March 15, 2024 | Vol. 53, Issue 5

The only bilingual Chinese-English Newspaper in New England

Bicultural awareness necessary in addressing depression and mental health among Asian Americans

(請點這裡閱讀中文版。)

Warning: potentially triggering and sensitive content. Includes talks about depression, thoughts of self-harm and suicidal tendencies. 

Under the climate of hate and anti-Asian sentiment, it is even more important to take care of one’s mental health. According to a study conducted by the National Latino and Asian American Study (NLAAS), Asian Americans have a 17.3% overall lifetime rate of any psychiatric disorder, yet are three times less likely to seek mental health services compared to white Americans. 

Emily Chen, representing the University of Massachusetts’ Chinese mental health program 心怡Harmonious, explained that there are several cultural obstacles for Asian Americans seeking support. Chen said, “Depression is underreported and drastically undertreated in the Chinese American and Asian American communities probably because of two factors: culture and being a person of color in the U.S.”

One of the major cultural aspects is “people not wanting to cause trouble and burden other people, so they tend to keep their emotions to themselves,” said Chen. As a result, they cannot get appropriate help and support. Language barriers and overall understanding of the patient’s culture are also major obstacles. Moreover, with the highest wealth gap in America, it is likely that the impoverished circumstances are a major cause for depression. 

Fanny Lio works at the Asian American Civic Association’s (AACA) Multi-Services Center. As a social worker, she often has clients in impoverished situations that are oftentimes the cause for depression. “The pandemic has had a significant and wide impact on many families in the community,” Lio said. “This is especially the case for immigrants with a language barrier and [who] most often take on jobs that require physical labor like working in restaurants, having to stand for several hours at a time.” 

One of her clients, May*, sought help at AACA for her family of four. Having immigrated from mainland China, May originally worked as cleaning staff in a hotel. However, she lost her job as the hospitality industry suffered as a result of the pandemic. Her husband Bob* and her son both worked in restaurants but were laid off also due to the pandemic. Their youngest still attends school. 

Still under the pressure of having to pay for the immense costs of rent and utilities, Bob began behaving differently. He stopped wanting to talk to anyone, started sleeping in late as well as avoided going out and interacting with people. Bob has even tried to take his own life twice. The first time he attempted to overdose on sleeping pills. May found out and took Bob to the hospital where they had to perform gastric lavage on him. The second time he tried to commit suicide by jumping in front of a moving subway. He was saved by a stranger who pulled him off the tracks. 

Now, Bob is going to therapy and receiving treatment for depression at South Cove Community Health Center Beta Health. In terms of alleviating their living situation, Lio helped May apply for cash benefits, food stamps, food purchase gift cards, and fuel assistance among other things. 

Another client of Lio’s lives in Taitung Village with his wife and two kids. One day on his way to work, he encountered an accident when a stranger pushed him onto the subway tracks. He fractured his leg and was unable to continue his physically demanding jobs. Since his accident, his memory has also been affected. Under financial stress and other overwhelming circumstances, he developed depression. Lio helped him apply for Social Security Disability Insurance (SSDI). However, because he is not yet 62 so he is unable to use his retirement funds. 

While impoverished situations can be a cause for depression, Chen said “The goal of therapy is to become more aware of who you are or the world you live in and the complexities of all that, fixing things that are stressful to you by connecting to your community through the arts or sports.” 

However, immigrants are more likely to encounter language barriers which is another major obstacle – not being able to speak English well enough to articulate their struggles and seek help and treatment. 

“There are very few therapists of color in the first place, let alone someone who can speak Mandarin or whatever dialect. […] Then for the people who are second generation and beyond, who have a different issue of being bicultural, growing up with Chinese values at home and American individualistic values at school or work,” said Chen. “It’s knowing how to live in these two worlds and habits so that they’re not causing a lot of stress from that cognitive dissonance.”

Jane* is a second generation Chinese American who has struggled with her cultural identity. Cultural and media depictions of the emasculation of Asian males and the white male fetishization of Asian females contributed to some of the problems she faced. She said, “I was in a relationship that was very toxic to me, and unfortunately it was another Asian American basically shaming me for not being kind of Asian enough, so to speak. There was a lot of gas lighting and it made me really vulnerable.” 

Jane was hospitalized twice, once being an inpatient hospitalization.  It took four to five tries before she found a therapist that was culturally competent to understand all the stresses that she was under. When the COVID-19 pandemic first began, Jane was terrified for her parents’ safety. She sought help but upon explaining it the 10th or 11th time, her white doctors tended to “chalked it up to this toxic relationship, but I was like no, I’m confused about my identity.” 

As Chen explained, cultural awareness from a therapist is important for the patient to “feel acknowledged and respected.” 

Jane said, “I don’t really feel like I belong anywhere. I feel like I belong, and I feel like I’m Chinese enough. I also don’t feel like I’m American enough. And also now society is telling me that I have no place here. Where do I stand, you know, so that’s why it was important for me to find someone who does understand that kind of divide and those identity issues.”

*Names have been changed in order to protect the privacy of the individuals mentioned. 

WeChat for Project Harmonious

If you would like to share your journey with mental health, UMass Harmonious has social media accounts and a link for story submissions: 

Instagram: @projectharmonious

Facebook: @harmoniousproject

Story Submissions: projectharmonious.org/share

Emily Chen has a video series on Asian American mental health called DisOrient. They are planning a collaboration with UMass Harmonious soon, which can be viewed at:

Website: https://www.emilychenstudio.com/disorient

Or YouTube playlist: https://youtube.com/playlist?list=PLIV6Ehn2JnvJ2GQMnumYKOe46_ey0Yybr

Facebook: @disorient.represent

(請點這裡閱讀中文版。)

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