The young man arrived with delusions. He heard voices. And his family was desperate to shake him of his demons.

Therapists called him psychotic and paranoid. His family considered him possessed.

In traditional Hmong culture, the connection between health and illness is often deeply rooted in superstition and the world of spirits.

"Their view of what causes mental illness is not our view," said Cindy Wang, the clinical director at the Transcultural Wellness Center, where the young man was treated.

"Many typically come from countries where there is no such thing as mental health treatment."

To free him from his tortured world, the young man's family put its trust in Western psychotherapy – still a foreign concept for many new immigrants.

For reasons that are complex, Asian Americans seek mental health treatment in far lower numbers than the rest of the population, according to preliminary findings from a study conducted by researchers at the University of California, Davis.

A mere 28 percent of Asian Americans diagnosed with psychological problems opt for Western-style mental health treatment – compared with 54 percent of the general population.

Among immigrant Asians, just 23 percent get treatment from a mental health professional, according to the UC Davis study.

What's more, many of those who seek help don't remain in treatment for very long.

In many Asian cultures, "suffering is accepted. You persevere despite your pain so you can again become a part of the social fabric," Nolan Zane, a professor of psychology who directs the Asian American Center on Disparities Research at UC Davis.

"In Western cultures, the goal is to reduce a person's distress. The focus is on self-esteem, self-efficacy," he said.

"In Eastern cultures, the goal is not about the individual person. It's to get the person back into the collective culture. The individual is less emphasized."

Studies over the years suggest the scope of the problem:

• Girls and women of Asian American or Pacific Islander descent, between the ages of 15 and 24, consistently have the highest rate of suicide.

• Teenage girls of Asian descent report symptoms of depression at a higher rate than any other race.

• Southeast Asians are at particular risk for serious emotional and behavioral problems: 40 percent of Southeast Asian refugees suffer from depression, 35 percent from anxiety and 14 percent from post-traumatic disorder.

• Older Asian Americans have a greater prevalence of dementia than the general population.

• The suicide rate among Chinese American elderly women is 10 times higher than for white elderly women.

The National Asian American Pacific Islander Mental Health Association contends that there's a lack of data that offer an accurate picture of the issues.

The UC Davis research center, established last year and funded with a $3.9 million grant from the National Institute of Mental Health, is the only one of its kind in the United States.

"We're trying to find out what it is about a person's culture – about being Asian American and being an ethnic minority – that often leads to dropping out at a high rate from therapy compared to whites," said Zane, the center's director.

When they do seek help, they don't always get appropriate services or treatment. The feelings of shame and the stigma are difficult to overcome.

"It's like telling your family secrets. There's shame, embarrassment. You have to overcome the stigma or the embarrassment," said Judy Heary, executive director of Asian Pacific Community Counseling, which runs the Transcultural Wellness Center.

Certainly, the same issues arise among different groups, but some of those feelings are especially heightened among Asian Americans because of varying cultural values.

"Sometimes, it's not the patient, but the family who does not want them to get treatment," said Heary.

"Having a mental health issue is not your fault," she said.

"It's not a moral issue. It's not because God is blaming you. We're trying to counter all those myths."

The agency began 30 years ago to help increase access to counseling services.

At the start, the focus was on providing interpreters.

But it now provides direct therapy services to clients.

Thirteen languages are spoken.

Most of the clients are Vietnamese, Hmong and Chinese.

The agency serves about 200 people annually, the bulk of them coming in for counseling for severe mental illness issues – major psychosis, major depression, bipolar disorders, schizophrenia.

"There was no real program set up for people to serve them in their own language and have a sense of understanding and sensitivity culturally," said Heary.

Why aren't they seeking treatment?

"Now, that's a question I've been asking myself," Heary said.

"It's not about doing a marketing blitz."

Call The Bee's Bobby Caina Calvan, (916) 321-1067