Twice a week, dozens of older communities, mostly Chinese immigrants, head to a tai chi class in South Brooklyn, New York, so they can flow with the constant movements of the art form while dedicating a deep Focus on every breath, every muscle.
Tai chi classes may not fit the quintessential image of mental health treatment, but behind the soothing background music and flowing movement are moments for participants to soothe their anxieties and focus on wellness. They can also avoid some of the stigma that can be attached to professional help, said Don Lee, president of Homecrest Community Services, the nonprofit organization that runs the classes.
Treatment delivered through a Western framework, such as traditional talk therapy, is not always inclusive or as effective for everyone, and often fails to respect Asian family dynamics, cultural values and racial sensitivities, experts said. But in recent years, other, more culturally appropriate methods have been on the rise.
The Asian American Mental Health Roundtable, for example, a collective of organizations offering non-clinical services, including Homecrest, has seen a growing need for mental health help, in part highlighted by the mental toll of the pandemic on the community. And it has resulted in an estimated 20% increase in the number of local organizations joining the roundtable since 2020., most of them turning to prioritize access to mental health.
Of tai chi and yoga to nurture mental health-focused online communities targeting the children of immigrants, a growing number of Asian-American professionals are pushing the boundaries of community mental health care by advocating for complementary or alternative methods that they incorporate elements of their inheritances.
“The further away you are from Western culture, and that could be because of your immigration history, your age, your language abilities, the less likely talk therapy will work, because you are being asked to participate in a lot of things that just aren’t neither natural nor normalized,” said Kevin Nadal, the distinguished professor of psychology at the John Jay College of Criminal Justice in New York. «There are a lot of therapeutic approaches that people in Asia… have been using that just aren’t labeled as therapeutic.»
That’s not to say that talk therapy can’t be improved to better help Asian Americans, the experts said. Given the trauma that the racial group has experienced, particularly among the elderly who have often gone through political turmoil and war, therapists should focus on building trust slowly and patiently, rather than expecting patients to dig right away. his painful past, Nadal said. But the health care system must also evolve to understand those needs.
“In an ideal world, a doctor might encourage a holistic approach where you might engage in some talk therapy, combined with these indigenous or cultural healing practices, combined with being mindful of your diet, nutrition, physical activity and whatever person. religious and spiritual practices are,” said one teacher.
Experts say unraveling the challenges Asian Americans face in finding effective treatment begins with the very foundation of modern psychology, a study born and raised in europe and united states in the XIX century. While different therapeutic practices in cultures of color predate the field, professionals in the US, from psychologists to social workers, receive training that continues to be «focused on white European values,» Nadal said.
For those in Asian cultures, which often communicate emotions through actions rather than words and prioritize the collective and family over the individual, the way individual talk therapy is conducted can be uncomfortable, said the Dr. Warren Ng, medical director of outpatient behavioral health at NewYork-Presbyterian/Columbia University Irving Medical Center.
“The idea of communicating directly or explicitly can sometimes be challenging, because there are also concepts related to shame or disrespect if we don’t consider others before considering ourselves,” he said.
In addition, therapists may interpret Asian American and Pacific Islander patients’ desire to consider the needs of their family members and involve them in their lives as overly dependent.
The sparse Asian-American representation in the field doesn’t help either. According to an analysis by the American Psychological Association, Asian Americans make up only more than 3% of the US psychology workforce.
Ultimately, issues collide, and Asian Americans who try talk therapy often end up dropping out or are seen by professionals as «difficult clients» who can’t connect in the same way as whites or others who are seen as more «Americanized», it could be, Nadal said. 2011 study of the Asian American Mental Health Landscape found that after initial contacts with mental health professionals, approximately one-third of Asian Americans drop out of treatment before intake sessions. And the American Psychological Association similarly notes that Asian Americans who seek treatment are more likely to end it early.
Actually, Asian Americans are not the problem, he said.
“In an ideal world, a doctor might encourage a holistic approach where you might engage in some talk therapy, combined with these indigenous or cultural healing practices, combined with being mindful of your diet, nutrition, physical activity and whatever person. religious and spiritual practices are,” Nadal said.
The Asian American Mental Health Roundtable includes groups such as Hamilton-Madison House and the South Asian Council of Social Services. They have offered yoga and tai chi classes to women’s empowerment groups. Some of the services that are geared towards seniors often organize group activities like tea time and origami folding.
The organizations, run by the nonprofit Asian American Federation, aim to give people a «non-threatening space» to process problems, and those with more serious concerns are connected to doctors, said Joo Han, deputy director of the federation.
Engaging cultural professionals has been an integral part of their strategy, Han said. Unlike Western society, Asian cultures often view wellness in a holistic way, with little separation between mind and body. So when mental health problems do arise, they usually show up in Asian Americans through physical and psychosomatic symptoms, she said. And it’s important that providers recognize this.
“People often come in and can talk about stress or tension headaches, stomach aches,” Han said. “For providers who are in tune with the way things are portrayed in the Asian community …they can ask follow-up questions.”
Lee said that for many, classes have become so essential to their routines and well-being that during the pandemic, many of the elderly have enlisted the help of their grandchildren to install webcams so they can continue classes virtually without missing a beat.
“We will find that they often become more relaxed, talk to each other more, become closer friends,” Lee said. «They tax towards that as well because they’re actually part of a Chinese tradition that they, especially some of the people who work their whole lives, never really had the opportunity to be a part of.»
Another practitioner, Patrick Lin, runs a tech program for predominantly Asian seniors in the Jackson Heights neighborhood of New York City, with the goal of addressing feelings of loneliness and fostering a sense of purpose, in which he pairs up adults older with mostly Asian American high school students. students so they can learn to navigate apps to work with their phones. The classes, Lin said, focus on the cultural values of the community and collective healing. Meanwhile, the young volunteers learn patience.
“When I was seeing clients one-on-one for an hour each week, I realized that I was limited in what I could provide,” said Lin, who is trained in psychotherapy. “I was already imagining all the possible community services that could address mental health issues.”
Other Asian-American professionals have used social media to destigmatize the issue and help guide community members to think about issues that often go unaddressed in mainstream mental health spaces.
One such example, Brown Girl Therapy, an organization founded by therapist Sahaj Kohli in 2019, has amassed more than 221,000 followers on Instagram for Kohli’s posts targeting children of immigrants, particularly South Asian Americans. Through the platform, Kohli addresses topics ranging from managing family and generational tensions to processing the pain that comes from feeling invisible and unrecognized by society.
While second-generation Asian Americans may be more familiar with the concept of mental health help, she said, they still face what she calls «prosperous guilt,» which prevents them from seriously addressing all aspects of your well-being.
His platform, he added, has also helped introduce these concepts to Asian Americans, who are scattered across the country in underrepresented areas, to feel less alone.
“It’s almost like mental health imposter syndrome,” Kohli said. «We are convinced that our parents and our elders went through something worse, so our struggles do not feel so valid.»