系列报道八 | “中国病毒”和“模范种族”，亚裔心理健康不能承受之重

编者案：本文是九篇系列报道的第八篇。这个系列报道旨在让读者有机会更多了解费城地区不同亚裔社群，关注他们的历史，影响力和面对的挑战。现在，我们比以往任何时候都更需要为亚洲发声。

这一系列报道是新主流传媒公司与费城华埠发展会（PCDC）合作，和Sojourner Consulting协同，并获得独立公共媒体基金会（the Independence Public Media Foundation）的大力支持。

This article is the eighth of a series of nine stories which seeks to increase visibility and understanding of the diverse Asian American communities in the Philadelphia region and their strengths, challenges and histories. Now more than ever, we must ensure Asian voices have a platform to speak out against the issues impacting our communities.

This series is developed by New Mainstream Press in partnership with the Philadelphia Chinatown Development Corporation and in consultation with Sojourner Consulting, with support from the Independence Public Media Foundation.

Felicia Luo is a Chinese speaking psychotherapist. Last week, she received a call for help. At the other end of the phone was a young man who anxiously told her about his experiences at work. The young man had recently found a job in Philadelphia. On his first day at work, a new colleague kept asking him whether he was Chinese, and pressed him for his thoughts about "China virus.” This made him feel uncomfortable. He worried that he would not pass the probation period and lose his job if he did not conform to his colleagues’ pre-conceived views.

Felicia did not disclose additional details due to HIPPA confidentiality. However, among Chinese patients who come to her seeking psychological help, after the COVID-19 pandemic, racial discrimination and anxiety is an unavoidable topic.

Asian Americans and Pacific Islanders (AAPI) are experiencing unprecedented and growing health inequity issues brought on by the COVID-19 pandemic and anti-AAPI hate. The discrimination and prejudice against the AAPI community causes not only physical harm, but also psychological damage. However, not everyone can find therapists or psychologists or participate in community activities to seek help. Overall mental health of many victims has not improved.

We attempted to explore the state of AAPI mental health through interviews and reporters' observation with the goal of helping members of the community become self-aware of mental health.

In May 2021, the non-profit organization “Stop AAPI Hate,” headquartered in San Francisco, released the STOP AAPI HATE MENTAL HEALTH REPORT. The report states that AAPI individuals are experiencing unprecedented and growing health inequity issues brought on by the COVID-19 pandemic and anti-AAPI hate.

While racism targeting Asian Americans is not new to the U.S.—with exclusionary immigration policies that systemically barred immigration from Asia for decades—the contemporary antagonistic U.S.-China relations and inflammatory and demeaning rhetoric about the COVID-19 (e.g., “China virus” and “Kung flu”) exacerbated racism this community.

Asian Americans who have experienced racism have heightened symptoms of depression, anxiety, stress. Experiencing racism during COVID-19 is found to be more strongly associated with Post Traumatic Stress Disorder (PTSD) symptoms.

Asian Americans who have experienced racism are more affected by anti-Asian hate than the pandemic itself. A full 20% of Asian Americans who have experienced racism display racial trauma, the psychological and emotional harm caused by racism.

In response to the growing demand for AAPI mental health services, in April 2021, the Mango Tree Counseling & Consulting (MTCC). MTCC, where psychotherapist Felicia Luo practices, is the only organization in Greater Philadelphia that provides psychological counseling services targeting the AAPI community. They are equipped with therapists who speak Mandarin Chinese, Cantonese, Vietnamese, Korean, Filipino, and Hindi.

Felicia recalled that in November of 2021, a high school girl came to her practice after a group of Chinese American high school students were viciously beaten on the Philadelphia subway. The attack was unprovoked. It started when another group of students hurled racist insults at the Chinese American students before quickly escalating into a brutal physical assault. Although Felicia’s patient is not in the same school as the students who were beaten, after seeing the widely circulated video, she suffered from panic attacks. She dare not take the subway, venture outside, or go to school.

"It is very hard to say to patients that if you look on the bright side, everything will be fine. Because the psychological and emotional damage caused by racism is deep-seated, it may not be resolved for a long time, and some even affect each other between generations and are more difficult to resolve." Felicia recalled, "I talked with the girl a lot, including how to look upon the attack. I also followed her to feel the sadness and identify with her emotions, telling her, 'we can't control the occurrence of malignant events, but you have the right to be angry and sad. All negative emotions are reasonable and can be recognized.'"

Asian Americans have a long history of mental health problems. Cultural conflicts, family conflicts, intergenerational relations, racial discrimination and violence, and the discomfort of the immigrant environment are "weeds" in the hearts of many Asian Americans. Fueled by detrimental psychological effects, suicide and self-harm are all too common.

In the Asian American community, many teenagers are troubled by mental health problems. In traditional Chinese culture, one of the characteristics different from other cultures is that parents have high expectations for their children and "hope that their children succeed." Parents' high expectations have become an unbearable burden in the lives of Asian children. In school and society, they are "Americans." But when they return home, they are shrouded in Asian culture and concepts. The conflict between American social culture and parents' traditional concepts makes many children confused.

