Is there an Asian Australian language?

There is much research that highlights the way in which mental health issues are equally prevalent across all racial groups in Australia. However, it is also well known that Asian Australians have the lowest engagement with mental health services amongst all racial groups in Australia, and this is commonly attributed to the stigma of mental illnesses in Asian communities. What is interesting to note though is that only a small number of researchers question the quality of service provided that perhaps could be contributing to the low uptake of mental health supports by Asian Australians.

Stigma around mental illness is definitely present in Asian cultures, however in Australia, I would guess that this is more pronounced in newly-arrived immigrants and less so for those of us who have grown up surrounded by Western thinking and education. Yet still, we find ourselves up against barriers that deter us from accessing mental health supports. What could be creating and contributing to these barriers?

As someone who has spent some time working in the community and mental health sectors, I sense that our low engagement with mental health services perhaps has a bit more to do with the lack of culturally responsive practice available to the Asian Australian community. One aspect that needs to be considered in “culturally responsive practice” is the language and communication styles commonly attributed to Asian cultures. Because we speak English, I would say that predominantly white-centric services aren’t quite able to hear the cultural influences at play in the words that we use and this impedes the care and quality of support that we are able to receive.

Here’s a story to demonstrate what I mean a little more clearly:

I used to work in a youth homelessness crisis service and here, I was witness to young people facing some of the worst experiences of their lives. Essentially, young people would drop in to the service, speak with the workers, and then wait in the space until they found out whether or not they’d have a safe place to sleep that night.

Interestingly, there were barely any Asian Australian young people who walked through the door. I assume this is because our family and community structures are built in a way that makes it harder for people to fall through the cracks. So, whenever I would see an Asian young person, I’d need to contain my excitement (there were barely any Asian staff too) but also my sense of “what the hell happened to you!?” Because for me, I knew that things must be super bad for an Asian person to present to our service.

And then there was Paul.

I remember this one particular Asian Australian young person clearly. A quiet, shy guy who grew up in the Eastern suburbs of Melbourne (if you’re not from Melbourne, lots of East Asians live on that sound of town) who was quick to share that his older brother was studying medicine at uni. This guy, let’s call him Paul, was the younger self-described “useless” brother who had somehow fallen into a depressive state around year 10 or so which had then affected his ability to do well at school. Despite this, he’d somehow managed to gain a pretty okay ATAR score and found himself in an arts degree at one of the “regular” universities (again, his words not mine) in Melbourne.

To him and his parents, it seemed like this was the worst thing that could have happened. He hated life, hated uni, had zero motivation, felt miserable all the time and because of this and on top of this, his parents were physically and verbally abusing him at home. At some point though, something really bad must have happened because he decided to move out of home and sleep rough in an unused stairwell in the city. In the middle of winter.

When I met Paul, I mentally assigned him as a high priority. I thought, the violence must be really out of hand at home for him to need to leave… However, what was interesting was that Paul presented in a very “Asian” way to the housing workers and they in turn didn’t quite understand the severity of his situation.

He would say things like, “I don’t want to be a burden on the service…” and “my situation’s not that bad, other people need more help than me…”. And the crazy thing would be that the workers would say, “well… he said that he’s okay so we’re going to prioritise another young person instead.”

And because of this, Paul slept in a damp, freezing cold stairwell for a couple of months with zero connection to his family, friends or anything that could potentially bring him a slither of joy. He did eventually end up receiving the support he needed but it took a very, very long time.

This is a very acute example of why we need to talk more about the role of language in understanding and supporting Asian Australian mental health. We need to explore the ways in which we communicate, because we’re not actually being understood by white service providers. Despite having no language barriers and speaking English with no accent, for many of us, the way we speak is inherently laden with the cultural values of our families or countries of origin.

For example, when Paul says, “I don’t want to be a burden…”
I can hear, “I acknowledge that you’re going out of your way to help me”.
But what white services hear is, “you don’t need to worry about me”.

When Paul says, “my situation’s not that bad.”
I can hear, “I’m still surviving but I’m here talking with you so you know it’s bad”.
But what white services hear is, “I’m okay”.

When Paul says, “other people need more help than me.”
I can hear, “I’m aware that there are others who need help too”.
But what white services hear is, “I’ve seen everyone else here and now I know that my situation’s not that bad”. 

A slow and tricky path forward.

Addressing Asian Australian mental health properly requires an examination of the culture embedded in the words that we speak. We don’t need services translated into different languages, but we need service providers to have a stronger understanding of the cultural values, norms and styles that we communicate from.

The tricky thing here though is that we all have ties to different countries (my Japanese values would differ greatly to another person’s Indian values) and we’re all different in our ratio of cultural influences (I feel very connected to Japan whereas other Asian Australians may have less connection to their ancestral country), that the “culture” we’re talking about links closer to a diaspora culture than to any particular country. And not many, apart from those with lived experience, truly understand what diaspora culture looks and feels like.

Yes, it is the responsibility of mental health services to become more culturally responsive however, there is no doubt that this is going to take a very, very long time. Services still think that being culturally responsive means putting up posters in different languages so imagine how long it will take them to understand the complex, multi-faceted and variable cultures of being “Asian Australian”.

So, it is up to us to gain a stronger understanding of what’s happening, to articulate what is working and what isn’t working and to use all of this to demand better quality support for ourselves and our community. If we do this together, we will inevitably make impact and change. 

Reflective exercise.

To deepen your exploration of your communication style, here are some reflective questions for you:

• When you think about Paul, what first comes up for you?

  • For me despite my empathy for Paul, inevitably my very first gut reaction is, “I’m sure you can tough it out, we’ve all been slapped and told we’re useless.” It’s that stoic/grit kind of thinking that I’m not sure I’ll ever shake.

• Think of the way you communicate. Is there an Asian influence in the words that you use and the style in which you speak?

  • For me, I’ve grown up in Australia all my life but it’s still so hard to speak in a direct manner. I speak in that very roundabout Japanese way and when I do speak directly, I feel that it comes across way too aggressive and intense.

• Can you think of any times where you feel like you were misunderstood by white peers/colleagues/managers/health providers? And why do you think you were misunderstood?

  • Okay I have too many examples to share here but I’d say that when I was experiencing burnout at work, my manager didn’t quite understand for months and months. It was only when I told her some very graphic symptoms (which I felt was too personal and intense to share at work) that she stopped and listened, which then finally led to some changes being made in my role.