Advancing Best Practices 

in Behavioral Health for

Asian American, Native Hawaiian, 

and Pacific Islander Boys and Men 

2017
2 

Setting the Stage

In March 2015, the Substance Abuse and Mental 

Health Services Administration’s (SAMHSA) Office of 

Behavioral Health Equity (OBHE) and the American 

PsychologicalAssociationco-sponsored a conference: 

“Pathways to Behavioral Health Equity: Addressing 

Disparities Experienced by Men and Boys of Color.” 

The meeting, aligned with the Presidential initiative, 

My Brother’s Keeper, focused on understanding 

behavioral health issues related to men and boys of 

color - namely Black/African Americans, Latinos, 

Native Americans, and Asian Americans, Native 

Hawaiians, and Pacific Islanders (AANHPIs) - across 

the United States. At the convening, leaders of the 

AANHPI community noted that there was limited 

research on AANHPI men and boys, despite the recent 

report that Asian Americans (AAs) are the fastest 

growing ethnic group and are expected to be the 

largest immigrant group by 2055.1 Further, although 

Southeast Asians (e.g., Hmong, Vietnamese, Laotians, 

and Cambodians) and Native Hawaiian and other 

Pacific Islanders (NHPIs) tend to experience similar 

educational and socioeconomic disparities as Black, 

Latino, and Native American men and boys, 

behavioral health programs or resources are limited 

for thesepopulations.

In March 2016, SAMHSA’s OBHE issued a brief 

entitled “A Snapshot of Behavioral Health Issues for 

Asian American/Native Hawaiian/Pacific Islander 

Boys and Men: An Overdue Conversation.”2 The issue 

brief provided a background on AANHPI communities 

– describing the diversity of ethnic groups, 

immigration histories, and current socioeconomic and 

political experiences in the US. The brief then 

highlighted research covering a spectrum of 

behavioral health issues related to AANHPI boys and

men including:

● Behavioral health issues (e.g., depression, 

suicide, substance use, and schizophrenia)

● Ethnic and cultural factors affecting helpseekingbehaviors

● Social determinants of health, including 

educational factors, involvement in the 

criminal justice system, and racism and racial 

microaggressions.

The brief concluded with a call for local and national 

strategies to develop programs, services, and 

resources that specifically target behavioral health 

issues among AANHPI boys and men.

Clarifying thePurpose

Building on the initial brief, SAMHSA’s OBHE 

contracted with leadership from the Asian American 

Psychological Association (AAPA) and the Okura 

Mental Health Leadership Foundation to develop this 

strategy brief to highlight the types of existing 

programs or services that address behavioral health 

disparities and promote equity for AANHPI boys and 

men. This brief summarizes “best practices” and 

expert consensus on culturally appropriate 

approaches, treatment modalities and effective tools 

in working with this population.

Collecting the Information

The leadership from AAPAand the Okura Foundation 

reached out to scholars, service providers, and 

community leaders in the AANHPI community who 

have been providing and developing effective 

interventions, services, and support systems for 

AANHPI boys and men. These experts represented 

various regions of the country (e.g., the East Coast, 

West Coast, Alaska, andHawai’i), ethnic backgrounds 

(e.g., multiracial, Native Hawaiian, Filipino, Chinese, 

South Asian, Thai, Japanese, Hmong, and Korean), 

generational status (e.g., immigrants, second 

generation, and fourth generation), gender identities 

(e.g., men and women), sexual orientation (e.g., 

heterosexual and gay), and areas of expertise (e.g., 

psychologists, social workers, clinical directors, 

researchers, educators, and non-profit organization 

leaders). The information collected from these experts

informed this strategybrief.

Reporting the Findings

This strategy brief highlights essential approaches for 

addressing behavioral health disparities and 

providing effective services for AANHPI boys and men. 

Seven practice strategies are highlighted for clinicians, 

substance abuse counselors, program coordinators, 

educators, and leaders of community groups. Four 

systemic and institutional strategies are provided for 

local, state and federal policy makers and staff, funding

agencies, and other stakeholders. Examples of best or 

promising behavioral health practices (e.g., programs, 

therapeutic approaches, and supports, etc.) are

provided from organizations and behavioral health 

practitioners who have successfullyutilized

these strategies.
3 

SevenStrategies for Practitioners, Educators, and Community Leaders 

1

Integrate Culturally-Based 

Strategies in Working with 

AANHPI Boys andMen

Integrating culturally-appropriate 

approaches in clinical interventions and

behavioral health programs that promote behavioral 

health wellness and recovery is essential. While the 

actual approaches may vary based on individuals’ 

ethnic background, acculturation level, and cultural 

identity awareness, there are several general 

approaches that experts deem as being effective. First, 

when utilizing Western therapy methods, it is crucial

to integrate cultural traditions. Recent studies have 

supported that NHPI men prefer culturally congruent 

practices for coping with distress (e.g., family support, 

religiosity, or spirituality) rather than psychotherapy 

or substance abuse counseling.

