Mental Health and Wellness knows no nationality, race, colour, culture, community, socio-economic status, gender, sexual orientation, or profession. In fact, it impacts and is impacted by all areas of one’s social, mental, physical, emotional, spiritual, psychological and financial health. Canadian society has begun to shift its focus entirely from the ‘problems’ and reducing these ‘problems’ to focusing on how we define and create a better sense of health and wellness. By taking this positive approach, the South Asian community is able to focus on how we can better define what good health and well-being means to each of us first and then what we can do to discover and to maintain a better harmony and balance between our healthy minds, bodies, and spirits.
Mental health and wellness in Canada’s South Asian community has continued to be a taboo topic and this community is only beginning to have a healthy dialogue regarding it. Organizations such as SAMHAA (South Asian Action & Awareness at www.samhaa.org), with the support of a number of community volunteers and organizations such as the CMHA (Canadian Mental Health Agency); have begun a movement and are designing a platform whereby South Asians can discuss and increase our consciousness about mental health and wellness by increasing awareness within our families, our loved ones and especially within ourselves.
An Australian research study examined multicultural mental health and has defined mental health and well-being as being culturally bound, but it has also found that the definition of mental health and wellness is a universal one -regardless of one’s cultural, religious, gender, and socio-economic status.
Well-being is Universal:
- feeling and being safe & secure
- having meaningful & trusting relationships
- having a sense of belonging to a social group
- having a sense of identity
- having basic needs of life met such as housing, food, clothing & water
- being in control of one’s own life
- being independent
- feeling good about one’s self
- having physical & psychological health needs attended to
- having traumatic experiences validated
- having a sense of optimism or hope for the future
- Source: Multicultural Mental Health Australia
For more information please visit the website: http://www.heretohelp.bc.ca and Crosscultural Mental Health Issues.
However, there are many culturally-specific factors and barriers that we must acknowledge in visible ethnic minorities such as in South Asians before we can go further in this conversation.
Some culturally-specific factors and barriers include:
- a lack of awareness about mental health & wellness
- defining what is accepted & considered ‘normal’
- understanding factors that increase poor mental health & mental disorder
- deciding how we perceive, accept & move forward in a positive manner after we or a family member gets diagnosed with a mental illness or disorder
- stigma & superstition
Factors such as racism along with the stresses of daily living, and discrimination increase the risks of South Asians developing mental disorders, emotional and behavioural difficulties along with psychiatric symptoms – but the single most difficult barrier to seeking support for mental health concerns is cultural attitudes. Cultural attitudes have been pivotal for increasing behaviours that encourage denial and avoidance, which then delay the process of seeking help from mental health professionals.
Interestingly, although newcomers and immigrant populations such as those within the South Asian community face more stress, they are less likely to seek support and guidance from a mental health professional than a Euro-Canadian. This group may in fact have an increased risk of physical, emotional, social and economic stresses because of immigration, resettlement and settlement especially during the early years of becoming a Canadian citizen. Moreover, these processes become even more complex if people are also experiencing various stresses from: having to move and transition, grief and loss of previous comforts, employment income and financial stability, home, status, family and loved ones and identity.
With all of these increased risks to poor mental health and wellness – is it any wonder why South Asians are not seeking support? There are many factors and barriers that are preventing families to acknowledge and seek support. These include: increased post-traumatic stress, unemployment, poverty, social isolation, cultural misunderstanding and shock, racism, feelings of worthlessness and language skills which are many experiences that are keeping many South Asians to continue suffering from mental health related issues.
However, whether we are discussing first generation or third generation South Asian Canadians, there are distinct issues related to experiencing racism, discrimination, shame, guilt and stigma. We know that when one family member is diagnosed with a mental illness or disorder, the entire family will feel the shame, guilt, discrimination and stigma from others – especially from within this community.
