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;

Story

The challenges of mental health services for Chinese-Australians

by Katherine O'Chee

Stories/475 , Issues/People of Colour , Issues/Mental Health

Sydney NSW, Australia

14th Dec 2018

Lifeline's partnership with the Bridging Hope Charity Foundation attempts to better understand Chinese-Australian's mental health needs.

When Clare*, a Chinese mother of two, moved from Hong Kong to Australia, she felt like a stranger trapped in a strange land. Life, for her, has been a struggle: after experiencing domestic violence and divorcing her husband, Clare fell into severe depression, and considered suicide as an option on multiple occasions. Now, without any money, visa or government welfare support, she relies on credit card overdrafts to feed her children.

And she sees no point in seeking help. "If you tell people about the bad things in your life, they don't want to listen. This kind of hardship, this feeling of helplessness ... who do you tell it to? You go to the doctors; they can prescribe you medicine. But they cannot truly help you beyond that."

Clare's story is not uncommon: 68 per cent of participants in one survey for Chinese-Australians stated that they had either felt a high level of stress or emotional distress (38 per cent) or known a family member or friend who had been highly stressed or distressed (36 per cent). Since 2016, there has been a 9.1 per cent increase in the number of Australians who have died by suicide, according to Australian Bureau of Statistics data released this September.

In the Chinese-Australian community, the situation is worsened by deep-seated cultural stigma. The notion of 'saving face' -- the pressure to maintain a 'good' image of one's family and hide 'shameful' conditions or circumstances -- means that many Chinese migrants facing mental health problems or crises do not consider professional support as an option.

"[Mental health issues are] not seen as something that needs to be treated; it's seen as something that you can get over," says Erin Chew, the co-founder and convener of the Australian Asian Alliance. "No matter what mental health condition you might have, you're seen as crazy."

Lifeline Australia's $450,000 three-year partnership with Bridging Hope Charity Foundation, the major foundation of TWT Property Group, is attempting to combat the silence around mental illness by working to better understand mental health needs within the Chinese-Australian community. As part of the partnership, Lifeline has conducted a feasibility study for providing helpline services in Mandarin and Cantonese and is looking to run a small pilot to trial this service.

"Knowing that someone at the other end speaks your language will lift the confidence levels that you are being helped," says Anke Timm, the foundation manager of Bridging Hope. "The barrier [for communication] is lowered considerably if you know there aren't going to be any misunderstandings and the person on the other end absolutely culturally and linguistically gets what you're talking about."

Eddie*, an international student from Singapore of Chinese ethnicity, recalls one moment of cultural incompetence while accessing mental health services through the university. He was "classified as Chinese" and assigned a Mandarin-speaking therapist from mainland China, even though his family background is closer to Cantonese culture.

"It was very hard to relate with her," he tells me, "[because] different types of culture exist even within Chinese society."

The Chinese style of communication in general is also "very indirect" so there needs to be reassurance that these services do not leave a "paper trail", says Professor Tebbin Koo, a Chinese-Australian nurse and cross-cultural public health researcher from the University of Sydney.

However, by hiding one's true emotions, much of the vocabulary for expressing those emotions have become lost -- hardships in life, for Clare, are "unspeakable".

"In Chinese culture, we seldom really express ourselves explicitly," says Tebbin. "So already in the Chinese language, we may lack sufficient terminology to describe how we feel."

Erin believes that having a Chinese-language Lifeline service is a starting point but not enough. She places emphasis on sharing stories in language-specific media and adopting a community-wide approach to engage those Chinese-Australians who do not participate in any groups or organisations.

"You can have this service and it could all be perfect, with the best workers ... but it takes time for these services to actually be accepted by the community," says Erin.

For instance, over the past six months, Bridging Hope has supported CASS, a Chinese-language support service, in running mental health seminars within their community groups, mostly comprised of grandparents and older senior citizens. Lifeline is currently holding mental health first aid workshops for equipping Chinese-Australians with skills to help others deal with mental health problems and to promote mental health within their community.

Increasing the mental health literacy of the Chinese migrant community is also crucial because then "[Chinese-Australians] have better knowledge of what [mental health] is", says Tebbin. In particular, there remains a need to raise awareness that mental health issues are not only extreme illnesses like schizophrenia or psychosis, but also negative emotions or minor cases that could lead to more serious problems if left buried and untreated.

Still, efforts to bring these conversations to the forefronts of public discussion have a long way to go. "Mental health itself as a sector is completely underfunded," says Anke, "and multicultural mental health is not even on the agenda."

This lack of funding has negative consequences. Clare says she would not be able to access mental health support without free sessions provided to her. And now she faces the prospect of having to give up professional support after being told that her next session with a psychologist may cost her the standard AUD$100 to 200.

"One hundred to two hundred dollars would last [my family] for a week," she says. "Who could afford that kind of money to go and see a psychologist?"

*names have been changed to protect the privacy of the interviewees.

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