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Vinita Srivastava (VS): From The Conversation, this is Don’t Call Me Resilient, I’m Vinita Srivastava.
Maneet Chahal (MC): We all have self-stigma to mental health. If tomorrow we’re emotionally challenged, we are going to wonder: What is wrong with me? Why is this happening to me?
VS: It has been a tough year. We have all struggled and our collective mental health has taken a real hit. But according to a recent Stats Canada report, South Asians have taken an even bigger hit, reporting lower levels of mental health than any other Canadians during the pandemic. Today, we’re going to talk about some of the reasons why, including the pressure of needing to be a model minority. That’s the idea that Asian immigrants keep their heads down. They don’t rock the boat. They are successful and they prosper. Well, those ideas are mostly myths. And those myths can cause all kinds of problems. Mostly, it forces people to internalize their mental anguish and it can end up leaving gaps in our mental health services. My guests today are intimately connected to the situation. Satwinder Bains is an associate professor and director of the South Asian Studies Institute at the University of the Fraser Valley. Her research focuses on access to mental health support in South Asian communities and the effects of migration and social isolation on mental health. And Maneet Chahal is co-founder of Soch Mental Health, which encourages better access to mental health support in Canada’s South Asian communities. Thank you both for joining me.
MC: Thank you.
Satwinder Bains (SB): Thank you, Vinita, for having us here today with you.
VS: Maneet, as the co-founder of Soch Mental Health, your work with the South Asian community has really kept you close to the issues. And I’m wondering what kinds of trends you’ve been seeing.
MC: I don’t think it’s any surprise that South Asians were as hard hit as they were. This has been happening a long time before the pandemic. And it’s really sad when you think that because you don’t know your environment, you haven’t acclimated to the culture around you, that that’s a disadvantage to your experience, your mental health narrative, essentially. We look at mainstream systems, mainstream mental health services that are catered in a way, for those that are educated, that are literate, that are English-speaking, predominantly from a white background is what you see. So, South Asians we’re struggling with depression, with anxiety, without even knowing it’s depression and anxiety. I think that makes it even more challenging when you’re navigating something related to your mental health in the dark because you don’t associate it to be a problem or for it to be even recognized as something that can be addressed or you can get help for.
VS: So there’s a few things that you’re bringing up there. One is this idea of culture and how important it is in terms of getting the kinds of help that you need to take into account that culture or someone’s culture, and the position that they’re coming from is important when you’re talking about their mental health. But you’re also saying that this idea that the pandemic has exacerbated existing mental health issues, I think that’s what you’re saying, is that it’s not the pandemic necessarily. It’s just the pandemic that highlighted existing mental health issues. But I’m wondering specifically if things got worse during the pandemic?
MC: Yeah, things definitely got worse during the pandemic. And I think the reason why Soch started is because a lot of people, a majority of their life, will probably go falling through the cracks of the mental health system. They’ll never get picked up. They won’t even know they lived their entire life having a mental health concern. So some of those things that are exacerbated during COVID in relation to mental health are depression, anxiety, suicide, addictions. Addictions is a huge issue in our South Asian community. Specifically speaking to the South Asian Punjabi community. And drinking is a No. 1 inquiry we actually get at Soch, where concerned loved ones are reaching out because a loved one is drinking and they don’t know how to navigate and support them.
VS: Satwinder, you’ve been researching South Asian communities for years, why do you think some of these communities have been so hard hit during the pandemic? The South Asian communities that we’re talking about?
SB: I feel that in B.C. there has been an explosion in terms of an understanding of the vulnerabilities of ethnic communities through COVID. And partly it’s been because of the issue of racism. I understand culture as being a very critical point in terms of understanding mental health and wellness and making sure that practitioners take that into account. But to kind of say that it’s because of culture is also a bit not warranted because sometimes it’s not the culture that’s at fault is actually the whole society that’s at fault, that hasn’t really understood their needs. And I think the good thing from the pandemic has been that there has been a really bright light shone on the vulnerability of ethnic communities, and they’re starting to be a greater understanding at the higher level of government to show a deeper understanding of the needs of these communities as taxpayers, as citizens, as children born here, not as put to the side kinds of groups, but really integrate their designs so everybody’s needs get met, the needs don’t get met. And then what you say is, well, these people don’t know what they’re doing. It’s their problem. They live in extended family systems. They’re spreading the disease. Without understanding what is going on behind it. Our community is matured and evolved from the ‘70s onwards. Even I would say, not hiding our mental health issues, but coming forward with them. There has been a shift and I think that shift has helped.
