Many Asians suffering from severe bi-polar, mania and mental distortion refuse to seek help - they fear others will judge them as crazy, said Chia-Chia Chien, an Alamo mental health professional.
Chien noted she saw a high volume of cases where Asians denied having mental problems when she worked for the Berkeley Mental Health Clinic for 28 years.
"Ninety-five percent of the Asian population, who are in crisis and in severe tragedy, seek help at a late stage," said Chien. "They feel stigmatized."
"They don't know where to go," she added.
She recalled police escorting Chinese clients to her clinic when they disturbed their neighbors, while screaming and pacing frenetically. Families brought their loved ones to the clinic after seeing them throw violent fits, overdose on drugs, refusing to eat and cutting themselves. Chien received cases where children would even hit their parents.
Nonetheless, Asians were embarrassed in admitting they had mental problems, she said. She remembered her clients having no trouble telling her about their pain - except in the mind.
"Do you have a headache?" she would ask them.
"Yes," her patients would say.
"Do you have neck pain?"
"Do you have back pain?"
"Do you have trouble sleeping?"
"Are you losing weight?"
"Are you depressed?
Chien started the Culture to Culture Foundation, which includes the Chinese American Senior Center of Contra Costa and the Chinese American Mental Health Network, as a support group for Asians. The mental health network helps Asians get over the shame of having mental issues, and it has a strong network of psychiatrists and psychologists available for assistance.
Many Asians suffer from depression in the U.S., Chien said. Asian-American women have the highest suicide rate among women in the U.S. over the age of 65, according to a study.
Their depression stems from cultural traditions. The elderly were seen as heads of their family in China. Family members listened and looked up to their elders. When children became adults and got married, they stayed close to their parents and grandparents.
However, the U.S. culture is much different. It trains children to become independent, and they move away from their families after maturing, often forgetting their parents. For instance, in China, a relationship between a mother and her son would be close, and he would continue the bond even after he got married. But in the U.S., a Chinese son may have a tendency to give more importance to his wife - rather than his mother.
"Children drop them and let them go," Chien said. "They feel they have been deserted."
"It's not that they don't love them," she added. "It's just a different culture. They feel isolated and lonely."
Additionally, young Chinese couples are busy working, and may neglect their relationships with their elders, who moved from their native land to be closer to family. Elders visiting families in the U.S. are taken aback when their grandchildren ask them: "How long are you staying?"
"When you hear that, you are hurt," Chien said.
She said the greetings that Asian seniors receive in the U.S. are not as warm or welcoming as they would like them to be and their social status becomes equal when they arrive in the U.S. In addition, elders cannot speak English well, which creates a language barrier, Chen noted, and they need their children to drive them around.
"Who wants to be totally dependent on their kids?" Chien said.
As a result of the cultural differences, tensions smolder between different generations of Asians.
"The elderly suffer from a loss of engagement and feel very angry," Chien said. "They can't mobilize themselves."
Like Asian seniors, young Asians are immersed in pressures: to achieve high expectations. Parents place great importance on education and success.
"They feel their children's glory is their glory," Chien said. "If their dream can't be carried out, then their children will be carry it out."
Many Asian parents have their kids learn the piano, violin, dancing and other activities at an early age. They work on everything with their kids - advanced placement courses, taking the SAT and PSAT exams and other academic endeavors.
They also encourage them to become engineers, doctors, lawyers, accountants, computer professionals and businessmen.
"These are fields with a bright future," Chien said. "They make good money and bring good social status."
When offspring fail to meet their parents' expectations, they may become depressed, unstable or even commit suicide. Plus, when many children come to their families with their problems, their parents tell them what they need to do.
"It's either 'yes' or 'no,'" Chien said. "Parents think kids know nothing."
"Children are seeking an understanding," she added.
Chien's odyssey in mental health began in her home country Taiwan where she majored in sociology and social work at Tung-Hai University. She said her grades weren't high enough to study law; they were only good enough for sociology. Her peers wondered how she was going to make a living with her degree.
She recalled them asking, "What are going to do when you graduate?"
She moved to the U.S. to do graduate work at University of Illinois, Champaign Urbana in the 1970s. She said she had difficulties learning English and working with her American supervisor.
When she was an intern, she started counseling a couple that was pondering a separation. The couple asked her how she would know about their issues when she was single. Her supervisor told Chien the analogy that a doctor did not need to have cancer to cure a cancer patient.
Despite her language difficulties and inexperience, Chien persevered and received her master's degree in social work. A woman who was being treated in couples therapy made her a white dress. Chien said she kept it for a long time. Talking about this gift still makes her cry.
"I like to hear people's stories," she said. "I like doing community service. It's a good feeling. It's an achievement."
"I felt (social work) was good for me," she added. "I never tried anything else. I never thought about doing something different."
After graduating from Illinois, she moved to California and attained a master's degree in public health at UC Berkeley.
She retired after serving nearly 30 years at the Berkeley Mental Health Clinic. But she continued working. In 2001, she started the Culture to Culture Foundation, a nonprofit organization dedicated to promoting mental health and emotional wellness within the San Francisco Bay Area's growing Asian community, which she says numbers about 300,000.
The foundation's senior programs started at the Alamo Women's Club but moved last year to the Veterans Memorial Hall on Hartz Avenue, which now houses the town's senior activities. Chien noted that the Town of Danville and Linda Stolow, a Danville senior activist, helped with the move.
"We want to share cultures," Chien said. "We want others to learn from each other's cultures."
The programs include dancing and Tai Chi, and they are expanding to other cities in Contra Costa County such as Pleasant Hill and Lafayette. Chien noted that the activities for seniors help to keep them engaged and mentally healthy.
The Culture to Culture organization has expanded to giving scholarships to mental health graduate students in California State University, East Bay and UC Berkeley. It also has started a "Mental Health Warrior" essay contest where applicants of Asian descent write stories about overcoming severe mental issues. The winner of the contest receives $5,000.
Chien received the 2005 Peter H. E. Haas Public Service Award, which is given to a UC Berkeley alumnus for public service and included a $40,000 prize. She said she donated $20,000 to the foundation and kept the rest.
Above all, Chien wants the stigma removed from people seeking mental help. Culture to Culture Foundation's mental health network provides educational workshops about overcoming the stigma of having mental problems. Listening, instead of trying to solve people's problems, made her a success in guiding her clients through the therapeutic process.
"Relax and understand with them," she said. "It's the process of working with them that helps."
"People need to pay attention to this," Chien said, about Asians acknowledging mental issues. The issue is still in the dark.
She noted her husband has been supportive of her public service, often helping her move tables for the foundation's programs. She has two daughters who both graduated from Stanford University. One continued on to Harvard Medical School and now is an oncologist at UC San Francisco; the other went to law school at UC Berkeley and studied international law in Hong Kong through a Fulbright Scholarship.
"I'm a proud Asian parent," Chien said.
For more information about Culture to Culture Foundation or a mental health assistance directory, call 831-9988 or visit www.culturetoculture.org or www.asianmentalhealth.info.
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