3Experts describe the 

importance of involving family – especially in 

culturally focused psychoeducation, treatment, and 

recovery programs. For NHPIs, key informants in 

Hawai’i describe how the traditional healing process 

(or ho’oponopono) involves the family- which can

include both a kupuna (elder) and a licensed clinician; 

male clients specifically request this kind of healing 

session to bring the family together.

For educational or support programs promoting 

behavioral health, experts also recommend involving 

kupunas (or elders). Elders can be instrumental in 

promoting interventions and healing because they 

have lived experience, life skills, wisdom, and 

knowledge. Several experts report that kupunas’ 

intergenerational wisdom guide young men and boys 

in their development. Further, experts emphasize the 

importance of cultural education when promoting 

behavioral health. Many key informants describe how 

AANHPI boys and men need to be centered on their 

cultural identities, in order to develop healthy selfesteem and positive mental health. For instance, Hina 

Mauka Drug Treatment Program inHonolulu,Hawai’i 

offers a class on “Hawaiian Values” where a kupuna 

teaches Hawaiian history and cultural keys to the past 

and future. Similarly, the Hmong Youth and Family 

Program at Keystone Community Center in St. Paul, 

Minnesota offers afterschool enrichment programs 

including Hmong dance instruction, traditional

Hmong cooking with parents, and holiday

celebrations. Allowing young men and boys to learn 

about their cultural background can help increase 

self-esteem and ethnic identity, which may promote 

optimal mental health and coping behaviors.

2

AddressMasculinityandGender 

Roles

Masculinities have different attributions in 

different cultures; some assigning more 

aggression to masculinity; others more 

receding, passivity. AANHPI men and boys are often 

emasculated or desexualized in American media and 

in American society in general. Experts described how 

gender role expectations and masculinity affected 

behavioral health. For different ethnic groups, cultural 

pressures manifest differently. For East Asian 

American (e.g., Chinese, Japanese, and Korean 

Americans) and Southeast Asian American men, the 

pressure to appear more masculine is motivated by a 

need to negate stereotypes of AA men as weak, 

asexual, or submissive. For Filipino Americans, the 

pressure to appear more masculine is shaped by a 

need to abide by the machismo gender role 

expectation that was embedded into Filipino culture 

through Spanishcolonialism.

Previous research has found that when AANHPI men 

believe their masculinity is being threatened or 

questioned, they may develop lower self-esteem and 

other mental health issues; they may also engage in 

unhealthy and harmful coping mechanisms and 

behaviors (e.g., intimate partner violence or 

substance abuse).

4Research has also supported how 

AA men uniquely experience masculinity in negative 

ways – due to the intersection of their racial and 

gender identities; often, the pressures to conform to 

Westernized masculine ideals may result in AA men’s 

psychological stress5 and substance abuse.6 It is 

recommended for practitioners and educators to 

discuss masculinity with AANHPI male clients, in 

order to understand how racism and gender role 

expectations have influenced their self-concepts and 

other presentingproblems.
4 

3

Discuss Coping Strategies and 

PromoteHelp-SeekingBehaviors

Related to masculinity, experts identified 

how AANHPI boys and men are less likely to

seek help for their psychological or

behavioral issues, drop out of mental health services 

or substance use disorder treatment, or seek services 

only after symptoms have worsened or functioning 

has deteriorated. AANHPI boys and men tend to have 

a difficult time seeking help due, in part, to cultural 

expectations and gender norms.1While seeking 

support for mental health issues is stigmatized across 

AANHPI ethnic groups and genders, AANHPI boys and 

men often face additional pressure to be viewed as

smart, successful, and emotionally strong.

It is important for practitioners, counselors, and 

educators to discuss coping mechanisms with 

AANHPI men and boys. Experts recommend 

facilitating discussions on cultural and gendered 

expectations on coping, while encouraging AANHPI 

men and boys to seek professional help when they 

need it. Specific to counseling and other clinical 

therapy services, providing psychoeducation about 

the therapy process may be especially important for 

AANHPI male clients, as they are often unfamiliar with 

the process or may not be inclined to discuss 

emotional or psychological hardships with others. For 

substance abuse counselors, discussing how alcohol

or drug use has been a primary way of coping with life 

stressors or traumatic events can assist AANHPI men 

to understand the need to change or minimize 

suchbehaviors.

