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Asking For Help in a System that Doesn’t Speak Your Language

July 3, 2019

In many Asian cultures, it’s common for grandparents to take care of, and even raise, grandchildren as their parents work. For grandparents whose children and grandchildren live in the United States, maintaining that tradition often means making a trek across the world. As the number of Asian-Americans in the United States increases, so too does the number of older immigrants from Asia (according to the State Department, 30,602 immigrants from Asia in 2014 were parents of current Asian-American U.S. citizens over the age of 21). Often these older immigrants don’t speak English, and don’t adapt to a new language and culture easily. Most can’t drive and are thus confined to their child’s house.

Research has shown that such circumstances of loneliness and social isolation are key predictors of depression and other mental health issues in seniors. Social isolation intensifies for many as they experience increasingly limited mobility, and their friends begin to die. But it’s particularly an issue for what Abul Hossen of Shahjalal University of Science and Technology in Bangladesh terms “late-in-life immigrants,” because, Hossen notes, of their “recent arrival, unfamiliar social environment, poverty, poor health and communication problems.”

The language barrier may be a significant factor: A 2011 University of California study of 20,712 Asian-American elders found that Korean, Chinese, and Vietnamese respondents — most of whom reported limited English proficiency — were more likely to express symptoms like hopelessness, worthlessness, or even major depression; but Japanese respondents — of whom 9 in 10 reported speaking English every well — were the least likely to report those same symptoms. Compared to non-Hispanic white respondents, all groups who were more likely to report distress were also less likely to have seen a mental health professional. Which is to say: Of those Asian-American seniors who might need help, very few of them actually seek it.

There are two likely reasons for this: the strong cultural stigma against mental illness, and the dearth of culturally appropriate support. Remarkably few mental health professionals speak Asian languages, and those who do tend to be concentrated in large metropolises such as New York City and Sacramento. A 2013 report of the U.S. health workforce noted a mere 2.8% of psychologists identified as Asian.

It’s not just about the language barriers though — cultural barriers exist as well. Most nursing homes serve food and organize activities that Asian seniors aren’t used to. Asian cultures often place importance on folk tradition for healing (such as ayurveda or traditional Chinese medicine), a sentiment not usually shared by doctors in traditional nursing homes.

Fortunately, there are people working to provide Asian-American elders with more opportunities to socialize and receive culturally appropriate services. Mental health professionals are experimenting with technological solutions that would help Asians in isolated communities access mental health care. For instance, Matthew Miller, associate professor at University of Maryland, is creating a Korean-language video series to educate Korean-American elders about mental health issues with strategies for coping and normalizing the experience.

Read more at BuzzFeed.com.

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