Supporting Asian Mental Health Through Cultural Strengths

Carrie Zhang started the Asian Mental Health Project to make topics that may be difficult to talk about within the Asian American and Pacific Islander (AAPI) community more approachable. Her inspiration dates back to her college experience, in which she dealt with a series of mental health crises that she struggled to address. Her inability to express how she felt at the time led to the realization that her experience was heavily tied to her culture and identity. “In many Asian households, they don’t talk about mental health very often,” says Zhang. “It’s changed a bit now, but there’s still a long way to go.”

In this month’s Q&A, Dr. Christine Koh speaks with Zhang about the Asian Mental Health Project’s mission, cultural strengths to draw from within AAPI families, and efforts to push back against the stigma around mental health. 

Christine Koh: A lot has happened in the past couple of years in the wake of discrimination and violence against the AAPI community. Are there trends or particular pain points that you’re seeing in the AAPI community as it relates to mental health now? Has anything shifted?  

Carrie Zhang: I started the project a year before the pandemic started. Many mental health topics we talk about today weren’t talked about at all back then. And then when COVID hit, there was a huge surge in xenophobic comments. And then violence ensued. And on top of that, people were struggling with the trauma of being isolated and quarantining. We were all going through this collective trauma – suddenly feeling really stressed, paranoid, and anxious all the time. What we found is that in the beginning stages of this, people didn’t know where to turn. Now, with the power of digital and social media, people feel a lot more empowered to talk about it, because a lot more resources and stories are being shared and have been shared throughout the last couple of years. The hurt and trauma and these things that we’re going through with our mental health are finally acknowledged. 

CK: What do you think are some of the cultural strengths within AAPI families to help them support teens? 

CZ: I think one of the things is dedication to family is so important. For instance, when I am really going through the thick of some problems, I know my dad will be there. Also, in Asian culture, people think about each other and their impact within the community. In many Asian cultures, we prioritize the needs of the larger group over the individual; and that should be celebrated. To help heal our collective trauma we can lean on our community. We’ve been united, especially in the wake of the Covid pandemic, and xenophobia. It’s been really amazing to see grassroots organizations and community-based organizations rise up and celebrate culture, and provide resources.  

CK: We talked a little bit about stigma, that’s a real underpinning in seeking mental health care. But, what do you think? Are there any other large culturally-informed challenges that Asian adolescents might face these days when it comes to their mental health?

CZ: Yes, absolutely. There’s plenty of culture-focused issues that we face, especially with younger folks. One thing that comes up a lot is intergenerational trauma. There are studies that say trauma is literally carried through our DNA. A lot of things that our immigrant parents, their parents, this generation and other generations have gone through is literally passed through our DNA. I think young folks today have really been grappling with that as well as being in a “hyphenated” culture – that of being Asian and American – and wondering where they fit in. 

Sometimes it can be really difficult to find where you belong when there’s so much racism, bigotry, sexism, and patriarchal ideals. All those things play into making things difficult for young folks to feel a sense of belonging. And, if things are going on at home, it can really mess with somebody’s sense of security and safety. Also, there can be challenges when it comes to how our cultural values influence the way we approach mental and physical health in our day-to-day lives. 

For example, my parents will do anything but go to a doctor. If I sprain my ankle, they’ll say to treat it with Chinese medicine. They’ll do anything, but go see a medical professional, and that permeates through to mental health as well and a sense of trying to fix things on their own and not accepting the help of others. Financial practicality has also been vital to survival. For example, because healthcare can be so expensive, if it doesn’t feel like it’s going to pay off, it’s often viewed as an unnecessary investment. We have to, as a culture, understand the value of protecting our mental well-being, and better invest in that.

CK: Based on your lived experience, and what you’re seeing at the Asian Mental Health Project, How do you think AAPI parents and caregivers can compassionately support adolescents who may be struggling right now?

CZ: A parent approached me at a recent event and said, “My daughter has been depressed for so long. I don’t even know how to talk to her about it and vice versa.” I think a lot of young people are struggling with how to tell their parents about this. For parents, it’s important to remember the foundation you have built as a family and start with very approachable questions. Come from an open and empathetic learning mindset instead of jumping to conclusions about why your kid is feeling a certain way. For example, my mom would say, “You’re sad because you failed this test, aren’t you?” This felt accusatory. I recommend instead an approach like, “I care about you. How are you feeling?” Or, “You’re going through this change right now. How does that make you feel?” Try to listen first. 

Also, as a parent or guardian, remember that not everybody expresses things the same way. I would spend time learning the communication style of those you would like to help. Ask how they’re feeling and what they need from you. Then perhaps gently encourage them towards professional mental health care, knowing that a lot of Asian folks are scared of being judged. Erase your judgment before approaching someone you want to support. 

CK:  At the Center for Parent and Teen Communication, sharing resources, and guidance and tips around character building is a real cornerstone of the work. Character is about having strong morals and values and being a good person, especially when no one is watching. So what piece of advice would you give to your younger self, or teens now about one of the strongest ways to show up as a human being? That has nothing to do with the achievement goals that are often associated with Asian parenting?

CZ: For teenagers who want to show up for themselves, for their community, and for their loved ones, first, honor your needs and fill your own cup. There’s a lot of pressure on younger folks to fix the next generation or fix what’s going on at home. I grew up as a people pleaser, because I believed that if I achieved or did all these things, then maybe my parents would love me the way I wanted them to. I think we have to unlearn the mindset that you have to achieve to earn love and support. You deserve for people to show up to whatever you need. In turn, you can extend that support for your community and loved ones. 

CK: Do you have any final words for AAPI parents looking to support their teen’s mental health journey?

CZ: For anybody who has a young person in their life struggling with mental health, I think it’s important to look to local resources. We have resources on our website, Asianmentalhealthproject.com, and on our Instagram @asianmentalhealthproject. There are grassroots organizations in so many cities that have mental health resources in person or online. Look to those local spaces because they often have the most relevant information. I encourage folks to do that if they are going through something or if they want to support somebody who is going through something.

Other resources: 

https://aapaonline.org/

https://www.naapimha.org/

https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Asian-American-and-Pacific-Islander