Further, because of cultural shame and the stigma in 

seeking behavioral health care, some researchers 

have supported the use of internet outreach and 

online support groups to promote behavioral health 

among AANHPI men.7Because AANHPI men are less 

likely to seek mainstream psychotherapy or 

substance abuse counseling than AANHPI women, 

practitioners may utilize the internet to provide 

psychoeducation or outreach services to AANHPI 

men. Clinicians may also consider monitoring online 

support groups, in addition to promoting in-person 

support groups. While promoting behavioral health 

online alone may not be ideal, such methods can be 

the first step that AANHPI men and boys need to 

attaining information or addressing any problematic 

psychological or behavioral issues. It may be a first 

critical step ofengagement.

4

Acknowledge Experiences of 

RacismandMicroaggressions

Experts described how AANHPI men and 

boys experience racism- in both overt and 

subtle ways. One example of overt

discrimination that AANHPI men and boys encounter 

is bullying- which the U.S. Department of Education 

reports AANHPI youth are experiencing at increasing 

rates.

8 In 2015, 19 percent of Native Hawaiian 

students and 17 percent of Filipino students reported 

being bullied in Hawai’i high schools, and 60 percent 

of Native Hawaiians and Filipinos reported being 

bullied in Hawai’i middle schools. AANHPI students 

report being bullied for a number of cultural reasons, 

such as their racial characteristics, immigration 

status, or family background and history. When 

AANHPI men and boys experience discrimination, 

they may turn to substance use (e.g. alcohol, nicotine, 

illicit drug use) to cope with their problems.

9

Subtle forms of discrimination often come in the 

forms of microaggressions- which are covert acts of 

discrimination that are often unintentional by the 

perpetrator or appear to be harmless or innocuous.

10

For instance, experts who worked with NHPI young 

men cited how others (e.g., police officers, teachers, 

store clerks, and others) often perceive and treat 

NHPI men as dangerous or criminal due to their 

darker skin color and typically larger physical stature. 

As a result of this, some NHPI young men learn to 

expect these stereotypes as commonplace or truthful 

which affects their self-efficacy, their assessment of 

their potential, and their ability to succeed. AA men, 

particularly East Asian American men, often 

experience gendered, racial microaggressions in the 

forms of demasculinization - or acts of discrimination

in which AA men are viewed as weak, effeminate, 

asexual, or not masculine enough. Again, such

racialized and gendered experiences may result in 

lower self-esteem,potential mental health issues, and 

other behavioral concerns. Recent studies with AA 

samples have found that racial microaggressions can 

predict depression10 and lower academic selfefficacy.

11

Clinicians and other practitioners may address racism 

and microaggressions by directly asking about 

discrimination with clients, particularly since many 

AANHPI men and boys may not initiate conversations 

about racism or microaggressions. Experts 

recommend providing education about the different
5 

forms of racism, including both subtle and overt 

racism, since many clients may not be aware of how 

even subtle racism may affect their lives. Further, 

developing support groups or other programs that 

encourage AANHPI men and boys to discuss 

discriminatory experiences with each other can be 

especially effective in normalizing and validating 

others’ experiences with overt racism and racial 

microaggressions. Moreover, discussing how 

individuals may turn to substance use as a way of 

coping with discrimination may help AANHPI men 

gain insightinto their problematic behaviors.

5

Discuss Immigrationand 

GenerationalIssues

Key informants reported that generational 

issues were salient for AANHPI men and 

boys that they had worked with, particularly 

for American-born young men and boys who 

experienced generational conflicts with their 

immigrant parents. For instance, one clinician

described their psychotherapy experience with a 

second-generation AA young man whose parents had 

emigrated from countries in East Asia and Southeast 

Asia. The client presented with symptoms of 

depression and anxiety- stemming from his 

internalized notions that he was "not good enough." 

Despite his near perfect grades, his parents pressured 

him to be perfect and even punished him when he 

received anything less than 100% on assignments. 

When he developed mental health symptoms, he 

reported that his family viewed him as "not trying

hard enough" or that he just needed to "be stronger." 

Experiences like these match previous literature 

which cites how excessively strict parenting in AA 

families may result in social, developmental, and 

emotional issues for AANHPI children.

12While 

AANHPI girls and young women may also face 

parental pressures, the gendered and cultural 

expectations of being a man (e.g., carrying the family 

name, being a provider for one's family, etc.) may 

result in unique psychological and behavioral health 

issues for AANHPI boys and men.

Experts also described the need for targeted 

behavioral health services for AANHPI boys and men 

who are recent immigrants and refugees. Previous 

research has found that AANHPI immigrants and 

AANHPIs who are less acculturated are less open to 

seeking mental health services than those who are 

American-born or are more acculturated.

