‘A collective effort’: Asian Americans work to improve mental health care

California shootings reveal barriers to care in Asian American community, including language access and cultural stigmas

One Saturday evening, as she was watching TV at home, Barbara heard what she assumed were fireworks going off for a Lunar New Year festival. It was not until the next morning that she learned that the popping had not been celebratory fireworks, but gunshots at the Star Ballroom Dance Studio in Monterey Park, California, the site of a mass shooting last month that left 11 people dead and nine injured. It was the studio her own parents attended weekly for the past 30 years.

After fleeing the Vietnam War and resettling as refugees in the United States, Barbara’s parents, both in their 70s, found joy, comfort and community at Star Dance. Barbara had been to the studio countless times to watch their performances and, occasionally, pick them up late at night when they had “partied too hard”. The only reason they weren’t there that night was because they were away on a cruise.

“My parents came back the morning after it happened,” said Barbara, 33, who asked that her last name not be used. “I was so shaken, but my parents were nonchalant about it, even though they knew almost all of the victims. I asked if they were sad and my dad said: ‘We survived a war. This is nothing.’”

In the wake of the Monterey Park shooting and another, two days later, on a mushroom farm in Half Moon Bay – both of which were committed by gunmen of Asian descent, against mostly victims of Asian descent – many Asian Americans are now working to increase access to mental health care in their own communities.

Asian Americans have long faced barriers to care, including language access and cultural stigmas against therapy and other treatments. Overall annual average estimates for the 2008 to 2012 National Surveys on Drug Use and Health found that of all racial groups surveyed, Asian adults were the least likely to use any mental health service.

Kaila S Tang, a psychotherapist and founding team member of the non-profit Asian Mental Health Collective, says that much of that stigma is rooted in trauma. Like Barbara’s parents, many Asian immigrants and refugees survived genocide, war and other hardships before coming to the US.

“Many first-generation Asian immigrants have been so focused on survival that there’s no room for anything else, like emotions,” Tang said. “This survival tactic has protected them, but as a result, they don’t have the tools to cope with the overwhelming emotions. And if you’ve been through something as emotionally challenging as what they’ve experienced, why would you want to revisit that trauma or open that box?”

Barbara said that for as long as she’s been alive, her parents have shared almost nothing about their lives in Vietnam. “Their answers to a lot of my questions are along the lines of ‘it’s not important; we’re here now.’ They’ve blocked that time out of their memories.”

There’s also shame associated with asking for help among Asian immigrants, and a common belief that therapy and counseling are only for people with severe mental illness.

According to a 2022 study published in the Journal of the American Board of Family Medicine, Asian American elders receive significantly less emotional support than peers of other races – one reason being the lack of accommodation for their language needs. Only 15% of Asian Americans aged 65 years and older speak English at home, and 60% have limited English proficiency.

Because of these barriers, Asian American organizations have taken a more culturally sensitive approach to the way they provide resources to the community in the wake of the shootings.

AAPI Equity Alliance, a coalition of community-based organizations, created in-depth resource guides for Monterey Park community members in seven languages, including English, Chinese, Vietnamese, Tagalog, Thai, Korean, Spanish and Hindi. The guides contain links to local mental health centers and non-profits, as well as direct language support lines to organizations offering legal assistance, such as Asian Americans Advancing Justice Southern California.

Yellow Chair Collective, a psychotherapy private practice group that specializes in serving Asian American clients, is offering six free therapy sessions to those directly affected by the Monterey Park shooting, including victims, survivors and their families in English and Mandarin.

The Chinatown Service Center and City of Monterey Park partnered to offer drop-in, multilingual counseling services at the Monterey Park Bruggemeyer library – a more familiar environment for many of the city’s residents.

“We knew that because of the stigma that counseling services have in the Asian community, people might not be comfortable with going to one of our behavioral health clinics,” said Nina Loc, Chinatown Service Center’s director of behavioral health. “The library is much more accessible, we’ve created private areas for counseling sessions, and we can match each client with a counselor who meets their specific language needs.”

Though Loc said initial turnout was low, they have started to see more clients, including older adults, visit the library over the last several days after being encouraged by their loved ones.

“So much of this work is a collective effort,” Loc said. “We all have to put in the effort to spread the word and have conversations with the folks who are the hardest to reach.”

Tang also believes that it will take time and lots of conversations to change the way the Asian American community addresses mental health, rather than one or two isolated events – and younger generations can lead those conversations. Tang, whose private practice is based in Atlanta, Georgia, saw an influx of younger Asian Americans seeking therapy after the Atlanta spa shootings in 2021 that left eight dead, six of whom were Asian women.

“A lot of Asian cultures are collectivistic – we’re all about community, and conversation is something we have with our families every day,” Tang said. “We give recommendations, we gossip, and in that same vein, there can also be moments where we bring up the shootings and ask how they feel about them. The dream is for us to be able to casually have these conversations more regularly.”

Though Barbara has struggled with communicating with her parents about the shooting, she is considering seeking therapy for herself to process her emotions first. Then, she said, she will approach her parents again.

“Sometimes I catch myself thinking that this problem is just too big for me. Like, how do I fight our entire culture’s way of life?” Barbara said. “But then I remember that I could’ve lost both of my parents in an instant that night. We don’t have time to sit around and hold back, and hide things from each other. This is the generation to break curses.”


Taylor Weik in Los Angeles

The GuardianTramp

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