# Access to Mental Health Treatment Services in Asian Languages

## TL;DR

Mental health services in Asian languages are scarce in the US, especially in rural areas, leading to access barriers for Asian language speakers with limited English proficiency.

## Contribution

This study quantifies the persistent and declining availability of Asian language mental health services in the US from 2015 to 2024.

## Key findings

- Only 5.6% of US mental health facilities offered Asian language services in 2024.
- Rural areas had almost no access to such services despite significant Asian language-speaking populations.
- Facilities with Asian language services were concentrated in urban areas like California and the Northeast.

## Abstract

This cross-sectional study examines the availability of mental health treatment offered in Asian languages in US mental health facilities from 2015 to 2024.

Has the availability of mental health treatment services in Asian languages changed over time?

In this cross-sectional study of 3847 US mental health facilities from 2015 to 2024, the availability of Asian language services remained persistently low and declined in later years, with limited access especially in rural counties.

The findings suggest that policies aimed at increasing access to culturally and linguistically competent mental health services are needed, especially in rural areas.

Asian language speakers with limited English proficiency (LEP) face significant barriers to accessing adequate mental health care. Despite worsening mental health outcomes for this population, there is limited research examining the availability of Asian language mental health treatment in the US.

To quantify trends and analyze disparities in the geographic availability of Asian language mental health treatment from 2015 to 2024.

This cross-sectional study of US mental health facilities from April 30, 2015, to December 9, 2024, used longitudinal data from the nationally representative Mental Health and Addiction Treatment Tracking Repository linked with county-level demographic data from the 2023 American Community Survey. Facilities were included if they completed the National Mental Health Services Survey or the National Substance Use and Mental Health Services Survey.

Primary outcomes included the annual proportion of mental health facilities offering Asian language services and the proportion of counties with at least 1 such facility. For 2024, facility-level characteristics associated with Asian language services were assessed and geographic mismatches between service availability and the proportion of Asian language–speaking individuals with LEP were mapped.

The study included 3847 mental health facilities. Of these, 214 facilities (5.6%) offered services in at least 1 Asian language in 2024 (including Arabic, Chinese, Farsi, Hindi, Hmong, Japanese, Korean, Tagolog, and Vietnamese). The proportion peaked at 265 facilities (6.9%) in 2021, then declined from 2022 to 2024. The number of counties with at least 1 facility with Asian language services was 98 (6.3%) in 2024. Facilities offering Asian language services were concentrated in metropolitan areas (208 [97.2%]), particularly in California (57 [26.6%]) and the Northeast (52 [24.3%]). Rural areas lacked such services (3 of 485 rural facilities [0.6%] in 2024), even in counties with substantial populations of Asian language–speaking individuals with LEP (0 of 5 facilities).

This cross-sectional study found a persistent geographic mismatch between the mental health needs of Asian language–speaking individuals with LEP and the availability of appropriate linguistic services. The gap was pronounced in rural areas. The findings suggest that policies aimed at expanding the behavioral health workforce and increasing access to culturally and linguistically competent services to reduce ongoing disparities in mental health outcomes and access to care are urgently needed.