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Mental Health in China and Supporting the AAPI community in the U.S.

Celebrate AAPI Heritage and Mental Awareness months in the U.S. by reflecting on the intersections.

by Zhou Fang, Intersectional Group

In my last article about “Reentry Cultural Experience” in China, I briefly mentioned how less of taboo mental health related topics are in China these days. People feel comfortable discussing and sharing mental health related experiences and challenges, without the fear or discomfort of being judged or shamed.

I have been reflecting on my experiences on this particular topic since my return to the U.S. As it happened, May is both AAPI Heritage and Health Health Awareness months. I see it as an opportunity to discuss mental health in the AAPI community in the U.S., as well.

The first time I heard about a mental health related discussion was at lunch, during my first week back in China. A family member went through a dark phase in the last year or so. A friend of the family asked, quite bluntly, how they’ve been doing since their (using they/their to protect my family’s privacy) diagnosis. I was genuinely shocked hearing this question as I regarded such questions as private and personal. I looked nervously at the family member, feeling uncomfortable and worried about what they might say. To my absolute surprise, they responded with “I am doing much better now. I have been taking meds and I am able to sleep 8 hours a night. My appetite is back. My partner is now taking care of most of the tasks at home.” I would have gasped if I didn’t think it would have been rude. How refreshing to see people talk about mental health as part of a casual conversation! One thing I have to point out is the absence of shame and judgment in this exchange. Almost everyone at the table, except me, seemed to not be bothered by this question and was interested in learning more about my family member’s wellbeing. At the end of this conversation, everyone said something like, “I am so glad and relieved that you are doing better. I was worried last time when I saw you.” “Sleep is so important. I am so glad that you have it back now.” “I am so glad that your partner has stepped up and taken more responsibility.”

Over my 3 weeks of stay in Guilin, similar conversations happened a few times, which in itself was a surprise to me. And a good one. Covid created a lot of mental health related challenges in communities like my family’s. As humans, when we run out of coping methods, hopefully, we will ask for help. Fortunately, many people did. Some folks, like my family member, was hospitalized for a short period of time and is now managing with medication. Some with more financial resources, went and found therapy. Many of the folks I talked to were able to get family and community support, which is incredible.

I would like to mention that therapy in China is extremely expensive. While I don’t know the cost range for therapy in China, I was told that someone in the family circle received therapy for 5,000 CNY (approx. $700 USD) a session. Unless you are highly financially privileged, therapy is out of reach for most people in China. That is also why most people use medication to manage, which can also be problematic.

Sharing what I learned about mental health in China sets the foundation for what I am going to discuss next: Supporting the AAPI community in the U.S.

While I have been a beneficiary of western mental health support, including talk therapy, medication, and guided self management, many members in the AAPI community (at large) are not accustomed or used to talk therapy. There are a few possible factors:

1. Asian folks keep things to our inner circles, we don’t feel comfortable sharing our struggles with a therapist who is essentially a stranger. However, sharing with family and close friends, like my experience above, is much more common and comfortable.

2. Eastern culture offers many holistic tools to address mental health challenges such as yoga, meditation, qi gong, tai chi, acupuncture, etc. (additional reading: Talk therapy falls short for many Asian Americans)

3. “You are what you eat” is a big part of Asian culture. For example, ginger is considered warm, watermelon is cold, goji and dangsen are good for your “qi”, and walnuts are good for your brain. According to Chinese medicine, and many eastern medical practices, our body parts are all interconnected, as well as with our mind and soul. Adapting to a diet that works best for every individual, is an important part in Chinese medicine.

4. Many Asian families immigrated to the U.S., carrying generational trauma and systemic harm from both the eastern and the western systems. Asking them to share something very few western practitioners can empathize with or understand, is like trying to build a building without the foundation.

5. Many Asian community members value relational and communal connections. When there is no or little trust between a therapist and the client, expecting them to open up is close to impossible. Some therapists may describe some Asian clients as “difficult”. That is partially because the trust was not there.

6. There is too little AAPI representation in the mental health practitioner community. If an Asian patient had a list of therapists who look like them to choose from, they’d be more likely to invite a practitioner-client relationship in and allow healing to happen with a therapist’s guidance.

Western mental health practice can help the AAPI community if it also learns about the AAPI community. Just asking the community to listen and follow is a form of racism, lack of compassion, and cultural incompetency. Intersectionality shows up in layered and complex ways. In order to better our collective practice on mental health in the U.S., we must carry the lens of intersectionality as we heal as a nation.

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With love and humility,

Zhou Fang (方舟)


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