Parental Immigration Generation and Mental Health Service Disparities Among Asian American Children

Background: Asian American children are among the fastest-growing youth populations in the United States yet remain significantly underrepresented in mental health service utilization studies. As children’s mental health service use is significantly influenced by their parents’ situation and decision, this study investigates disparities in emotional or behavior problems (EBP) and mental health services use among Asian American children based on whether their parents are first/second or third generation immigrants.

Methods: This study utilizes cross-sectional data from the 2020–2021 National Survey of Children’s Health (NSCH), focusing on a subsample of 3,247 Asian American children ages 6–17. The main analyses were conducted with 399 Asian American children who were reported having mental, emotional, developmental, or behavioral health conditions. Immigration generation was classified by whether the children’s parents were born in the United States. Chi-Square Analyses examined the prevalence of EBP and service utilization patterns by the parents’ immigration generation.

Results: Preliminary findings indicate that third generation Asian American children (23.4%) had significantly higher prevalence of EBP compared to their first (8.1%) and second (10.1%) generation peers (x2= 78.978, p < .001). In general, the third-generation Asian American children saw more mental health professionals (13.0% vs. 4.1%, p<.001), received more special education plans (9.7% vs. 4.2%, p<.001), special services (8.1% vs. 3.8%, p<.001), and behavioral treatment (13.5% VS. 4.7%, p<.001) at school than the first and second-generations. They also took more medication (9.8% vs. 2.3%, p<.001). Even after adjusting for health need, first and second-generation Asian American children underutilized mental health services compared to the third-generation counterparts. Only 31.2% of the first and second-generation Asian American with EBP reported seeing a mental health profession within 12 months compared to 41.3% among the third-generation Asian Children. First and second-generation children were also less likely to take medication for EBP (22.5% vs. 38.8%, p<.001). However, there were no significant differences in the utilization of school-based services (special education plans, special services, behavioral treatment).

Conclusions and Implications: Immigration generation plays a significant role in mental health service utilization patterns among Asian American youth. Findings highlight the need for culturally responsive outreach, early identification in schools, and policies that reduce systemic and cultural barriers to care. Social work professionals are uniquely positioned to bridge these gaps by advocating for inclusive service models and integrating community and family-based approaches that address intergenerational and cultural dynamics.