As a collectivist community, our families identify as a group and so the entire family will share the denial, confusion, anger, blame, guilt, and shame. In doing so, families will hide and stop others within our community from discovering their ‘family secret’ related to mental illness. Finally, South Asian families are experiencing an increase in mental health issues related to depression, anxiety, addiction and substance misuse and prescription dependence, violence in relationships and families, gang violence, bullying, and eating disorders.
Family members will often feel and experience a sense of responsibility and often blame themselves for their child or family member who is mentally unwell. This guilt and blame often result in an experience of shame and further makes the ‘unwell’ family member to become even more vulnerable to receiving little to none or inadequate mental health support and to further experience shame, stigma and discrimination from others.
Therefore, South Asians (like other Canadians from Eastern cultures), often together feel the shame, guilt and fear to discuss mental illness and addiction. These feelings and actions hugely influence how vulnerable and how long a family will live in denial or by ‘pushing issues under the rug’. This way to cope for families can then seriously delay a diagnosis and a treatment plan until issues become more severe.
So in essence, this fear of mental illness has more to do with how others in the South Asian community will perceive the family and family member rather than the fear of the mental illness itself. For this reason, families tend to hide the fact that they or a family member has been diagnosed with a mental health condition in the first place. And it’s been repeatedly proven that ethnic minorities face more stigma and more harshly than other groups in Canada.
But let’s not forget that we’ve only begun to scratch the surface of working with mental health professionals to enhance appropriate multi-lingual, culturally- and spiritually-sensitive services within the community. Although we have embarked on a remarkable journey in the past few years, there are still many factors that our mental health professionals themselves are facing that are delaying adequate, respectful, culturally-sensitive and timely support to families such as those from our South Asian community.
Obstacles to better mental health care include the lack of cultural awareness of mental health and wellness, the need for mental health resources and services, and how to move forward once the need for mental health services has been established.
Other barriers include: how mental health and lack of mental health is perceived and treated, cultural differences and approaches, racism and discrimination from mental health professionals themselves and the lack of services catered to culturally-specific needs of ethnic minority communities who may be struggling from further complex issues of immigration, re-settlement and settlement and the perpetuating of negative thoughts, attitudes, perceptions, behaviours and actions carried on between the different generations.
As one can see there are many factors that are keeping South Asian families from replacing their negative cultural attitudes towards mental illness with more positive ones. We must shift our thoughts from thinking about ‘looking after our own’ towards encouraging, planning, forming and delivering services to suit all ethno-cultural groups and for each of us to know that we have places to go to seek support.
This is an important dialogue that has a profound influence over the quality of our lives. This discussion will facilitate and help bridge the gap between our cultural struggles and our resilient community. This bridge will also symbolize a higher consciousness in which we examine the impact that our cultural attitudes have in re-defining, perceiving, and finding treatment to health, well-being, addiction and recovery. Our culturally-specific aspects of the South Asian culture that value balance and harmony through remedies and treatments along with the family-shared responsibility can be used as a way to strengthen instead of limit how we work with mental health professionals and to support each other.
We can in fact use many of our Eastern approaches to collaborate our sense of spirituality, emotional, physical and social components with the Western promotion of physical and mental health. Moreover, this sharing of knowledge along with the interaction between the mind, body and spirit can in fact make our Western-based clinical settings much more culturally-sensitive, culturally- competent and well-rounded. There is hope and there are many actions that the South Asian community can take to increase our sense of awareness and understanding about mental health and wellness.
In ending, SAMHAA would like to make a call to action for all community members to spare some of their time, skills and expertise to volunteer for this movement, organization and upcoming conference this year. SAMHAA is currently planning their first annual conference to be held on October 8th and 9th in 2011 where this will be a two day multilingual conference for all age groups. This community forum will bring discussions of mental health in the South Asian community to the forefront and will serve as a forum for awareness, acceptance, support and empowerment around mental health issues.
Please visit: http://samhaa.org or Twitter: @SouthAsianMH, or visit Facebook at http://samhaa.org/facebook for more information and to sign up on the Volunteer List.