Changing Attitudes About Mental Health in the AAPI Community
My family is as dysfunctional as any other family. My mother, who was raised in China, had a father who had many concubines. After she emigrated to the United States, she married "down." Down was my dad. Also born and raised in China, he was a forever-optimist who believed he would become the next Colonel Sanders, by building a Chinese food empire in America and making his family rich. Not a day went by when my mother didn't remind him of his failures.
Then came my turn. I chose a "loser" for a husband; at least, that's what my mom would say. He and I fought every day. He was verbally abusive, and because my parents always fought, I subconsciously sought comfort in the constant arguing. While sitting in the back of a car with my children one day, my mom and dad went at it. Their words were hateful and loathing and I hated the fact that my young daughters were being influenced by their vitriol. That's the moment I realized I was repeating my parents’ relationship. Without the help of an amazing therapist, Karen, I would never have had that breakthrough. I kicked my husband out that evening—for my sake as well as for my children.
A Generational Issue
My parents never discussed therapy; and, honestly, I don’t think they ever even knew it existed. One time they got physical with one another and the following night they sat down at a table with a friend and a relative. I think that was supposed to be some kind of mediation. It didn’t work. The battles ensued until the day my dad passed.
Perhaps if they had sought therapy, they would have been happier people. Sweeping feelings under the rug or ignoring the underlying situation was common in my family, as well as in many other AAPI families. Many Asian and Pacific Islander older adults, like my parents, feel the need to protect their family’s reputation at the cost of their and their family’s mental health.
For many in the community, discussing mental health issues with outsiders can put the family in a bad light—and shame is to be avoided at all cost. "Criticism, that is a form of love language, it carries shame in the AAPI community," notes Rachel Forbes, a Korean-American licensed clinical social worker in New Haven, Connecticut.
In fact, 2.1 percent (or 2.7 million people) in the AAPI community report having a serious mental and/or substance-abuse disorder, but Asians are three times less likely to access mental health services than whites.
The need to keep things private is highly regarded. Problems are to be ignored with the hope that any issues will get better on their own. Instead, though, they just fester. And therapy is often viewed with suspicion or incomprehension.
Janet Chen, M.D., a psychiatrist based in Houston, never had any exposure to psychiatry when she was growing up in Texas. She knew she always wanted to be a doctor when she was young, and discovered psychiatry along the way. Her Taiwanese parents were happy about her decision to seek a career in medicine, but mystified by her chosen specialty. "My parents still don’t understand what I do for a living," she says.
During the height of the COVID-19 quarantine and the spike in anti-Asian violence and bias, mental health issues became more prevalent, and last year many in the AAPI community, particularly the younger generations, realized they needed help but felt at a loss as to what to do. "The world is a different place than it used to be," says Forbes. "It’s just harder to exist in this world, people are struggling more."
Forbes says that the younger population is more comfortable seeking therapy, since society and, of course, social media, shows therapy as a good, sometimes even cool. Still, some young adults go into therapy in secrecy and conceal their mental health care from their more conservative parents. As a result, her practice is busier than ever.
One oft-cited roadblock to mental health care in the AAPI community is difficulty finding culturally aligned practitioners or those who offer multilingual services. Many AAPI persons feel more comfortable with therapists of their own race, hoping they will be more empathetic to their issues, notes Forbes, whose clients are predominantly Asian. "There is such a high need for clinicians of all people of color," she says. "With anti-Asian hate rising, my clients are coming to me and finally feel the intensity of community that they’ve never really connected to before."
Forbes has also found a niche in working with Asian children adopted by non-Asians. It’s incredibly important for Caucasian adopters to allow their AAPI adoptees to wholeheartedly embrace their ethnicity and allow them to seek therapy, if needed. Perhaps Caucasian persons are more in tune with therapy. One friend of Asian and African American descent expressed to me that both sides of his family feel psychotherapy is a "white person’s thing." Clearly the stigma of psychotherapy needs to be debunked in many other cultures, too.
Although it may be difficult for our parents’ generation, the way forward is to talk more. Our parents did the best they could when they arrived in this country and had so many other obstacles to contend with trying to fit into American culture. No one is at fault in this.
It’s important that we check in with one another to see if we are struggling, says Chen. "The AAPI community is not likely to spontaneously come to therapy without being asked," she says. "Keep asking your friends and family questions about how they are feeling."
Asking seemingly simple questions like, ‘How do you feel about the recent attack?’ ‘Have you been eating and taking care of your personal hygiene every day?’ and "Do you feel safe?' can open the door to needed discussions that can help build a bridge to making psychotherapy and psychiatry a norm.
These organizations can help you find a culturally-aligned mental health professional:
- Asian American Psychological Association
- National Asian American Pacific Islander Mental Health Association
- Asian Mental Health Collective
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