VS: Let’s talk about that shift for a minute. We all know that this is not a new issue. I mean, as you said, it’s been going on since the ’70s. In the ’70s, one of the higher reported suicide rates in Canada was for South Asian women. And many in the South Asian communities have struggled quietly with mental health for years. I guess what you’re saying is actually it has changed since the ’70s, which is very hopeful, but it is an ongoing issue. So, what are some of the reasons that, you know, South Asian communities have struggled quietly? What are some of those issues at play there?
SB: In B.C. we have some very unique issues. We have, although a hundred year plus history of South Asian Canadians living in this province, we still have a very large influx of newly arriving immigrants. The newer immigrants, as they come and continue to bring traditional ways of dealing with situations. One of them is look within the family. Don’t put this out. Don’t let other people know there’s mental health issues in the family, because the sense of this collective identity, that we will all be tarnished with this brush. And as you know, in the South Asian community the family is sacrosanct. It is the cornerstone of everything we do. And people will sacrifice the individual for the family. And unfortunately, that does happen with mental health, that we tend not to get the kinds of help we need for the individual thinking that the larger group, the collective family, is the support the person needs. As Maneet said sometimes that support is right and sometimes it isn’t. So partly it’s been that we are not getting access to the services we need. One: the services aren’t there. Two: if they were there, we’re not accessing them. Three: there is still lots of stigma and the stigma continues. Even with COVID, there was stigma. And Vinita I want to say that we no longer can see ourselves as a homogenous group. We can’t say all South Asian Canadians deal with — every community has cohorts of people that deal with things differently. So we also have to have the diversity of access options for all of us as well. And I think that’s not happening. And to some degree, we are seen as homogenous.
VS: The South Asian diaspora, what that means is so diverse. We come from so many different places. But you talked about two things there, the stigma, this idea of the ongoing stigma. You talked about this idea of this collective identity, that somehow there’s this notion that the collective is more important than the individual. That is a cultural echo that continues. Maneet, what are some of the other things that you’re seeing? Why do folks in the South Asian communities tend to struggle quietly? This idea of not accessing the help?
MC: The stigma is huge. I think with stigma it’s the guilt. Guilt and shame are huge. I think it’s with anyone who struggles with mental health. But when you don’t have that health promotion, that preventative lens, that mental health dialogue happening — it takes years to break down stigma. We all, I’m sure all of us, anyone listening, we all have self-stigma to mental health. If tomorrow we’re emotionally challenged, we are going to wonder: What is wrong with me? Why is this happening to me? So add on a layer of not knowing what mental health is. No one’s ever having the conversation around you in the cultural way, the linguistic way for you to challenge that. You forever remain stuck there. And then comes that point. Maybe one day you take a leap of faith and you go to the health-care system. And as a mental-health professional, it is so broken and so complicated, you wouldn’t even know where to go, what to do. So what you see here in Brampton, locally, is things are unaddressed. They’re shoved under the rug. You end up in ER, likely, because you don’t know the system. What will happen is you end up having a panic attack. You only went to the hospital because you think it’s a heart attack. If you knew it was a panic attack, you probably wouldn’t go because you’re like it’s mental health. I got to keep this hidden. I can’t tell anyone.
VS: But then you feel it in your chest —
MC: You physically start feeling something is wrong with you now. It’s like, OK, it’s OK for me to go get help. But then a lot of those visits are left like that. You have a visit, you may have a follow-up and you never follow up again. That’s one example. The other example is you might go to a service provider, try to seek help and they don’t recognize, appreciate, value, your cultural experience, your family dynamics. And you are forever turned off from the entire experience and you don’t want to go back.
VS: You mentioned family, Maneet. I know that you’ve spoken publicly about your dad’s struggle with mental health. I’m wondering how that impacted you in terms of your work and where you ended up.