13 For

instance, studies with South Asian Americans report 

that American-born individuals are more likely to 

turn to social support, while immigrants are more 

likely to internalize negativeemotions.

14Accordingly, 

immigrants and less acculturated populations are 

often in need of specialized, targeted services which 

are difficult to find across the country. Further, for 

behavioral programs that do provide linguistically 

competent clinicians or therapists, key informants 

reveal that funding usually makes it difficult to be 

specifically focused on only boys and men. Given this, 

it is crucial for programs to make efforts to hire 

practitioners who can provide culturally and 

linguistically appropriate services, to hire translators 

when necessary, and to provide training in gender- or 

male-specific services.

6

BeKnowledgeable of EthnicitySpecific Concerns 

Because the AANHPI community consists of 

over 40 distinct ethnic groups, it is crucial to

recognize that there is a spectrum of

experiences that AANHPI may encounter. Within each 

of these groups, there is a range of socioeconomic 

statuses, languages, religions, and other cultural 

factors which may result in even more nuanced 

experiences. Key informants identified several 

ethnicity-specific concerns that they encountered 

when working with AANHPI boys and men. While 

there are many unique ethnic variables that can 

influence behavioral health, we list a few examples to 

demonstrate some of the potential experiences

among AANHPI men and boys.

Some experts shared that male suicides among 

Native Hawaiians were disproportionately high, 

particularly for Native Hawaiian men who were 

transitioning back to normal life after incarceration, 

drug treatment, or both. Spaces where they felt safe 

and accepted in the community were needed for them

to get continued help, support and hope. While the 

research on Native Hawaiians and behavioral health 

is scarce, existing research has found that Native 

Hawaiians have a higher prevalence of substance 

abuse, depression, and delinquency than their AA 

counterparts. However, Native Hawaiians are unlikely 

to seek treatment unless they are involved in the 

criminal justice system.

15 Another expert described 

how suicide is also prevalent among Micronesian boys 

and men, aligning with previous literature which 

finds that Micronesian boys and young men were 
6 

11 times more likely to die by suicide than their 

female counterparts.

16This expert also described how 

Micronesian boys and men in Hawai’i have 

insufficient human services and resources, which

increases health disparities for this population.

The experts described how some South Asian 

American males may struggle with domestic partner 

violence. While the literature on intimate partner 

violence in South Asian communities tends to focus 

on experiences of South Asian American women, it is 

important to create programs that address male 

dominance and abusive behaviors of the male 

perpetrators.

17 Further, the expert shared how 

coronary heart disease and diabetes are also serious 

health problems for South Asian communities, which 

often result in psychological distress and other mental 

health problems. Hindu temples are used for health 

education for the whole community, including boys 

and men, but often do not focus specifically on mental 

health issues. Finally, one expert described how 

Filipino American boys and men are often perceived 

as Asian American, Pacific Islander, and other racial 

and ethnic groups due to unique experiences with 

colonialism and racialization in the US. Aligning with 

previous literature, psychotherapy and behavioral 

health programs for Filipino American men should 

focus on the Filipino cultural values of kapwa (shared 

identity between self and others) and utang ng loob 

(reciprocity and connectedness with loved ones), 

instead of framing mental health fromWestern

perspectives.

18

7

ConsiderSexualOrientation 

Issues

Key experts who worked with AANHPI men 

who identified as gay, bisexual, or queer

(GBQ) reported that the men’s cultural 

backgrounds negatively affected their ability to

connect to their sexual orientation identities. While 

our expert panelists reported that many of these GBQ 

men accepted their sexual orientation identities, some

reported working with young men who lived "double 

lives" (i.e., they were closeted when with their 

families and they were open about their sexualities in

other aspects of their lives). Previous researchers 

have described the psychological distress of feeling

unable to connect to one’s sexual orientation due to

family pressures, cultural expectations, and

homophobia in some AANHPIfamilies and

communities.19

Related to sexual orientation issues, two mental 

health practitioners reported how their GBQ clients 

also developed body image issues or symptoms of 

Body Dysmorphic Disorder. These AANHPI male 

clients reported not feeling attractive enough, often 

comparing themselves to White male standards of 

beauty. While there is a dearth of literature examining

this trend, there is a substantial amount of literature 

that has supported how GBQ men of all racial groups 

tend to have more body image issues than their 

heterosexual counterparts.

20Thus, it is important for 

future researchers to examine this phenomenon, 

while practitioners can discuss body image issues 

with the AANHPI boys and men that they work with. 

