Candace Kim has a soft, easy-going voice when she talks on the phone. One evening last week, she was using it to comfort a caller to the Didi Hirsch Suicide Prevention Center. The caller had a blade nearby, and Kim was gathering information about the person's intentions.
"Have you started cutting?" she asked. "Where did you scratch yourself?"
Afterwards, Kim said the caller wasn't suicidal and just needed some help to get through the night. Kim has a masters degree in social work and is a part-time employee at the center. Most of the other counselors work as volunteers. Kim gets a paycheck because she speaks fluent Korean.
Didi Hirsch hired her to help in its effort to meet the needs of underserved communities. English and Spanish-speaking counselors work the phone lines every hour of the day. Korean and Vietnamese-speaking counselors are available during evening hours most nights.
However, Kim's linguistic talents haven't been in high demand.
“Ever since I started working here as a bilingual counselor in October of last year, I took maybe about, I think three Korean calls," Kim said. "So that’s not too many."
A Tough Sell
Asian Americans tend to use mental health services less than the general population does. A report by the California Asian Pacific Islander Joint Legislative Caucus puts the number at half.
That low number doesn't mean the population doesn't suffer from mental illness. Rather, among certain age groups, Asian American women have been found to have the highest numbers of suicide mortalities of all ethnicities, according to a report by the National Alliance on Mental Illness.
Experts say several factors may discourage members of the Asian Pacific Islander community from seeking out mental health services. One of the biggest is a strong stigma among many in the Asian community against acknowledging mental illness.
“When you have a mental illness, it’s not just you that is impacted. There’s a reflection, supposedly, on the entire family name," said Dr. Michi Fu, director of statewide prevention projects at Pacific Clinics. "It’s something that is so much more a part of our community that people are willing to die over this.”
Merely realizing that a stigma exists may not be that helpful for service providers hoping to reach out to Asian Americans. Each culture, ethnicity and generation has its own unique needs. And stigma isn't the only roadblock.
“Due to language disparity, transportation and unfamiliarity with the Western mental health services, many of the API community members, even if they had the need, could not access the service,” said Rocco Cheng, project lead for the Asian Pacific Islander branch of the California Reducing Disparities Project.
Cheng said that a good starting point for service providers would be to ensure that they have readily available information about their services in languages that minority groups will understand.
Opening a Dialogue
At a health fair at the Los Feliz United Methodist Church on a recent Sunday, Young Ahn was answering questions from parishioners about mental health services. Ahn is a mental health services coordinator for the Los Angeles County Department of Mental Health. Last year, she spearheaded an effort to provide more information about mental illness in Korean. Thanks to her efforts, she spread a dozen brochures and flyers printed in Korean on a table in front of her.
She said her most successful flyer among Korean Americans was a self-diagnostic of stress levels. Ahn said Koreans are more open to discussing stress than they are to discussing mental illness. Ahn uses the idea of stress management to open the door to discussing mental health issues. It's a topic she said she has to ease into gently.
"Don’t even mention mental illness," Ahn said, laughing. "They’re not going to come."
Many experts say that it's important just to get people more comfortable talking about mental health. Julie Kang, a software engineer who lives in Long Beach, suffered from a major depressive disorder in college. She said she didn't recognize her symptoms because her Korean upbringing had taught her to play down her symptoms. That led to a breakdown, which forced her to suspend her college career temporarily while she sought treatment.
She has since blogged about her experience and shared her story before groups of Korean Americans. She said just knowing that mental health services exist helped her.
“The key part in my recovery process was just realizing that there’s this whole world of medicine that I just didn’t think about before, and there are diseases and disorders, but they’re actually really treatable, and you can actually make full recoveries.”
Didi Hirsch Suicide Prevention Hotline
Los Angeles County Department of Mental Health ACCESS Hotline
Alzheimer's Association Helpline
Girls and Boys Family Town National Abuse Hotline
California Youth Crisis Hotline
Child Abuse Hotline
Domestic Violence/Sexual Assault Hotline
Elder Abuse Hotline
Substance Abuse & Homeless Health Care