Mental Health Stigma and Help-Seeking among South Asian American Young Adults in Texas: A Mixed-Methods Community-Based Needs Assessment

Background: Although barriers to mental health help-seeking among Asian American populations are well documented, less is known about how favorable individual attitudes toward mental health treatment coexist with family and community influences among South Asian American young adults or which intervention strategies members of this population themselves prioritize. Methods: A cross-sectional mixed-methods survey was completed by 191 South Asian American young adults aged 18-30 years residing in Texas between May and June 2026 using convenience sampling. Participants completed 5-point Likert-scale measures assessing mental health attitudes, stigma, help-seeking, and barriers to care. 144 participants also provided responses to optional open-ended questions exploring barriers to mental health care and recommendations for improving access to mental health support. Quantitative data were analyzed using IBM SPSS Statistics, and qualitative responses underwent thematic analysis in MAXQDA. Results: Participants reported generally positive attitudes toward mental health care and high perceived importance of mental health despite family- and community-level barriers. Greater family pressure was strongly associated with increased mental health stigma (r = 0.711, p < 0.001) and perceived barriers to care (r = 0.654, p < 0.001), while greater perceived barriers were associated with less favorable help-seeking attitudes (r = -0.158, p = 0.036). Qualitative responses contextualized these findings, identifying anticipated community judgment, family expectations, privacy concerns, and limited mental health literacy among older generations as barriers to care. Participants emphasized culturally responsive care and recommended mental health education involving parents, elders, faith leaders, and trusted community institutions. Conclusions: South Asian American young adults may hold favorable attitudes toward professional mental health care while navigating family, community, and cultural contexts that constrain help-seeking. Participant-generated recommendations prioritized culturally responsive care and community-level mental health education involving parents, elders, faith leaders, and trusted institutions, suggesting that interventions targeting individual attitudes alone may be insufficient.