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My Turnby Maileen Hamto |
 |
From The Asian Reporter, V17, #29 (July 17, 2007), page 6 & 7.
Minding our issues
Being a teenager is hard enough without the challenge of dealing with issues of ethnic and racial identity. For young people of color, particularly those being raised in immigrant households, emotional and behavioral health issues often are left undetected and untreated.
Mental-health services are underutilized among youth of color. Often, when youth of color are engaged in the mental-health system, their issues are addressed through the child welfare or juvenile justice systems.
There are significant disparities between the need for mental-health services and usage rates among families of color. Particularly among Asian Americans, there is a certain amount of stigma and shame affixed to mental-health issues, which in turn prevents people from getting the help they need.
The recent Building on Family Strengths Conference brought to light challenges faced by social work and mental health professionals in providing culturally competent services to diverse families. Sponsored by the Research and Training Center of Portland State University, the event drew more than 600 professionals from all over the U.S. and from as far away as New Zealand and South Africa. Larke Nahme Huang, from the Substance Abuse and Mental Health Services Administration of the U.S. Dept. of Health and Human Services, shared statistics on the use of mental-health services among youth of color, and presented strategies that have worked well in reducing disparities among underserved populations.
Why should we care? Populations of youth of color are growing nationwide. It is estimated that between 1995 and 2015 the Asian-Pacific Islander and Native Hawaiian youth population nationwide will grow by 74 percent.
Increases in youth populations among other major racial/ethnic groups include: Latino/Hispanic, 59 percent; African American, 19 percent; American Indian, 17 percent; and white, -3.0 percent.
"The rates of change have implications for providing services and supports, and coming up with meaningful and effective strategies in serving the emerging diverse populations," says Huang.
About 88 percent of Asian-American youth are growing up in immigrant households. "This increases their risk of intergenerational conflict, linguistic isolation, and other issues," says Huang.
What are the problems? Many youth who abuse alcohol and drugs also have concurrent mental and behavioral health issues. Multiracial youth have higher rates of depression and substance abuse. When compared to other groups, Asian-American and Latino youth have higher levels of "internalizing" symptoms, such as depression, anxiety, and suicidal problems.
Youth of color who identify as gay, bisexual, or lesbian experience the "double jeopardy" of being a part of an ethnic or racial minority as well as a sexual minority group. "They have the challenge of integrating ethnic and cultural identity with their sexual orientation. Often, they deal with a tremendous lack of acceptance within their racial/ethnic community and racism within the GLB community, leading to further isolation," Huang says.
What can be done? It’s encouraging to see that behavioral health professionals are recognizing that one size does not fit all in delivering mental health care to youth of color. Stepping away from a paternalistic approach to diagnosing and prescribing treatment for behavioral health problems, social workers and mental-health counselors recognize that being aware of cultural issues is important in working effectively with youth and families.
Diverse youth exhibit different responses to forms of intervention. Huang shows that long-term residential care treatment impacts various groups of color differently. For example, Latino youth taken out of their families fare worse in long-term care settings than their white or multiracial peers, says Huang.
What can those of us who don’t work in the mental-health arena do to ensure that young people in our communities have access to appropriate services? Asian Americans have the lowest use of mental-health services among all ethnic populations. Thus, recognizing how mental-health problems are perceived in Asian cultures is an important first step toward ensuring that individuals get the help they need, says Gayathri Ramprasad, who runs a mental-health consultancy. A native of India, Gayathri suffered through severe bouts of anxiety attacks, left untreated for many years. She didn’t receive the help she needed because cultural stigma viewed her symptoms as a sign of personal weakness, immaturity, and lack of self-discipline.
Mina Schoenheit, on the clinical faculty at the Oregon Health & Science University Psychiatry Department, is an expert in cross-cultural counsel- ling, particularly outreach to immigrant Asian families and youth. An immigrant from Iran, Mina knows first-hand the struggles associated with being a new transplant in the United States. Her experience as an ethnic minority is complicated by the fact that she is a Muslim. In addition to sharing what she knows about effective strategies to engage immigrant families, her work also revolves around helping communities understand that stress is a natural part of adapting to a new society.
Stories and experiences shared by people like Mina and Gayathri show that there is no shame in realizing that our communities are not immune to mental- and behavioral-health problems. Even for families that do not have a genetic predisposition toward mental illness, the process of immigration creates changes in family boundaries, gender roles, parental authority, and a host of other issues. Combined, these factors create a recipe for strained family relationships, anger, pain, and despair.
Their mantra: Mental- and behavioral-health issues — like physical problems — need to be identified, diagnosed, and treated. Like physical ailments such as diabetes and heart disease, one cannot simply "will" mental- and behavioral-health problems to go away or get better on their own.
There’s no easy fix. Consistent and continuous advocacy for increased mental-health awareness among our communities gets us talking and sharing. Taking steps toward acknowledging that mental health issues exist in our communities is important, as is recognizing that help is available for our families when we need it.