You are sitting at the dinner table. Someone in the family is struggling – visibly, undeniably. Maybe it is you. Maybe it is a parent, a sibling, a cousin whose eyes have gone flat in a way that worries you.
Someone suggests, carefully, that talking to someone might help.
The table goes quiet. Then comes the redirect: have you tried praying more, eating better, staying busy, thinking positive? Maybe someone says, gently but firmly, that these things stay inside the family. That outsiders do not need to know. That what looks like suffering is really just a phase, or ingratitude, or weakness that more discipline can fix.
You leave the table carrying what you came in with, plus the weight of knowing that asking again will cost something.
This scene plays out daily in may immigrant households, including South Asian ones, across Vancouver, Surrey, Burnaby, and Richmond. Not because these families do not love each other. Because stigma around mental health in certain communities runs deep, was built over generations, and carries real consequences that many mainstream conversations about therapy don’t mention.
The Number Worth Naming
In March 2023, the Centre for Addiction and Mental Health (CAMH) and the Mental Health Commission of Canada released landmark research on mental health in South Asian communities in Canada. The finding stopped people: South Asians, Canada’s largest racialized group at approximately 2.6 million people, are 85% less likely to seek mental health treatment compared to the general population.
85%.
That number does not exist in a vacuum. It reflects generations of cultural messaging about strength, privacy, family loyalty, and the meaning of suffering. It reflects communities where mental illness has historically carried associations with shame, spiritual failure, or weakness. It reflects a mental health system that was built for and by a Western, individualist framework – and that has consistently failed to meet South Asian communities where they are at.
Source: CAMH/MHCC Culturally Adapted CBT Research Report, March 2023
Where the Stigma Comes From
Stigma around mental health in South Asian communities did not appear out of nowhere. Understanding its roots does not excuse the harm it causes – but it does make it possible to hold people with more compassion, including yourself.
Many South Asian families carry a deep and legitimate mistrust of systems that have historically caused harm: colonial medical institutions, psychiatric practices that pathologized cultural difference, healthcare providers who dismissed pain or misread behaviour through a racist lens. That mistrust is not irrational. It accumulated across generations for reasons that made sense.
Alongside that history sits a set of cultural values that, in their healthiest forms, are genuinely sustaining: collectivism, family loyalty, interdependence, spirituality, the prioritization of community over individual comfort. These are not dysfunctions. They are values. The problem emerges when those values get weaponized against people who are struggling – when “family comes first” becomes a reason to silence pain, when spiritual practice becomes a substitute for support that someone actually needs, when collective reputation becomes more important than individual wellbeing.
South Asian communities in Vancouver, Surrey, Burnaby, and Richmond also carry the specific weight of immigration and diaspora. Many families came here with very little, built stability through enormous sacrifice, and survived by not looking too closely at what the sacrifice cost them. Mental health care was not part of that survival equation. For many, it still does not feel like a legitimate need.
What the Stigma Actually Costs
Stigma is not just a cultural inconvenience. It has measurable, documented consequences.
South Asians in Canada have higher rates of anxiety and mood disorders than the general population – and far lower rates of treatment. That gap does not close on its own. Untreated mental health conditions compound over time, affecting physical health, relationships, work, parenting, and the next generation.
A 2023 study examining South Asian youth mental health in the Peel Region of Ontario (Islam et al., Journal of Transcultural Psychiatry) found that young people and their parents frequently distrust Western psychiatry and find standard cognitive behavioural therapy, (CBT), the backbone of publicly funded mental health care in Canada, disregards their experiences. South Asian youth reported that CBT’s focus on individual behaviour change and goal-setting failed to account for the interdependent family structures and collective values that shape their lives.
That is not a failure of the young people. That is a failure of a system that designed its primary treatment modality without an inclusive lens, and has not done enough to build anything better for everyone else.
Source: Islam et al., South Asian youth mental health in Peel Region, Journal of Transcultural Psychiatry, 2023
The cost extends inter-generationally. As explored in What Is Intergenerational Trauma? And How It Shows Up in Immigrant Families, when parents carry unprocessed pain without support, that pain does not disappear. It moves. It shapes how children are raised, what emotions are modelled, what needs get named and which ones stay silent. The stigma that kept one generation from seeking help becomes the water the next generation grows up in.
Why Standard Therapy Often Doesn’t Work
Even South Asian people who overcome the stigma and seek therapy frequently encounter a second barrier: the therapy itself does not fit.
Standard CBT was developed within a Western value system that centres individual autonomy, self-disclosure, and the separation of self from family and community. For someone whose sense of self is deeply collective – whose decisions are made in relationship to parents, extended family, and community expectation – a framework that treats the individual as the primary unit of analysis misses the point.
This is not a small gap. When a therapist suggests “setting boundaries” with a family structure built on interdependence, or frames filial piety as a sign of enmeshment, or treats collective grief as individual pathology, they are not offering culturally competent care. They are offering a Western framework poorly fitted to a non-Western life.
The CAMH research responded to this specifically. Working with South Asian communities across Canada, CAMH developed and tested a Culturally Adapted CBT (CaCBT) specifically for South Asians experiencing anxiety and depression – integrating family dynamics, cultural context, spirituality, and collective identity into the therapeutic approach. The results showed meaningfully better outcomes than standard CBT for this population.
That finding matters. It confirms what South Asian communities have known from experience: the problem was never that therapy does not work. The problem was that the therapy available was not designed for them.
What Is Changing – And What Still Needs To
The landscape is shifting, slowly and genuinely.
More BIPOC therapists are entering the field. More South Asian practitioners are building practices specifically designed to hold the complexity of diaspora experience, intergenerational dynamics, immigration grief, and the specific texture of South Asian family life. As the conversation about culturally responsive care grows louder, more therapists, (regardless of their own background), are doing the work of adapting their practice to fit their clients rather than expecting clients to fit the practice.
The stigma conversation is also moving. Younger generations of South Asians in Vancouver, Surrey, Burnaby, and Richmond are talking more openly about mental health, often through social media, peer communities, and the kind of quiet conversations that happen between cousins who finally admit they are both struggling. The cultural shift is happening, slowly but surely.
What has not changed fast enough: access. Finding a therapist who understands South Asian community dynamics, who practices from an anti-oppressive framework, who does not pathologize collectivism or require you to justify your cultural context before the work can begin, that search is still harder than it should be. Cost remains a significant barrier, particularly for newcomer families and those without comprehensive benefits. And the shortage of therapists who speak South Asian languages fluently enough to hold therapeutic work is a gap that systemic underfunding has not addressed.
Additional Resources
Browse BIPOC therapists in Vancouver and the Lower Mainland
Related Reading
- What Is Intergenerational Trauma? And How It Shows Up in Immigrant Families
- How to Talk to Immigrant Parents About Therapy
- BIPOC Burnout and Imposter Syndrome
- When Therapy Causes Harm: Microaggressions in the Therapy Room
- Depression in Second-Generation Immigrants: Why You Feel Guilty for Struggling
- First-Generation Immigrant Trauma: When Success Doesn’t Heal the Weight You Carry
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About Healing in Colour
Healing in Colour connects BIPOC clients across Canada with therapists and allied professionals who practice from anti-oppressive values. We believe BIPOC people, in all our intersections, deserve therapy that supports our healing and liberation.
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