Another Asian group suffering from psychological problems is the elderly. Many seniors can't speak English. Language barriers prevent them from communicating with the outside world. Many of them have found that life in the U.S. is completely different from what they imagined after they moved here with their children. The proportion of elderly people suffering from depression is high because of the language barrier and a lack of an independent social network. These feelings become heightened after their children move out of the house. A sense of isolation often grows.

Asian American women is another subgroup of particular concern. Their pressure mainly comes from the gap between real life and expectations, as well as marital problems caused by changing family roles after immigrating to the U.S. Domestic violence also has devastating physical and emotional effects on many Asian women, and on some Asian men.

Although Asian Americans suffer a disproportionate rate of psychological problems, Asian Americans have a lower rate of mental health treatment. When faced with emotional problems, many Asian Americans do not actively seek treatment and simply ignore these feelings. Through investigation and interview, we found several reasons.

In 1966, the New York Times published an article on the success story of Asian Americans by William Peterson, an American sociologist. The article bestowed the label “Model Minority” on Asian Americans who worked hard and valued family relationships. In the following decades, the “Model Minority” sobriquet has become inextricably linked to Asian Americans.

However, the "Model Minority" myth not only covers up the ordinary or difficult living conditions of most Asian Americans, but also makes Asian Americans experience unhealthy pressure because they cannot meet such unrealistic economic and social expectations. Furthermore, many are externally defined, and may self-define, as "an obedient group that does not need additional help or attention." The illusion conditions Asian American to suffer in silence.

During our interviews, we found that for many Asian Americans, mental health is a forbidden topic. Many people think that mental illness is shameful. The tendency of American society to equate mental health with mental illness also makes the Chinese American community feel uncomfortable when talking about it.

Although Asian Americans have great need for mental health services, there are not many psychologists with Asian background who can provide behavioral health and mental health care in the U.S. We once tried to find Chinese psychiatrists in the great Philadelphia area on the Internet. The results we found were few and far between. Many doctors were at full capacity and could not add new patients.

Chinese psychologists are hard to find. Finding a white psychiatrist may lead to poor communication and even misdiagnosis due to language or cultural barriers.  Felicia said that many of her patients had previously sought counseling and treatment from white psychologists. " We know that success in therapy is not race determinant, but they still cannot understand culturally, even if there is no language problem,  Clinicians of different races might 'prescribe the wrong medicine.' And the ‘homework’ they leave cannot be done. In contrast, when seeing a Chinese therapist, at least they will know the background of the patient and do not need to explain it to them. Those who come to the consultation feel that they are ‘heard’ and ‘understood.’”

High cost is also one of the stumbling blocks for Asian Americans to receive psychological treatment if they are low or moderate income and lack of health insurance . The cost of a single session can be anywhere from $100-300. Even for people with health insurance, therapy is often only covered once they have reached the max deductible.

To provide better mental health service resources for Asian Americans, Noel Ramirez and several young people established the Mango Tree Counseling & Consulting (MTCC) focused on serving the AAPI group in April 2021. Currently, they have 11 psychotherapists who are proficient in native Asian languages, serving patients with different native languages.

This collection of strengths not only allows institutions to have clearer goals, but also provides more psychotherapists to Asian Pacific communities through relevant training.

Through case research and training, MTCC also cultivates more therapists who focus on the Asian Pacific community. In addition to one-on-one psychological counseling services, every Monday and Thursday, MTCC holds online discussions on different topics with the participation of psychologists and the public.

At the same time, MTCC also launched a program called "Ginger Root" in response to the various pressures that teens face affecting their mental health, which provides short behavioral health counseling, stress management, and behavioral health coaching for AAPI students in Pennsylvania.

In April of this year, a Philadelphia African American and Asian American Solidarity Event was held at the Philadelphia Chinatown Development Corporation. This is both a specific response to the November 2021 SEPTA attack on four Asian American teens, and a solution to the overall heightened racial tensions between the African American and Asian American communities due to the pandemic.

The organizer of the event, Esther Hio Tong Castillo, said that when racial violence occurs, it is very easy to cause secondary psychological trauma, so we began to do a psychological counseling and construction around the understanding and mutual trust of Africans and Asians work. 

This program is a part of the Chinese Immigrant Family Wellness Initiative (CIFWI) project. The project was created in 2020 by Esther Hio Tong Castillo, a former American sociology of science professor turned community organizer. MTCC is also an active member in this project.

Castillo, 37, is CIFWI's program director, implementing and organizing programs and workshops for immigrant parents and their children. The group works to provide Chinese youth with tools to talk about mental health, as well as catering to Chinese American seniors, who also have difficulty accessing to mental health resources.

While discussing issues such as family stress, intergenerational communication and self-care with Chinese American seniors, the project spawned a new program open to all Asian families: the "Youth Leadership Program." The project involves young people of Chinese, Cambodian, Vietnamese, and Filipino origins, and brings together mental health professionals and young Asians of diverse backgrounds to discuss issues of race, gender, inclusion, and healthy relationships.

During the interview, we felt strongly that the psychological problems of the Asian American community merit more attention and additional resources. We were pleased to learn that the groups and consortiums described above are advancing the ecosystem for the community.

As Castillo puts it，“I experienced firsthand the power of having better mental health and how it can transform families. The passion continued to drive me to do community organizing.”

In the future, we hope that sunlight illuminates the dark corners that remain in this area.