One expert also described how GBQ AANHPI men and 

boys were often affected by intimate partner violence 

(IPV). While research on intimate partner violence is 

limited, one study found that 29% of GBQ AANHPI 

men reported being the victim of IPV by a male 

partner in the past year, with 62.5% reporting 

physical abuse in the past 5 years and 64% reporting 

multiple victimizations in their lifetimes.

21

Accordingly, practitioners and educators need to 

recognize that while men are falsely presumed not to 

be targeted by IPV, GBQ AANHPIs may be at risk.
7 

Four Strategies for Policy Makers and Funding Agencies 

I

Create Funding Opportunities

for Programs for AANHPI Boys 

and Men

There are very few mental or substance use 

prevention/treatmentprograms across the 

United States created specifically for AANHPI boys 

and men. While there have been increasing programs 

addressing the needs of other men and boys of color 

(e.g., Black/African American, Latino, and Native 

American boys and men), programs addressing 

behavioral health among AANHPI boys and men are 

scarce. Experts report that such programs are needed, 

but that there are few funding opportunities for 

AANHPIs in general. Key informants described some 

of the major obstacles in funding programs for 

AANHPI boys and men. First, public funding policies 

rarely provided targeted and/or gender-specific 

services for AANHPI behavioral health programs, 

indicating that this is not seen as a need in the 

AANHPI community. Second, funding tends to be 

granted to larger, older, established organizations, 

instead of localized, newer and more recently 

established organizations. Third, funding tends to be 

temporary or project-focused, making maintaining or 

achieving long-term goals unpredictable or difficult.

Despite this limited funding, many practitioners 

described how a sizable amount of their treatment 

population was AANHPI and many are AANHPI boys 

and men. Yet, there were few or no services targeted 

specifically for them. For instance, the director of 

Adult Outpatient Treatment at Hina Mauka in 

Kaneohe (on Oahu, HI) shared that in 2014, over 40% 

of the clients in their program were Native Hawaiian 

or part-Hawaiian, but that ethnicity-specific programs

were limited. Other practitioners described how

AANHPI boys and men might over-utilize certain 

services that are open for all, but that the programs 

do not recognize cultural or gender-specific 

approaches, often due to funding restrictions or 

minimal resources. For example, a practitioner from 

the South Asian Network described how mental 

health services are largely utilized by men over 

women. Similarly, the clinical supervisor at City of 

Fremont described how many psychotherapy groups 

for children with symptoms of Asperger Syndrome

tend to be majority AANHPI boys. Despite these 

observations, such programs are not adjusted or 

tailored specifically for AANHPI men or boys.

II

IncreaseCulturallyCompetent 

Training and/or AANHPI 

Practitioners

The experts identified the lack of 

linguistically or culturally competent

providers as another major systemic barrier to 

addressing behavioral health for AANHPIs. Experts 

who resided in areas with larger AANHPI populations 

especially viewed this as problematic, given that their 

clientele were majority AANHPI and other people of 

color, while their service providers were 

overwhelmingly White. While many experts affirmed 

that there are more AANHPI women who enter 

mental health related careers, they observe the lack of 

male AANHPI providers in psychology, counseling, 

social work, and other fields. When asked about this 

trend, experts described that stigma often prevented 

AANHPI men from entering the helping professions. 

Some experts described how psychology graduate 

programs are not training their students to work

effectively with AANHPI clients. While students may 

learn about multicultural competence, programs often 

neglect to teach students specifically about AANHPI 

experiences – in part, due to the presumption that 

AAs do not have mental or substance use issues. Due 

to a lack of cultural competence training, it is common 

for AANHPI men and boys to be misdiagnosed, 

without considering cultural components that may 

influence behavioral health. For instance, scholars 

describe how gender role socialization in Vietnamese 

men may result in male bonding rituals of binge

drinking, also known as nhau.

22Without having this 

type of cultural knowledge or awareness, clinicians 

may pathologize or shame Vietnamese men who 

engage in alcohol use, without understanding the 

cultural and gendered meanings of such behaviors. 

Instead, culturally competent clinicians should 

provide a safe space for AANHPI men to discuss 

culture and gender expectations, which can validate 

their clients’ experiences, while allowing clients to 

assess their own health behaviors and change on 

their own accord.
8 

III

Disaggregate Data based on 

Ethnicity, Gender, and other 

IntersectionalIdentities

One common theme among most of the 

key informants’ input was the need for

data to be disaggregated among AANHPI boys and 

men. Because AANHPI boys and men are still treated 

as a homogenous group, there is limited knowledge 

regarding the differences that can exist among 

groups. When data is actually disaggregated, rich and 

salient information emerges, often countering the 

narratives of the lack of behavioral problems or 

providing new knowledge about certain AANHPI 

subgroups. For instance, studies of schizophrenia find 

that there is a lower prevalence among AANHPIs; 

however, when the data is disaggregated, one study 

found that(a)Native Hawaiians tend to be 

hospitalized more than Chinese, Japanese, and 

Filipinos, (b) Filipinos and Japanese report higher 

severity of symptoms, and (c) Chinese, Japanese, and 

Filipinos tend to have longer hospital stays than 

Whites.

