According to the National Alliance on Mental Illness (NAMI), AAPI refers to “approximately 50 ethnic groups speaking over 100 languages, with connections to Chinese, Indian, Japanese, Filipino, Vietnamese, Korean, Hawaiian, and other Asian and Pacific Islander ancestries.” While some may feel well represented by the AAPI umbrella term, that may not be the case for all members of South Asian communities.

Licensed clinical psychologist and co-founder and director of the Center for Cognitive Behavioral Therapy and Mindfulness, Suraji Wagage, PhD, JD, asks, “When you hear the term “Asian American,” who do you picture? If you talk about eating ‘Asian’ food, what type of cuisine do you mean?” Wagage expects that many picture someone of East Asian or Southeast Asian background rather than South Asian, and that most associate Asian food with Chinese, Japanese, or Thai cuisine, rather than Indian. While she is South Asian, Wagage notes that although South Asians may be intended for inclusion with the term “Asian,” they can largely be forgotten as a subgroup. “I personally always feel uncomfortable checking ‘Asian’ when required to select my ethnicity on a form,” she says. A 2019 article in Asian American Policy Review outlined the brown Asian American movement as necessary for Filipino, South Asian, and Southeast Asian communities who may feel marginalized within AAPI spaces. Wagage explains, “Asian Americans/the AAPI community are not monolithic, though we are often described using umbrella terms, comprising individuals of over 50 ethnic groups from over 20 countries.” South Asian, East Asian, and Southeast Asian communities may share certain experiences of living in America, as Wagage notes how they are regularly being othered and subjected to “model minority” and other stereotypes, but in many other ways, their experiences are distinct. Wagage highlights, “National and international events that catalyze waves of greater racism and hate crimes differ. South Asian communities saw increases in racism after 9/11 and in the context of the previous administration’s ‘anti-Muslim’ and ‘Muslim ban’ rhetoric.” As East Asian and Southeast Asian communities experienced an increase in violence during the COVID-19 pandemic, Wagage notes that South Asian communities may have been less impacted. “#StopAsianHate is a movement I stand in solidarity with, but am not central to,” she says. Wagage explains, “AAPI Heritage Month presents an opportunity to discuss these issues in a nuanced way. We can educate ourselves, we can be vigilant and speak up about our values to create communities that stand firmly against hate, we can speak up when we see or hear racism, hate, or stereotypes, and we can start conversations with our Asian American friends and acquaintances to listen and empathize.” While people often hesitate to start conversations about race and racism for fear of saying the wrong thing, Wagage notes how this can make individuals feel even more unseen. “You don’t have to ‘solve’ the problem for them, just listen, validate, and show that you care,” she says.

Who Gets to Be “Asian”

Psychologist Shamin Ladhani, PsyD, says, “When one has a history of experiencing racism in the United States, instances of discrimination against your sister countries are likely to raise your consciousness about your experiences of racism." Ladhani explains, “It is important to honor that while the victims of hate crimes in the Atlanta shootings were East Asians, South Asians have a history of experiencing racism in the United States also and are unfortunately often left out of the discussion.” With ambiguity over who “Asians” are, Ladhani notes that there may be a tendency to contextualize groups by their country of origin. “My daughter came home the other day questioning her own ethnicity when a classmate told her that she was not Asian if she was of Indian descent,” she says.  Ladhani highlights, “Post-9/11 hate crimes demonstrated that racism against the South Asian population is very much a part of our country’s history as are other instances of hate crimes in this population where South Asians are typically misconstrued as being terrorists.” As an example, Ladhani describes the killing of four Sikh Americans in April 2021, when former employee, Brandon Scott Hole opened fire at a FedEx Ground facility in Indianapolis, Indiana to demonstrate that such violence is ongoing and notes that these individuals are Asian too.  Ladhani explains, “Historically when hate crimes do happen against South Asians, they are not considered Asian and largely left out of the discussion when they do occur. My father was a South Asian refugee from Uganda who had to flee his country in the early ’70s to escape murder and genocide of his community because of being ‘Asian.’” When she tells people of her family’s story, Ladhani notes that most of them have never even heard this part of history. “These recent events remind me and my South Asian patients that racism is not going away and can re-ignite feelings of fear and apprehension when our communities experience discrimination and violence,” she says.  Ladhani explains, “While there are studies that use the term Asian, this typically refers to East Asian, so it is important to see if the data was disaggregated to represent unique differences between these groups. Researchers need to work to make sure that all Asian groups are represented in order to better account for these unique differences.” When the COVID-19 Delta variant took hold of India, spiking travel bans to and from the country, Ladhani highlights how this contributed to increased anti-South Asian sentiments. “This was not as well covered when considering the #StopAsianHate movement,” she says. Ladhani explains, “Stories of racism against South Asians are largely underreported or cycle quickly out of the news as the FedEx shooting did. This shooting was only a month after the shooting in Atlanta.”  Ladhani explains, “I found myself in dialogues where friends or colleagues were supportive and wanted to understand their privilege more, and others in which the idea of racism and discrimination did not exist.” While it is triggering as a first-generation daughter of a refugee, Ladhani notes that she is fortunate to be able to educate individuals at times. “Some relationships have to come to an end and at least I know that I have spoken my truth and stood up for others like me,” she says.  Ladhani highlights, “We need to raise our consciousness about discrimination and racism in the community by being aware of our own bias and being open to dialogue about this.” Responding to anti-Asian sentiments should not be the responsibility of any one group, according to Ladhani. “Being aware of your own privilege and how it impacts others you interact with and society as a whole is important when addressing racism in your community,” she says. Ladhani explains, “If you witness racism, speak out and stand up for that individual immediately. Stand up for the community as a whole, get involved in advocacy efforts, and share your own resources.”

The Path Forward

Hopkins-trained psychiatrist and regional medical director for Mindpath Health, Leela R. Magavi, MD, says, “I am a child, adolescent and adult psychiatrist and identify as South Asian American. I am extremely passionate about advocating for my community and combatting the discrimination faced by countless individuals.” Dr. Magavi explains, “I attempt to educate all the Asian American families I evaluate in clinic and know in my community and encourage others to join public policy efforts. There are many Asian American therapists and psychiatrists who are bilingual and trilingual.” While psychotherapy can support mental health, Dr. Magavi notes that online support groups, cultural forums, and religious events may also allow individuals to ease their fears regarding anti-Asian hate. Dr. Magavi explains, “South Asian Americans may be underrepresented in trials, and this is especially concerning as it has the capacity to exacerbate mental health inequities. Medical schools and training programs can help by emphasizing the pertinence of cultural competency.” Historically, public perceptions have been shaped by many factors, but Dr. Magavi highlights, “Local and national leaders can validate the disparate ways Asian American people are responding to this trauma to hopefully regain their trust, so we can prevent further stigmatization and trauma.” Dr. Magavi says, “We need to join public policy efforts, so we can educate, answer questions, and save lives. It is helpful to listen and ask open-ended questions to learn how to help friends, neighbors, and coworkers.”