Medical Minute

Stigma in the Asian and Black Communities

I am a “Mestiza,” half Filipina, and half Black.  The stigma around mental health and illness in both the Asian and Black communities is prevalent.  My mother, born and raised in the Philippines, was confused, and called to a need for prayer upon my diagnosis.  For my father, born and raised in Philadelphia, he thought that controlling my moods through changing my mindset and being mindful of my actions would suffice.

So, let us take a medical minute to discuss the stigma attached to mental illness in the communities that my parents come.

Asian Communities – my mother was diagnosed with depression when I was in my early teens.  It was a hush-hush thing like she was ashamed of it.  Once I was diagnosed, well misdiagnosed, with depression, she seemed to find relief, but it was something kept between us.  So why is that a thing?

In our culture, Filipinos, to be exact, “Eighty-five percent…are Catholic; … Faith is practiced in a personal and tangible manner with strict adherence to religious rites. The importance of prayer and spiritual counseling cannot be overemphasized.” (Sanchez & Gaw, 2007). Mostly, faith and family are all you need to combat mental illness, and even though you might have it, your family is looked upon as having it, too; they are sharing your diagnosis (Sanchez & Gaw, 2007).  Others in our community are willing to interact with people who have been diagnosed, but they might not accept them as cohabitants or employees; they believe they are dangerously unpredictable (Sanchez & Gaw, 2007).

Now other Asian cultures: In the Chinese culture, “mental illness is caused by a lack of harmony of emotions or by evil spirits.” (Kramer, Kwong, Lee, & Chung, 2002).  In the Japanese culture, “mental illness is caused by evil spirits and often thought to not be a real illness.” (Kramer et al., 2002).  In the Korean culture, “mental illness is caused by disruption of harmony within the individual or by ancestral spirits coming back to haunt the patient because of past bad behavior, the result of bad luck, payback for something done wrong in the past, and is considered shameful.” (Kramer et al., 2002).  For Vietnamese, depression is sadness and is not readily acknowledgeable because of stigma; home remedies, spiritual consultations, or the usage of herbal treatments are considered before seeking out Western medical care (Kramer et al., 2002). 

There is one common denominator in the Asian community; mental illness is not a chemical imbalance in your brain, you are not one with yourself, your faith is not strong enough, or you may be haunted.  Startling, isn’t it?

Now the Black Community – my father spent some time in the military, so he was full-on in the belief of attaching discipline to your life can fix everything as well as letting stuff roll off your shoulders.  Let us not forget the stigma attached to mental illness in the military community, I oversee some projects set in place to combat the stigma in that community, but that is not the point of this story.  It was not until my father had the opportunity to finally finish the undergraduate studies that he gave up many years ago that he took a Psychology course as an elective.  His entire opinion about my diagnosis changed.  He finally understood, and I think when I discovered that another member of my family on the paternal side had a Bipolar Disorder diagnosis, too, he also saw it was hereditary. 

Our community is seen as one with perseverance and resilience; we survived slavery so we can survive sadness or anxiety, and anything less would be considered a spiritual and moral weakness (Armstrong, 2019).  Our community fails to realize that mental illness is an illness just like cancer, diabetes, or high blood pressure. 

“According to the U.S. Department of Health and Human Services Office of Minority Health, adult Black/African Americans are 20 percent more likely to report serious psychological distress than adult Whites. Despite this, African Americans are less likely than Whites to seek out treatment and more likely to end treatment prematurely.” (Armstrong, 2019).   Our beliefs make us hesitant to reach out, and we may be discouraged at the lack of People of Color in the profession; we are not only afraid of the stigma; we fear underlying racism.  Yes, folks, racism is still a thing.

“…the prisms of stigma and historical adversity, includes race-based exclusion from health, educational, social, and economic resources. It is only by working together collaboratively as fully engaged partners that we can overcome this challenge.” (Armstrong, 2019). Bottom line up front – we are afraid we will not be taken seriously when we seek help, we are worried we will be accused of lying, and we are scared to be seen as weak after everything our community has suffered.

But did you catch on to the one thing that these two communities share in their beliefs around mental illness?  It is a spiritual problem. 

So how do we fix this mindset?  How do we start to look at mental illness for what it is – an illness?  We educate whether it be our friends or family.  And if you are like me who relies heavily on the facts and none of the B.S., you show points, and you show figures, you find everything and anything (factual, of course) that showcases how and why mental illness is an illness.

For my father, he has proved that education is a powerful thing.  His entire outlook about my need to be on medication has changed.  For my mother, she needed visual proof that the medication served a purpose, but they both see that I am stable.  Neither one of them believes it is a spiritual problem, and neither one of them look at me as weak or lacking self-control, at least not anymore.  Two of the most influential people in my life who came from very different walks of life only needed one thing – the facts.  For my father, it was literature and my mother, my improvement.

Until next time – Love, Peace, and Chicken Grease ❤

References:

Armstrong, V. (2019). Stigma Regarding Mental Illness among People of Color. Retrieved from: https://www.thenationalcouncil.org/BH365/2019/07/08/stigma-regarding-mental-illness-among-people-of-color/

Kramer, E. J., Kwong, K., Lee, E., & Chung, H. (2002). Cultural factors influencing the mental health of Asian Americans. The Western journal of medicine, 176(4), 227–231.  Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071736/

Sanchez, F., & Gaw, A. (2007).  Mental health care of Filipino Americans.  Psychiatry online.  Retrieved from: https://ps.psychiatryonline.org/doi/full/10.1176/ps.2007.58.6.810

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