23Without disaggregating such data, it might 

be presumed that schizophrenia is not problematic 

among AANHPIs or that the psychiatric disorder 

affects AANHPI ethnic groups similarly. Relatedly, if 

researchers do not disaggregate by ethnicity, they will 

likely also fail to examine differences in gender, 

immigration status, sexual orientation, or other 

salientintersectionalidentities.

Regarding substance use, disaggregated data is 

necessary to understand the experiences of AANHPI 

men and women from different ethnic groups. For 

instance, one study reported that NHPIs and 

multiracial people were two times more likely than 

AAs to be diagnosed with two or more substance use 

disorders (e.g., alcohol use, tobacco use, illicit drug 

use).

24Another study found that there were no gender 

differences between Filipino, Chinese, and 

Vietnamese men and women; however, Filipinos 

reported higher mean scores for drinking patterns 

than both Chinese and Vietnamese.

25The study also 

revealed that reasons for drinking differ between the 

ethnic groups, in that Chinese drank more when they 

had family conflict and Vietnamese drank more when

they experienced everydaydiscrimination.20

Disaggregating data based on gender is also 

important, as findings also reveal behavioral 

differences between AANHPI men and women. For 

instance, one study found that while Hmong men and

women may report similar levels of family conflict, 

higher levels of family conflict predicted less smoking 

and higher completion rates for the first year of 

college for Hmong men. Meanwhile, higher levels of 

family conflict increased alcohol consumption among 

Hmong women.

26 For AANHPI college students living 

in Guam, men were significantly more likely to exhibit 

depressive symptoms, but both men and women

reported equal levels of anxiety and stress.27

It is also necessary to disaggregate data regarding 

treatment effectiveness, based on ethnicity, gender, 

and other identities. In general, most studies that 

examine the effectiveness of substance use treatment 

programs for AANHPI people do not examine 

differences in ethnicity, gender, or the interaction of 

ethnicity and gender.28A program that evaluated 

school-based mental health program for AA 

adolescents found that Cambodian youth were less 

likely than Chinese youth to access such services.29

Accordingly, when educators and practitioners create 

programs for AANHPI boys and men, they must 

recognize that programs may not be applicable to all 

AANHPI ethnic groups or to AANHPI people of 

differentgenders.

IV

Create, Implement, and Assess 

Programs forAANHPIBoys and 

Men

Scholars have reported that evidencebased treatment for AANHPIs in general

(and AANHPI men and boys specifically) is rare 

because most evidence-based treatment programs 

are not culturally- or linguistically-based.

30Experts 

cite how culturally-based programs are less funded 

because they are not grounded in conventional 

empirical evidence. Consequently, practitioners must 

create and implement behavioral health programs for 

AANHPI men and boys, and researchers must assess 

the effectiveness of such programs.

First, in order for programs with AANHPI men and 

boys to be effective, they must be grounded in 

cultural values of the specific ethnic groups. One way 

to create culturally effective programs is to utilize 

cultural experts who can provide insights into how 

psychological and behavioral health is conceptualized 

within certain groups. When working with Samoan 

people, some scholars recommend using a culturally 

derived method, referred to as Fa'afaletui, which 

gathers gender-specific focus groups of elders who 
9 

discuss and consensually agree upon culturally 

effective ways to address health within their 

communities. In utilizing their own cultural 

knowledge and experiences, the groups develop 

culturally appropriate services that they consider to 

be effective – instead of relying on Western methods 

to be applied or replicated with their groups.

31

As it stands, there are very few empirical studies 

regarding the effectiveness of programs that address 

behavioral health concerns among AANHPI boys and 

men. Some researchers have found that group therapy

with Korean men can be effective in reducing tobacco

dependence with one pilot study finding that twothirds of participants reported abstinence from 

smoking after participating in a clinical tobacco 

dependence program.

32A similar study with a 

majority Chinese male sample found that a culturally 

and linguistically competent intervention program 

also resulted in two-thirds of the participants 

quitting smoking.

