The Mental Health Stakes of Asian Representation

In Atypical, therapist Julia Sasaki (played by Amy Okuda) is an unwavering professional. Faced with a client's crush and an unexpected pregnancy, she remains steadfastly committed to her job. When introduced to her family, the audience learns that her autistic brother is the inspiration for her career. Yet, we are given no cultural context for the familial silence that surrounds his autism. This is a rather stunning omission considering the documented stigma (and its consequences) among Asians when it comes to neurodiversity and mental health.

Rooshey Hasnain, a disability researcher and the project director of Asians with Disabilities Outreach Project Think-Tank, has found that disabled AA+PIs are underserved and receive lower-quality support and rehabilitation compared to other groups, including Latinx and Black people. Experts say a combination of factors, including shame, socioeconomics, cultural barriers, and the model minority myth have led to Asian Americans being underrepresented in the disability community. Similar dynamics shape AA+PI mental health and who provides it.

Just five percent of psychologists are Asian or Hispanic, four percent are Black or African American and one percent are multiracial or from other racial and ethnic groups. Given these realities, the placement of Asian American women in mental health care is odd at best, dubious at worst—particularly if they’re not given a backstory.

Asian Americans are one of the least likely communities of color to seek mental health resources. In a heartbreaking report released last year, the Trevor Project found that 49 percent of Pacific Islander and 50 percent of trans AA+PI respondents reported that they had seriously considered suicide in 2021. These dynamics translate into a small share of Asian American service providers; just five percent of psychologists are Asian or Hispanic, four percent are Black or African American and one percent are multiracial or from other racial and ethnic groups. Given these realities, the placement of Asian American women in mental health care is odd at best, dubious at worst—particularly if they’re not given a backstory.

An episode in the recently concluded season of Grey’s Anatomy features a South Asian couples’ therapist, Dr. Zoey Marchand. Marchand, played by Anisha Adusumilli, tends to the quickly dissolving marriage of series regulars Dr. Maggie Pierce (Kelly McCreary) and Winston Ndugu (Anthony Hill). Marchand has no backstory (interestingly Grey’s Anatomy has yet to feature a South Asian lead though close to 20 percent of the country’s physicians hail from this region of the world) but she does have clear ethnic markers in her office. One includes a marigold wedding garland, a prop my Desi partner explains would be akin to “placing birthday streamers in a business office.”

Despite many missteps, a path forward exists. Indeed, with time (and perhaps criticism) the Black Lady Therapist has gained complexity, a path her Asian counterpart could follow with the right support.

In 2021, ABC’s Station 19, which centers on a uniquely diverse firehouse in Seattle, dove headfirst into the topic of police brutality following the murder of George Floyd. One episode, “Get Up, Stand Up,” follows the characters as they seek the support of yet another Black television psychologist, Diane Lewis, played by Tracie Thoms. In the final eight minutes of the episode, a victim of police violence comes into Lewis’ office. Neither character speaks. Under the weight of the incident at hand, their work and the national failure of systemic racism, the two silently break into tears. The scene is a few seconds, but it is a rare moment that effectively illustrates how racism permeates personal experiences in the professional world. Even in roles that lack this kind of heft, could the Asian Woman Therapist exist in a similarly accurate world?

In April, Netflix and A24’s Beef debuted to critical acclaim. The show stars Ali Wong and Steven Yuen in an emotionally loaded and potentially deadly grudge match. It also includes an Asian woman therapist, Dr. Catherine Lin, played by Kayla Blake. The role is small, including just a few lines spread across two episodes. The audience knows close to nothing about Dr. Lin outside of her profession. Yet while the trappings of the Asian Woman Therapist seem similar to the aforementioned roles, Beef has an important  distinction: its cast is mostly Asian.

What might it take to accomplish not just diversity, but interiority, a phenomenon woefully lacking in Asian American roles?

In an interview about the show, Wong explained the advantages of moving beyond diversity and toward multi-dimensionality, saying, "It is really exciting when you have a predominantly Asian-American cast, because then all of the people get to be people." In this context, the character of Dr. Lin lands differently. She remains a plot device, but is not tokenized in her function as such. What might it take to accomplish not just diversity, but interiority, a phenomenon woefully lacking in Asian American roles?

Audiences demand a merging of entertainment, equity and honesty. To provide it, shows will need to get creative. Krista Vernoff, Station 19's white showrunner, brought in racial justice organizations and Black Lives Matter activists as consultants. She opened the door to her cast of predominantly people of color to weigh in. She leaned on the production’s director of diversity. These behind-the-scenes actions illustrate what content is possible when casting decisions are made with consideration of the values, experiences, and political demands of communities of color. Similar measures would benefit the media landscape, which continues to struggle with increasing visibility for people of color while failing to change the systems that have excluded them in the first place.

Fair or not, the stakes for representation are high and its limitations are exceptionally clear. In a study of more than 50,000 speaking characters in the 1,300 top-grossing movies, only 5.9 percent of speaking roles were given to Asian Americans or Pacific Islanders. Even for Oscar winning actors, this struggle can exacerbate very real inequity. We cannot be what we cannot see, but it is equally important that when depictions of the community appear, the picture aligns with a desired reality.