesses can be higher in some cultural groups and often is a major barrier to people from diverse cultures when accessing mental health services. This stigma can cause people to feel so ashamed that they hide their symptoms and do not seek treatment until the issue becomes acute.
Public stigma - This involves societal discrimination, negative stereotypes, and prejudice against people with mental illness. Public stigma can manifest through situations like social exclusion, difficulty finding employment, and reluctance to seek help.
Self-stigma- This is the internalization of these negative beliefs by individuals with mental health conditions, leading to feelings of shame, hopelessness, and reduced self-esteem. Self-stigma can prevent individuals from seeking treatment and support.
Barriers to Mental Health Care in Immigrant Communities
Cultural and structural barriers, coupled up with generational divides, significantly impede access to and effectiveness of mental health care, particularly for youth and families navigating complex cultural identities and intergenerational conflicts.
Cultural - Cultural barriers can greatly affect the access to mental health care due to various factors. Some of them include fear of familial judgement, preferring faith or traditional healing practices over therapy etc. In many cultures, stigma around depression and other mental illnesses can be higher than others. Stigma can cause people to hide their symptoms and not seek treatment due to feelings of shame and judgment. For instance, negative stigma surrounding mental health can be particularly intense in some Asian cultures where mental illness is perceived to reflect negatively on one’s family lineage as it could hinder marriage prospects and economic stability.
In certain cultures, age also plays a huge role in whether you are “valid” for seeking therapy. For example; In South Asian culture, the older you are, the more acceptable it is for you to seek therapy, as if you have experienced life enough. Whether that be financial stress, work stress or relationship issues. This is due to the cultural understanding that children are only supposed to focus on school and academic achievements. The idea of students working part-time or being in relationships at a young age are looked down upon by society.
The varying cultural understanding of health and illness can cause further delay in seeking appropriate treatment thereby adding another layer of complication. Public awareness, peer support groups and community based mental health services are some effective strategies overcome cultural barriers in mental health care 👏
Structural - Structural barriers such as lack of culturally competent providers, language barriers, financial constraints and concerns regarding immigration status can present significant challenges to immigrants accessing health care. As mental health symptoms manifest differently across various cultures, the lack of culturally competent care can result in misdiagnosis and false interpretations of issues. Simultaneously, language barriers can exacerbate these issues, which can then lead to misunderstandings and often, lack of trust between the client and helper.
Generational Divides
Older generations often exhibit resistance to seeking therapy due to their lack of acknowledgement for mental health. This negative attitude towards psychotherapy hinders their ability to efficiently engage in therapeutic practices and the recovery process. Younger generations on the other hand combat challenges pertaining to bridging traditional values with modern mental health awareness. They often find themselves struggling to connect cultural expectations with self- actualization which leads to additional stress and potential family conflicts.
The concept of intergenerational communication plays a role in addressing mental health issues. In most cultures, the openness to seeking therapy is heavily dependent on the views and beliefs of the adults in the family. In other words, their current beliefs and views on this topic could pave the wave or hinder the willingness and ability of the next generation receiving therapy. Therefore the concept of intergenerational communication helps reduce stigma and break barriers by creating a safe space for open dialogue and normalizing mental health struggles through shared experiences across all ages.
Effect on Youth and Families
Children in immigrant households face the challenge of navigating dual cultural identities, which often leads to increased levels of stress, anxiety and depression. As children navigate their multiple identities while trying to meet expectations of people within their culture and ‘fit in' with the dominant society, they are subjected to higher levels of anxiety and stress compared to their parents. Immigrant parents who may have faced significant hardships themselves, may downplay their children’s mental health concerns by viewing them to be ‘less severe” compared to their own experiences. This sort of undermining of mental health issues can stem from cultural beliefs and stigma surrounding mental health.
My experience is just one example of how deeply ingrained cultural stigma can isolate those who need support the most. In many immigrant communities, mental health struggles are dismissed, and even professionals can reinforce these harmful biases. The barriers—whether cultural, structural, or generational—make it difficult for youth to seek the help they deserve, leaving them to navigate their pain alone. To break this cycle, we must foster open conversations, advocate for culturally competent care, and bridge generational divides. Only by normalizing mental health discussions can we create a future where seeking help is not a sign of weakness, but one of strength.
Written by Nikita Ugandher
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About the Author
Nikita is a senior Psychology major at Virginia Commonwealth University (VCU), minoring in Education. She is passionate about advocating for mental health and social equity, especially in communities and cultures that tend to neglect youth mental health. Nikita's career goal is to become a Licensed Clinical Social Worker and use her multilingual skills to offer culturally responsive therapy to ethnic teens and young adults.
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