Crisanna Tang, a New York-based health care worker, was just on her way to work.
"A man got on the train without a mask," said Tang, a 31-year-old Chinese American born in New Jersey and raised in Port St. Lucie, Florida, "and he sits across from me. He started saying, 'Go back to China,' and started spitting all over me, and said all these things about Chinese people causing the virus."
Tang is not alone. The advocacy group Stop AAPI Hate said it's received almost 3,000 reported incidents of aggression targeting at Asian Americans between March and December 2020. The elderly and women were disproportionately attacked.
A growing body of research suggests that experiencing such racist aggression can have serious mental health impacts.
A study published in Ethnic and Racial Studies found that Asian Americans who encountered COVID-19-related discrimination experienced higher levels of anxiety and depression. And another review of 121 studies found that youths who experienced discrimination were more likely to develop chronic mental health problems.
"We know that when an individual experiences racial trauma, it can lead to a host of mental health issues -- increased anxiety, depression, trouble eating and sleeping," Joo Han, deputy director of the Asian American Federation, told ABC News.
Russell Jeung, co-founder of Stop AAPI Hate, said that many victims "are now displaying signs of racial trauma, where they have long-term effects of depression, anxiety and somatic symptoms."
Asian Americans were considered a high-risk group even before the pandemic, according to mental health experts. A study by the Asian American Federation found that Asian Americans had some of the highest rates of depression and suicide, and were less likely to seek help compared with other racial groups.
"The mental health toll that Asian Americans have always had to live with has been one of invisibility," said Sherry Wang, an associate professor in the Counseling Psychology Department at Santa Clara University. "Like colorblindness -- not really seeing Asian Americans as people of color who struggle with issues of racism, poverty and health inequities."
Experts have said Asian Americans are partly held back by the "model minority" myth, which stereotypes them as a compliant group that's upwardly mobile and not in need of extra help or attention.
"The model minority myth continues to be a challenge -- despite the fact that Asian Americans are the poorest group in New York City," with about 1 in 4 living in poverty, Han noted, adding that only about 1.4% of the city's social service contracts are for nonprofits serving Asian Americans even though they make up 16% of the population (5.6% nationally).
Skyrocketing unemployment among Asian Americans during the pandemic also has worsened the mental health of many. An AAF report found that "both the high rate of unemployment among Asian New Yorkers and the struggles of Asian small businesses to keep their doors open have created a high level of stress and anxiety in our community."
"We need to make sure we're calling on elected leaders and funders to invest in culturally competent mental health services," Han explained, "so this doesn't become a crisis of its own making."
Mishal Reja, M.D., an incoming gastroenterology fellow at State University of New York, Downstate, is a contributor to the ABC News Medical Unit.