The journey to finding the right mental health care for South Asians reveals that shared ethnicity does not guarantee a perfect therapeutic match, as individual experiences and needs vary widely.
This article explores the complexities of finding suitable mental health care for South Asians in America, highlighting that the right therapist isn’t always someone who shares your ethnic background.
In the early 1990s, Laavanya embodied the quintessential Indian American success story. Growing up in New Jersey as the daughter of a physician, she excelled academically, transitioning from a master’s in public health directly to medical school.
However, beneath her academic achievements lay a persistent inner turmoil that began in her childhood. Recognizing symptoms of depression and anxiety in his daughter, Laavanya’s father arranged for her to see both an Indian-origin adolescent psychiatrist and a therapist of a different background.
Despite her impressive verbal IQ of 140, Laavanya struggled with subtle social cues and unwritten norms. “I couldn’t really read a room well or pick up on people’s vibes,” she recalls. “I was always blunt. I never had filters.”
While her medication proved effective, the clinicians she encountered— including the Indian psychiatrist—failed to identify her neurodivergence or fully understand the nuances of her bicultural identity as an Indian American. “Those years just seemed like such a blur to be honest,” Laavanya reflects on her mental health journey that began in her teens.
“Remember, this was the early ‘90s,” she explains. “The only psychologists that were available were white. Issues like immigrant parents, children juggling two cultures, assimilation versus acculturation, and multicultural psychology were not yet addressed in the field.”
In 2003, while in medical school, Laavanya was diagnosed with mild Asperger’s syndrome at the age of 27 after undergoing numerous neuropsychological evaluations. The pressures of her internship ultimately led her to drop out of medical school. “I realized I wasn’t really cut out to be a physician or to practice clinically,” she admits.
Had she received an earlier diagnosis, Laavanya believes she would have explored nonclinical areas of healthcare. Instead, she trained as a biometric screener and became a mental health advocate.
Laavanya’s experience challenges the assumption that shared ethnicity guarantees a common perspective or immediate connection. She discovered that working with a South Asian American therapist did not necessarily mean the therapist was the right fit for her. Identity is shaped by more than race or culture, and each individual’s healing journey is unique.
The challenges of treating immigrants are significant for mental health practitioners in the U.S. First-generation immigrants, American-born children of immigrants, and individuals navigating multiple cultural identities often have vastly different needs. Clinicians must provide care that reflects these diverse realities while ensuring that mental health care is culturally congruent.
A generational culture gap often complicates these dynamics. Laavanya’s family was supportive of her mental health journey, a rarity in many Indian households where mental health is seldom discussed. However, she acknowledges that the “culture gap and generation gap” in her home environment contributed to her struggles.
“I was part of the first generation being raised here by the immigrants that came in the ‘60s and ‘70s. It was a very different time,” she explains. As her parents faced the pressures of adapting to a new culture, their children grappled with a different set of challenges, growing up between two worlds.
While her first therapist focused on symptom management, there was little discussion about parenting issues, identity formation, cultural conflict, or emotional awareness. Laavanya felt a stronger connection to American culture, often finding it easier to relate to mainstream Americans than to other South Asians.
Despite her disconnection from fellow South Asians, Laavanya cherishes Indian culture, particularly its intellectual richness and humanism, which her father instilled in her. She has traveled extensively throughout India, exploring her heritage and learning about its languages, art forms, spirituality, and traditions.
In 2020, Laavanya experienced a breakthrough when she met an Ecuadorian American immigrant therapist who specialized in working with high-functioning neurodivergent patients. This therapist employed a trauma-informed, culturally sensitive approach that helped Laavanya connect her bicultural identity with her neurodivergent brain.
“I thought since I was very Americanized and assimilated that I didn’t need to address these bicultural issues,” Laavanya admits. “But through her, I realized that even if I never really got along or felt at ease with Indians or my own community, the cultural duality will always be there.”
