I let the tears sting cuts on my face. A rusted pencil sharpener blade brings relief. I watch drops of blood drip into the water that envelopes my body. The warmth reassures me that I am ok.
I was not ok.
At the age of 13, self-harm became my personal therapy and way of dealing with depression, anxiety and suicidal thoughts. When I confided in my mother, she told me that it was a “phase” I could overcome myself. I was isolated from the world of professional aid and believed, in my adolescence, that I could cope alone.
Growing up Chinese in America, I struggled to reconcile Western beliefs of mental health, with that of my parents. I did not understand the stigmas nor their root. It left the issue rarely addressed in my home and seemingly nonexistent in the predominantly Asian American communities of the San Gabriel Valley, where the population of Asian American Pacific Islander residents has reached over half a million.
I knew I could not be the only one enduring tribulations fueled by a specific silence and shame.
Identifying the Issue
Asian American stigmas toward mental health are partially rooted in the long-standing traditions of Asian families, explained Christine Yeh, co-director of the University of San Francisco Center for Research, Artistic, and Scholarly Excellence (CRASE) and a professor at the USF School of Education. These include an urge for privacy, maintaining harmony in society, upholding the perception that one’s family is content and thriving, and being a good representative of one’s family unit or friend group. In addition, generational differences factor into mental health stigmas.
“Foreign-born parents are less likely to understand mental health and support it,” Yeh said.
Some Asian cultures foster the belief that mental health conditions are the cause of shame and embarrassment. Through an online study, Yeh discovered that Asian American students were more likely to talk about their situations when it was anonymous and online rather than in person.
In addition to viewing mental health conditions as disgraceful, the issue is compounded by the lack of culturally appropriate and bilingual mental health services for Asian Americans, she said.
“[An Asian American] may show up to their first session, but not come back. That is not the fault of the Asian American, it is the fault of the services that are not culturally competent,” Yeh said. “Research has consistently shown that Western ideas of mental health do not incorporate traditional Asian ways of thinking about mental health.”
To combat the lack of suitable services, U.S. Rep. Judy Chu (D-Monterey Park) introduced the Stop Mental Health Stigma in Our Communities Act in 2017.
As a former clinical psychologist, Chu has seen the necessity of mental health services firsthand, but has also how many in AAPI communities suffer in silence — afraid to talk about a problem they cannot understand.
“We need to let everybody know that mental health is just like physical health, and just like you wouldn’t ignore a physical ailment like cancer, nor should you ignore mental and emotional ones like depression,” Chu said.
The bill strives to increase partnerships between the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and local advocacy and behavioral health organizations that have an established record of serving Asian Americans and Pacific Islanders. The hope is for SAMHSA to provide the outreach and educational strategies, while the community groups reach and serve community members.
“These strategies will increase awareness of symptoms of mental illness common among AAPI populations, provide linguistically and culturally appropriate interventions, and encourage individuals and communities to use a comprehensive, public health approach when addressing mental and behavioral health,” Chu said.
These steps are crucial to provide resources that Asian Americans can effectively utilize.
“If there is a bilingual counselor who looks like them and understands their cultural values and beliefs, then Asian Americans are much more liking not only to go [to therapy] but to stay,” Yeh said. “The responsibility needs to be on schools, hospitals, mental health centers, community agencies to develop programs and services that are culturally relevant, bilingual, and really support the worldviews of Asian Americans.”
According to Yeh, when people do not get the help they need, problems can develop over time into devastating impairment: suicidal thoughts, social isolation, difficulty at work, or difficulty at school.
How Asian American Teens Cope
In the sixth grade, Emily Hana Wu was hospitalized at Kedren Mental Health Center after an incident at school related to her depression. She realized she was a danger to herself. As she was transported to the ambulance, Wu said her Vice Principal informed her to keep this situation between them and not tell anyone.
Coupled with her parents’ invalidation, Wu was afraid to confide in anyone after returning from Kedren. After two years in silence, she found the courage to tell her friends. After deciding that therapy was not helping her, Wu self-copes through reading. To this day, she feels that her parents are still disconnected with the reality of what she endures — things she must combat alone.
Carolina Ye was bullied since fifth grade. She resorted to self-harm and suffered from suicidal thoughts, Ye said. It was not until her sophomore year in high school, when she was admitted into a psychiatric hospital, that she finally received the help she needed, Ye explained.
Currently, she receives support from Asian Pacific Clinics. Ye firmly believes that family therapy sessions with a bilingual counselor have helped her parents become more accepting of mental health conditions and conscious of its severity in relation to other medical conditions.
In the fifth grade, Jocelyn Chi was diagnosed with Attention Deficit Disorder. At that age, it was hard for her to understand or fully grasp the concept of her disability.
“All I understood was that I was different from my peers and had a hard time focusing no matter how hard I tried,” Chi said.
In high school, the peer pressure to fit in academically resulted in constant anxiety. Due to the academic rigor of Arcadia High School, coupled with personal family issues Chi was experiencing at the time, she realized she needed therapy.
“My mom was at first upset and was reluctant to acknowledge that I had a problem, but eventually she was more willing to work with me to seek help,” Chi said.
“It was, however, very secretive and not spoken to the rest of the family. It was hard for me to continue pushing for therapy because my parents believed it wasn’t helping and it was expensive so my therapy sessions ended much earlier than how I would have wanted it to be.”
Jaycee Sacdalan struggles to cope with her stress and anxiety about academics. She allows it to build up and after a few weeks, she has spontaneous mental breakdowns. One time during hurdle practice, Sacdalan began to cry. To avoid anyone seeing her tears, she hid in a tire for an hour.
“Attending an extremely competitive school environment has created a lot of anxiety in life. Arcadia High School has become a hostile place for me to attend,” Sacdalan said.
Sacdalan continues to manage her stress and anxiety by running track and field, but remains reluctant to seek help from parents and teachers.
There are various ways Asian Americans who are struggling with mental health can find help.
You do not have to do it alone.
Steve Jennings, the director of business development at the Aurora Charter Oak Hospital in West Covina, Calif. said that anyone can admit themselves into a psychiatric hospital, though in some cases parents must first agree to admit their child. If you do not have insurance, they cannot refuse you access if your condition is extremely serious. If you confide in a school counselor or advisor, they can refer you to a mental health hospital and help admit you as well.
Pacific Clinics is another option to find counselors and therapists who are bilingual and are culturally sensative. They have clinics in over 60 locations across Los Angeles, Orange, San Bernardino, and Ventura Counties. You can schedule for an appointment on their toll free number: 1-877-722-2737.
If you are an LGBTQ youth, the Trevor Project has a 24/7 TrevorLifeline at 1-866-488-7386. For immediate help, call 911 or the National Suicide Prevention Hotline: 1-800-273-8255.
When I look at my scars, I remember the silence, the shame, the fear that came from stigma. Now, I hope to encourage others like me to find the help that fits them best.