Beginning from "Hitting Rock Bottom": A Phenomenological Study of Asian American Women's Mental Health Helping-Seeking and Service Utilization

Background and Purpose

It has long been evident that Asian Americans have underutilized mental health services, compared to other racial or ethnic groups (Kim & Omizo, 2021; Panchal& Lo, 2024; Tan et al., 2024). In 2022, 9% of Asian American adults reported receiving counseling and prescriptive medications for mental health issues in the past, compared to 28% of White and 16% of both Hispanic and Black adults (Panchal & Lo, 2024). Furthermore, studies found that cultural factors, language barriers, and the model minority myth added additional challenges for the help-seeking pathway among Asian Americans (Arnault et al., 2016; Cheng et al., 2021; Lee et al., 2021; Tan et al., 2024). This qualitative study employs Interpretative Phenomenological Analysis (IPA) to explore and identify factors that influence a pathway of mental health seeking behaviors among Asian American women: “How is mental health utilization and self-helping behavior for mental health expressed among Asian American women? How do Asian American women make sense of their experiences with mental health services?

Methods

Methodological Approach

Since the study aimed to explore the lived experiences of utilizing mental health services, it employed a qualitative interpretive phenomenological analysis (IPA). The structured approach embedded within IPA provided a rigorous, double-hermeneutic exploration of participants’ understanding of their own experiences (Smith & Osborn, 2015).

Participants
Participants were recruited from snowball sampling through collaboration with Asian student organizations and Asian community organizations in the Midwest. There were 10 women in total: six identified as Korean American, one identified as Chinese American, one identified as Japanese American, and one identified as Filipino American, ranging in age from 19 to 36 (m =26.8).

Data Collection

Data were gathered using in-depth 1:1 semi-structured interviews with 2 participants and two in-depth focus groups consisting of 4 participants each. Each interview lasted 1.5 hours, and focus group lasted 2 hours to glean rich, meaningful descriptions of the participants’ lived therapy experiences.

Findings

Through IPA, the researchers identified four superordinate themes: (1) “Hitting rock bottom” before initiating help-seeking, often after exhausting alternatives like self-help, spirituality, or medical remedies; (2) Supportive function of significant others in decision-making to seek help; (3) barriers to access mental health with limited cultural shared therapist, financial strain, and cultural stigma; and (4) Factors to continuing mental health services, highlighting therapy’s impact on functional improvement, emotional clarity, and self-awareness—citing trusted therapeutic alliances and tangible outcomes as key motivators for sustained engagement.

Conclusion/ Implications

This study contributes to policy and practice by offering culturally informed insights into how Asian American women utilize mental health services and make treatment decisions. It supports the need for transformative change in service delivery through expanded access to culturally responsive, affordable, and destigmatized mental health care (Kim & Lee, 2021; Lee et al., 2017; Lee et al., 2021; Na et al., 2016). By integrating clients’ lived experiences into provider training, organizational practice, and policy design, social work can more effectively bridge mental health disparities and promote equity among underserved Asian communities.