33

Many experts report that some programs have been 

effective in addressing mental health issues (e.g., 

depression, self-esteem) and substance abuse issues 

specifically in AANHPI boys and men. Experts shared 

that the most effective approaches were programs 

that were culturally-centered and directly addressed 

disparities affecting these populations. In Table 1, we 

highlight some of the community-based, communitydeveloped enduring and promising programs and 

services that promote behavioral health among 

AANHPI boys and men. While not an exhaustive list, 

experts identified programs that they believed to 

demonstrate cultural effectiveness or that showed 

promise in addressing the needs of AANHPI boys and 

men. It is hoped that these programs can provide a 

sampling of the types of work that is being done, 

while generating ideas for new programs that can be 

created.
10 

Table 1: SamplePrograms PromotingBehavioral Health for AANHPIBoys and Men

Organization Name City, State Descriptionof Services

Aha Kane

www.ahakane.org Honolulu,HI

Aha Kane aims to nurture a healthier Native Hawaiian male 

population by eliminating psychological, health, and educational 

disparities through activities founded on traditional cultural 

practices that build sustainability in the community. Its Hale Mua 

Initiative has created men's houses for Native Hawaiian men to 

gather and learn the ways of successful fathers, husbands, and 

warriors through cultural activities that aim to reestablish 

intergenerationaltraditionsincontemporaryHawaiiancommunities.

APICHACommunity 

Health Center 

www.apicha.org

New York, NY

APICHA offers comprehensive and integrated services for 

underserved and vulnerable people with opportunities for medical 

and mental health treatment, as well as programs focusing on 

education and social justice. The Men'sHealth Projectis a program to 

support and educate men to reduce their risk for HIV infection. The 

GAYME Youth Mentorship program connects LGBTQ youths with 

peers and adult mentors for support and growth.

Asian & Pacific 

Islander (API) 

Wellness Center 

www.apiwellness.org

San Francisco, CA 

API Wellness provides comprehensive and integrated services for 

LGBTQ and people of color that includes medical, mental health, 

educational, and social justice components.Its TRANS:THRIVE is a 

drop-in center for transgender individuals to engage in daily 

activities, which includes a biweekly group dedicated to 

transmasculinepeople.

Asian Counselingand 

Referral Service 

(ACRS) www.acrs.org

Seattle, WA

ACRS provides a comprehensive, multicultural, and multilingual set 

of services for variousAApopulations. Services include medical care, 

mental health counseling, employment and training support, civic 

engagement, and recreational activities. Its Southeast Asian Youth 

Men's Group particularly focuses on boys from immigrant or refugee 

families of Cambodian, Cham, Filipino, Hmong, Lao, Khmu, Mien, or 

Vietnameseheritage. The program supports this group of young men 

by improving their academics, familial relationships, peer 

relationships,vocationalplans, and various mentalhealthaspects.

Asian Pacific AIDS 

Intervention Team 

(APAIT)

www.apaitonline.org

Los Angeles, CA 

APAIT aims to improve the lives of medically underserved 

communities living with or at risk for HIV/AIDS or other health 

disparities by providing multiculturally competent services in 

Southern California.It offers two support groups for LGBTQ API and 

Latinx men. VIBE provides a space for LGBTQ API and Latinx men to 

become aware of HIV and available resources for prevention, along 

with other social support. VIBE+ provides a space for LGBTQ API and 

Latinx men who areHIV+ to gather and find social support.

Chinatown Service 

Center 

www.cscla.org

Los Angeles, CA

ChinatownService Center provides economic assistance, medical/ 

dental/behavioral services, and social support to all age groups in 

the local and greater community. The Men's Health Care program 

specificallytargetsprostatecancereducationandscreening.
11 

Organization Name City, State Descriptionof Services

Desis Rising upand 

Moving (DRUM) New York, NY

DRUM's mission is to build the power of South Asian low wage 

immigrant workers, youth, and families in New York City to 

win economic and educational justice, and civil and immigrant 

rights. DRUM hosts an annual summer leadership program for

young men and women, as well as “liberation caucus” support

groups based on gender.These liberationcaucuses focus on

personal and emotional development, relationshipbuilding,

andcommunicationskills.The organizationhosts one young

men’s liberationcaucus groupwhich comprise 6-12 members 

at any given time and meet monthly to discuss issues related to

young SouthAsian men.

Richardson Ocean 

CenterEducational 

CurriculumProject

Hilo, HI

Supported by the City and County ofHilo,HI, the program focuses on 

boys and young men in Hilo. The instructor involves the boys in a 

hands-on ocean experience where they learn to be the crew for the 

voyage, share the work and responsibilities and experience many 

valuable lessons in life through the voyage. The program has been 

effective in decreasing substance use symptoms and helping men 

develop a newdirection for their lives.

Waianae Men in 

Recovery Waianae,HI

The support group was created in 2000 for boys and men on Oahu, 

especially for those returning to the community from incarceration. 

