Watch: Why we need to reframe the conversation on ‘Asian’ mental health in Aotearoa

People of Asian heritages face many well-documented obstacles to their mental and physical wellbeing in Aotearoa – these include dealing with anti-Asian racism, xenophobia, migration stress, and access and language difficulties (or alternatively, generational language and cultural loss). Additionally, we’re often navigating nuanced cultural contexts above and beyond those we all encounter as part of life in New Zealand.

It’s no wonder, therefore, that many people in our diverse communities find themselves in need of help at some point in their lives – nonetheless, many of us still struggle to find that support when we need it most. All too often, the systems we attempt to engage with fail to hold space for the complexity of our diverse experiences.

Transcript

Rebekah:

Within the health space, there have been Asian health advocates calling for a national Asian health plan or policy or strategy for decades now.

And I guess that’s kind of testament to the fact that Asian people of different communities have been in Aotearoa for a really long time.

Rita:

Back in the 80s, the Asian community was very small, predominantly Chinese, and as immigrants and as a child of immigrants we were told to be silent because we need to fit in, you know, it’s kind of ‘be invisible’.

The needs of different Asian communities are not the same as the Pākehā majority.

The mental health of young people and older people have been highlighted as areas where Asian people are not doing well.

Maria:

I think there are many different reasons why it would be difficult for a member of my family or a member of my community or an Asian person to even contemplate or consider seeking help through a mental health service, or going to talking therapy.

Perhaps the experience of intergenerational or historical trauma and racism – and I think that not acknowledging that means that we sort of continue to put the onus on Asian communities that they’re not engaged, or not interested, and I think that’s grossly unfair.

Rita:

Asians have been viewed from the Western stereotype as a model minority.

You know, we’re obedient, we’re submissive, we’re quiet, we’re compliant, we don’t rock the boat.

In terms of mental health, the model minority perspective is that we’re successful, we are fine, we haven’t any problems.

Rebekah:

Part of the contribution to the stereotype is the fact that we’re homogenised as the Asian ethnicity group.

There’s such a lot of diversity in how we come to the country, the level of socioeconomic privilege we have, where we end up living, and all of that can have an impact on our health and wellbeing, and there are other factors as well.

We’re not all doing the same, and secondly, I guess, the model minority is kind of a long-standing racist stereotype that pits often Asian people against other racialised minoritised groups.

In New Zealand, it’s often used as a way to divide Asian peoples from Māori or Pacific peoples to say, “This group’s doing well, why can’t you be more like this group?” and it actually harms all of us and upholds white supremacy.

So, I actually think the model minority stereotype is really harmful but pervasive in health, and it stops people within the Asian grouping from getting the right level of support that they need but also harms other groups as well.

There is a bit of a stereotype that Asian people are doing well, and they don’t need “anything extra” which is also quite a problematic framing because providing the services that people need, regardless of their culture or other backgrounds, shouldn’t be considered as extra but as the standard.

Rita:

I think that we need to look at mental health from an ecological perspective, in terms of looking at what are the institutional and systemic barriers that come into play?

You know, what are the unjust and unfair systems that affect people’s mental health?

Maria:

Throughout my counselling training and exposure to Western psychology and approaches, modalities, it’s very apparent that considerations are made for the dominant culture or for Pākehā or for white people.

Rebekah: Not being represented in this really vital service, health, means that there is a risk that no-one is thinking about, or planning for the specific issues or needs of Asian communities.

Maria:

There’s not enough research, there's not enough funding to really cater to, or understand – begin to understand the needs of the Asian population.

I think it’s worth acknowledging that this sort of one-size-fits-all pan-ethnic label of ‘Asian’ is problematic.

Asian people – we’re not a monolith.

We see time and time again both emotional and mental labour being put on the backs of Asian people, women of colour, in so many spaces, to do things for free, or to do things out of the goodness of their hearts, and it can be exhausting being an Asian woman and trying to coexist within these white or Pākehā-centred structures and systems, agencies and services.

It can become really tiring when you feel that you continuously are advocating for culturally responsive and safe spaces for the people who you represent.

Rebekah:

Cultural competency is a framing that seems to be kind of being challenged more within healthcare.

Cultural competency might look like having a knowledge of how different cultures are different and then treating people differently based on that knowledge of difference.

Cultural safety is more about the power differential that can exist between a patient and a health professional, and the health professional acknowledging that difference.

Working to ensure that the care that they provide is acceptable and appropriate for the patient, and the patient actually has the power to define whether that care is safe or not.

Understanding difference, yes, but also understanding that when people enter the healthcare system, there are a lot of factors that make them feel small or powerless, and doing what we can as individual practitioners and [as] people building the system to reverse that cycle.

Maria:

I’ve sort of let go of this idea that the mental health system in Aotearoa has failed me, or my family, or my community, my culture, because it was never built for us and it centres Western European ideas and ways of seeing and being in the world over Indigenous, and, I guess, multicultural ways of being.