Therapy and Mental Health in Immigrant and First-Generation Communities

If you’re an immigrant or a first-generation American, therapy might feel a little unfamiliar—maybe even uncomfortable or taboo. In many cultures, mental health isn’t something that’s openly talked about. Asking for help can be seen as a sign of weakness. But the truth is, it takes real strength to step outside of what you were taught and to choose something different. As both a therapist and an immigrant myself, I’ve worked with many people who weren’t introduced to therapy by their families or communities. I’ve seen firsthand how powerful it can be when someone finally gives themselves permission to start.

Why Therapy Feels Out of Reach

There are real reasons why immigrant and non-Western communities tend to seek therapy less often than U.S.-born individuals. It’s not just about choice—it’s about access, history, and culture. Some common barriers include:

Stigma: Mental health struggles are often seen as shameful or private.

Limited access: In many countries, therapy simply isn’t available or affordable.

Lack of awareness: You may not know what therapy looks like if no one ever talked about it.

Language barriers and mistrust: It’s hard to open up when you don’t feel fully understood.

Cultural values: Many of us were raised to stay strong, never show vulnerability, and “handle it ourselves.”

Does any of that sound familiar? If so, you are definitely not alone.

Honoring Culture While Healing Differently

Just because your parents or community didn’t believe in therapy doesn’t mean you have to follow the same path. You can respect your culture and still create space for yourself to heal in a different way. And you don’t have to dive in head-first. Start small. Browse therapist profiles on sites like Psychology Today or MiResource. Read how different therapists describe their style. Many offer free introduction calls—take advantage of those. Remember, it’s normal if you don’t “click” with the first therapist you meet. Healing takes time, and so does finding the right fit.

Finding the Right Therapist

If it matters to you, look for a professional with cultural competence—someone who understands the unspoken pressures you carry. The right match can make all the difference. In my practice, cultural humility is not optional—it’s a priority. Every clinician I supervise is trained to honor your background and lived experiences.

Therapy on Your Terms

Therapy might not be the right fit for everyone, or maybe it’s just not the right time. That’s okay. People heal in different ways. Sometimes we simply want to walk alongside someone without judgment—and that’s the space I want to create. If something in this article spoke to you, I’d love to connect. My name is Jem Iwatsubo, and I lead a group practice in Charlottesville, Virginia. Whether you’re exploring therapy for the first time, looking for a consultation, or simply curious, we’re here when you’re ready.