The group holds an Annual Waianae Men and Keiki (children) Camp 

Out on the beach in Waianae in September. In the past, the group 

also participated in a statewide celebration of recovery from 

substance use called “Hands Across the State” as part of National 

Recovery Month. Waianae Men in Recovery made the members feel 

they were not alone and helped them deal with the stigma of being in 

recovery. Waianae Men in Recovery helped the members move on 

with their lives and overcome the challenges and barriers they faced.

Conclusions and Next Steps

Based on expert panel discussions, key informant interviews and research reviews, this brief highlighted seven

strategies critical to service provision and four strategies to consider in policy and practice development addressing 

behavioral health for AANHPI boys and men. Providing effective services for AANHPI boys and men requires 

bringing together cultural, ethnic, racial and gender-specific knowledge and practice to an understanding of 

behavioral health. It draws upon and requires integrating clinical, service, system and social justice perspectives 

and interventions. In this sense, it is not easy work. This brief has provided some guideposts for this work and a 

compilation of programs that have demonstrated effective and innovative work with this population. Much works 

remains to implement these strategies and to continue to garner support to serve and strive for behavioral health

equity and wellness for the underserved population of AANHPI boys and men. As this brief clearly indicates, it is 

not that we don’t know what works, rather it is knowing how best to move what we know works into practice

and policy.
12 

ACKNOWLEDGMENTS

This document was prepared by Kevin L. Nadal, Ph.D. 

(President of the Asian American Psychological 

Association) with the assistance of Ford Kuramoto, DSW 

(Executive Director of Okura Mental Health Leadership 

Services) and Patrick Lin, Ed.M. (Research Assistant). We 

also would like to acknowledge the Expert Panel members 

andKey Informants who provided their time and expertise 

for shaping this brief: Ana Liza Caballes,Deputy Director of 

Desis Rising Up and Moving (DRUM; New York, NY); Keola 

Chan, Executive Director, Aha Kane (Honolulu, HI); E. J. R. 

David, Ph.D., Associate Professor of Psychology at 

University of Alaska at Anchorage (Anchorage, AK); 

Gregory Desierto, Psy.D., Outpatient Clinical 

Psychotherapist, West Coast Children’s Clinic (Oakland, 

CA); Helen Hsu, Clinical Supervisor/Department Manager 

of Youth and Family Services forHuman Services (Fremont, 

CA); SaimaHussein,DeputyDirector, South Asian Network 

(Artesia, CA); Chai Jindasurat, Former NationalCoalitionof

Anti-Violence Programs Coordinator of New York City AntiViolence Project (New York, NY); Francis Lu, M.D., 

Professor Emeritus of UC Davis, Department ofPsychiatry

andBehavioral Sciences (Davis, CA); Bill Mousser, MA, 

Director, Clinical Services, Hina Mauka Drug Treatment 

Program (Honolulu, HI); Alan Shinn, MSW, Executive 

Director of Coalition for A Drug- FreeHawai’i(Hilo,HI);

Antony Stephen, Ph.D.,

NON-DISCRIMINATION NOTICE

SAMHSA complies with applicable Federal civil rights 

laws and does not discriminate on the basis of race, color, 

national origin, age, disability, or sex. SAMHSA cumple 

con las leyes federales de derechos civiles aplicables y no

discrimina por motivos de raza, color, nacionalidad, edad,

discapacidad o sexo.

President/Chair, NewJerseyAsian American Association 

forHuman Services (Belleville,NJ); and MikeWatanabe, 

MSW, Executive Director, Asian American Drug Abuse 

Program (LosAngeles, CA) 

This publication was prepared for the Substance 

Abuse andMentalHealth ServicesAdministration

(SAMHSA) by A-G Associates, Inc. under contract 

number HHSS2832012000731/HHSS28342001T,with

SAMHSA, U.S.Department ofHealth andHuman

Services (HHS). Larke Huang, Ph.D., and Roslyn 

Holliday Moore, M.S., served as theGovernment Task

Leaders.

DISCLAIMER

The views, opinions, and content ofthis publication are 

those of the author and do not necessarily reflect the 

views, opinions, or policies of SAMHSA orHHS.

Non-federal resources are included in this publicationas 

additional information for readers and do not constitute 

an indirect or direct endorsement by the Substance 

Abuse and Mental Health Services Administration orthe

U.S. Department of Health and Human Services ofany 

non-federal entity's products, services, orpolicies.

PUBLIC DOMAINNOTICE

All material appearing in this report is in the public 

domain and may be reproduced or copied without 

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appreciated. However, this publication may not be 

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HHS Publication No. (SMA) 17-5032

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HHS Publication No. (SMA) 17-5032 

Published 2017