Dr. Hari Nair, a psychiatrist who sees many South Asians in his Bay Area practice, emphasizes the complexity of identity for South Asians in America. First-generation immigrants often have different needs than those born and raised in the U.S. While patients may seek him out for their shared cultural background, Dr. Nair is careful not to assume that shared ethnicity equates to shared experiences.
“I guard against the idea that because we’re both Indian, I know exactly what they’re going through,” he states. “Being Indian just gets my foot in the door. Then I have to be curious about their specific life.”
Conversely, some South Asian patients prefer to avoid therapists from their own community to escape perceived social or cultural stigmas. “I’m sensitive to the fact that some Indian patients want a non-Indian therapist because they want a ‘blank canvas’ without the perceived judgment of their own culture,” Dr. Nair adds.
The National Alliance on Mental Illness (NAMI) reports that, on average, individuals wait 11 years from the onset of symptoms before receiving treatment. Cultural stigma and silence can exacerbate this delay within South Asian families. Although more than half of U.S. adults with mental illness receive treatment, only one-third of Asians do. Many South Asians report needing mental health support but struggle to access care, a situation worsened by a shortage of Asian psychologists and the tendency to group diverse Asian communities into a single statistical category.
With her therapist, Laavanya gained a better understanding of her neurodivergence and how to address the intergenerational trauma stemming from her Indian background. She learned to redefine success beyond the unrealistic expectations of attending elite universities and securing prestigious jobs.
In December 2023, her therapist recommended another neuropsychological evaluation, leading to a diagnosis of high-functioning autism and nonverbal learning disability (NVLD). While symptoms of autism can vary widely, high-functioning autism describes individuals who excel academically but may struggle with social skills.
NVLD, often less understood, is characterized by challenges with visual-spatial reasoning and interpreting nonverbal social cues, even as verbal abilities remain strong.
Laavanya’s lengthy diagnostic journey underscores the importance of finding the right combination of clinical expertise and cultural understanding to recognize her specific conditions. Seeking care from an Indian-origin clinician was not, in itself, the solution.
For Kiana, a creative and driven Bay Area teenager, the path to therapy began when she realized that despite her hard work, she was not achieving the academic results she desired. An only child in a South Asian family, Kiana is passionate about dance and community service but is all too familiar with the intense academic competition and cultural pressures to achieve perfection.
Today, the Bay Area is a vibrant hub for Indian Americans, making it less likely for young people to feel out of place due to their cultural background. With her parents’ support, Kiana sought treatment for school-related anxiety and overstimulation. Working with an Indian-American psychiatrist has been transformative for her, as their shared cultural background fosters understanding.
“It helps me to have someone to relate to and understand the same cultural context,” Kiana explains. Her psychiatrist recognizes the academic pressures prevalent in South Asian communities, which can be overwhelming for high-achieving students.
After undergoing neuropsychological exams, Kiana was diagnosed with Generalized Anxiety Disorder and mild NVLD. Her diagnosis, coupled with a strong therapeutic relationship, has enabled her to manage her anxiety and learning disability through talk therapy and dialectical behavior therapy (DBT).
Dr. Nair, who grew up in the U.S., relates to the challenges faced by his young South Asian patients. “Academic pressure, balancing STEM with the arts, the expectation to become a doctor—I get it,” he says. This shared perspective allows him to better understand their experiences navigating cultural and generational differences within their families.
At nearly 50, Laavanya has been a mental health advocate for five years, eager to share insights from her complex journey to assist others. Recently nominated for the 2026 NAMI NJ ‘In Our Own Voice’ Award, she emphasizes that self-discovery is a lifelong process.
“Just because you’re a U.S.-raised South Asian American doesn’t necessarily mean you are equipped to work with our community in this space,” Laavanya asserts. Living at home with her parents, she feels fortunate to have their love and support.
Ultimately, Laavanya has found greater peace within herself. “I just want to be me. I’m not willing anymore to remold myself to fit into a neurotypical world,” she concludes.
According to India Currents, the journey to finding the right mental health care for South Asians underscores the importance of recognizing individual experiences and needs in therapeutic settings.