The constant, fast-paced conversations in mixed Vietnamese and English create a soothing buzz around my parents’ house.
“Lấy rác ra!” my mother would say to my brother. “Rồi tưới cây nữa. hear that?”
“There. OK,” my brother replied on our way to our backyard to take out the trash and water the plants.
Or one of my family’s most important questions of the day: “What’s for dinner?”
“Mình có chè chuối,” my mother said, and suggested that after dinner we get the sweet Vietnamese banana dessert from my aunt who lives nearby.
But when I tried to speak to my father last March about the Atlanta-area shootings and the reality of anti-Asian hatred, the buzzing stopped. We grabbed the Vietnamese language and tried to find terms that could fully express our feelings.
We didn’t know how to accurately translate Western mental health terms and phrases into our language. After stumbling through words that still didn’t feel quite right, we settled for speaking English for the rest of the conversation.
I know my family is not alone in our struggle to open up about mental illness. I’ve read dozens of studies and spoken to friends who have had similar experiences.
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In recent years we have seen an increase in reported anti-Asian attacks and hate crimes. It’s been hard to feel safe in our own communities as fear-mongering politicians amplify misinformation about COVID-19 as we mourn the lives the disease has taken from us. And even when we seek treatment in psychiatric hospitals or clinics, too often many Asian clients encounter language barriers and a lack of cultural sensitivity.
Ajita Gupta, a licensed clinical social worker in California, receives requests for Hindi services from South Asian Americans on an almost daily basis. Gupta said many of her clients reported that their insurance provider would not refer them to a Hindi-speaking therapist if they also spoke English.
“Clients prefer to work with a Hindi-speaking therapist as they find it easier to explain certain things in Hindi related to their culture,” she said. “They are told to choose an English speaking therapist or there are no mental health therapists currently available. I have many South Asian clients who are willing to put themselves on a waiting list so they can choose to speak in their language.”
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The overall stigma surrounding mental health in the United States stems in part from how the country institutionalizes people with mental illness and subjects them to cruel and unethical treatment. It’s an approach that created myths that can still be seen in the media.
But that stigma and shame is particularly intense in many Asian American cultures and likely contributes to their underutilization of mental health services, said Derek Hsieh, who directs the LA County Department of Long Beach Asian Pacific Islander Family Mental Health Center Mental Health leads.
Mental health issues are not often communicated or openly voiced in Asian communities. Our cultures revolve around family and the collective community, and these cultural values can contribute to a strong sense of connectedness. But these same values can unintentionally fuel the stigma around seeking mental health treatment, even within one’s own family.
“It can be seen as shameful [your] Family honor,” said Jung Ahn, a licensed clinical social worker and training coordinator for the LA County Department of Mental Health. Ahn discusses mental health issues on Radio Korea and has initiated several outreach programs to engage the Korean community. “Because family status is central,” she said, “individual feelings, emotions, and thoughts can be suppressed.”
While there is tremendous diversity among Asian Americans in terms of educational attainment, income, acculturation, war experience, or other trauma, about 60% of all people of Asian descent were born outside of the United States, according to 2020 census data. As immigrants, securing basic needs for themselves and their families is often at the forefront of their concerns, Hsieh said.
“Focusing on feelings, especially negative ones, is seen as misguided indulgence and unproductive when you have a child to feed or a roof over your head,” Hsieh said.
Most Asian Americans have also experienced terrible historical trauma, which explains why the recent upsurge in hate crimes and discrimination could be so triggering, Hsieh explained during a recent presentation at a county mental health meeting.
Then there is the language challenge.
“In many Asian cultures, the concept or term for ‘depression’ or ‘anxiety’ as a syndrome or group of symptoms manifesting an underlying mental disorder does not exist,” Hsieh said, “or often they are imported Western terms similar to ‘coffee’ or ‘hamburger’, although unlike ‘coffee’ and ‘hamburger’, terms like ‘depression’ or ‘anxiety’ are not generally used in ordinary public discourse.”
Instead, there are cultural differences in how Asian American people perceive stress, and in many cases they describe physical or physical pain rather than psychological, said Kathy Trang, a Harvard postdoctoral researcher and co-founder of the Southeast Asian Mental Health Initiative and biennial conference.
“Slowing down…feeling tired all the time…experiencing loss of appetite…they might not interpret that as depression,” Trang said. “There will be no conversation about mental health if they never perceive it as related to mental health. So [we have to think] What… ways… might people understand their distress and how that shapes communication.”
At the same time, our languages have beautiful terms for emotions that English cannot capture. For example, Vietnamese has the phrase “xoa dịu,” a phrase that describes the process of rubbing a circular motion over a physical wound to relieve pain. But when you say it to someone in need, it means you are relieving their emotional pain and giving them spiritual comfort. Saying “to soothe your pain” in English doesn’t capture the depth or tenderness of saying “xoa dịu.”
Andrew Subica, a health disparity researcher and associate professor at the UC Riverside School of Medicine, adds that Asian Americans often understand the connections between the mind, body and spirit, which offers another way to talk about mental health.
“There’s a strong spiritual element, and it fits into this nice little health box in a way that the US doesn’t,” he said. “So that can also be a way to talk about mental health by including spirituality and the Spirit.”
Along with my colleagues at The Times, I want to hear how mental and emotional health is being described and discussed among you, your family members, friends and other members of the Asian American community. If you would like to share your thoughts and experiences with us, please use the form below.
My goal and hope is to use this research to expand the work our communities have already begun to document what does and does not exist in various Asian languages in terms of mental health terminology. I hope to engage with professionals, leaders, activists, concerned residents, and others to produce journalism that advances family discussions, service, and research. Your responses will help us better serve our community.
In the past few months researching this topic, I’ve had more conversations with my family about mental health than I’ve ever had in my life. It brought me and my parents closer together. I hope that through this work we can help many others to make the same connections.
Thank you for your time and perspective in answering our survey questions. If you would like to read more about our mental health coverage or find resources, you can visit our page.
This story was published with support from The Solutions Journalism Network through its Health Equity Initiative.
PS We understand that this is a sensitive issue and would like to give people another way to participate. If you’d like to share your story anonymously, have questions about the reporting process and how we would use your submission, or would like to reach out to this story in any way, please send me a message at phi.do@latimes .com.
Mental Health Voice Survey
https://www.latimes.com/california/story/2022-09-28/how-do-you-talk-about-mental-health-with-your-asian-american-family How do you talk about mental health with your Asian American family?