MC: Yeah, my dad struggled with depression, which started through grief. He lost his father. He lost his brother. And I think grief consumed him. And I think that is the driving factor along, I’m sure with family history, probably a lot of family history that he wasn’t even aware of because no one talks about mental health in the home, the immigrant experience, just milestones. But I think grief is the biggest thing for my father. And I think all of this as a professional and as a human being when it really struck me was when I lost my dad at the end of 2018 because I think that experience was like, oh my God. I think when you’re in it and you go through it. My entire perception — if you were to have this conversation with me in 2017, I’d probably have a very different perspective than I do today because I was like, oh, my God, grief can completely destroy you, destroy your mental health. And some of us bounce back. Some of us are broken and just carry on and others completely lose their way.
VS: I’m so sorry for your loss.
MC: Thank you.
VS: Satwinder, I know that you have done a lot of work in terms of the different generations and do different generations view and deal with mental health differently? Is that what you’ve noticed?
SB: Yes, absolutely. As I said, the family is the cornerstone of our communities. And I give it real credit for, one, holding things when things go wrong, but also falling apart when things go wrong. So I want to say that generationally because we live in multigenerational homes, there’s no empirical evidence of how many people live in multigenerational homes. What we kind of know, it might be half and half, let’s say, as a guess estimate that half the people live in multigenerational homes and half live by themselves in nuclear family systems. So I think living within multigenerational homes is both a support and it’s also a bit of a negative because I hear professionals saying all the time in B.C. that South Asian Canadians don’t need the kind of support from mental health services because they have family at home. Their family is able to help them. But I don’t think they understand that not all families are equipped or have the knowledge to really do the work and they can do more damage than harm. Whereas maybe if there were a nuclear family and they didn’t have the support, they’d have to look somewhere else. And others may step in and they may have to show through their assessment that the professionals do around the support you need, that they don’t have anyone and perhaps they would get the services. So I keep telling families to let people know that they’re working. They’re not home, looking after mental health and that they do need the support. But I think it goes beyond the understanding. It has to be a demand from us as South Asians to say to services that 25 per cent of the population in Abbotsford is South Asian. I want to see 25 per cent of your services reflective of that. I want to see 25 per cent of your staff having that cross-cultural competency, not just early knowledge of cultural competency, but really advanced skills, well-developed skills. Hire people who have gone through universities and had those types of educations. Why in our social work program or nursing program do we not have the cross-cultural, considering that the people that will graduate are going to work in these communities? And we can’t unfortunately always put the onus on the family to come forward and look for services. I would say to you, as Maneet has talked about the immigrant experience, immigrants generally are very passive. They come to Canada as a developed country and see the beauty, the milk and honey that they see. However, they see that with rose-coloured glasses because it is not milk and honey. They see it that way initially, and they kind of accept that they should take a second-tier position to demands. They shouldn’t go into the school and tell the teacher, I want this or go to a doctor and say I want this, because they see the immigrant position as a secondary position. They haven’t been accepted as full Canadians are rights and responsibilities, and it’s a very difficult dance that they are doing because they’re trying to uphold their cultural traditions, which they don’t want to let go yet, they’re frozen in time for a period of time. And then at the same time, they’re trying to adapt and culturalize to Canadian society. And you talked about these, you know, the environmental acclimatization that people have to go through. I have to tell you, that’s a very complex process. And we can’t expect people to jump off a plane and get acclimatized to Canada and figure out how things work and make the demands that they need. As you know, all of us know we have to be our own advocates for health care, unfortunately. But immigrants don’t always have the capacity and the wherewithal to do that. So multigenerational homes provide the support to people who are perhaps mentally ill because there’s someone in the home, someone to help, etc., etc. But it is not the optimum support system. There have to be services attached to that.
VS: It sounds like you’re saying not just do — I’m just going to use the “we” for a minute because I’m part of this community, too. But it sounds like you’re saying not only do we not have the capacity, but we don’t feel like we have the right.
SB: Yes. That’s why the idea of Soch — I love the word soch because soch is much beyond just thought it is a meaningful engagement in terms of our beliefs, our values, what we think, how we think, why we think it is a much bigger word than its actual small meaning.
VS: So for somebody who doesn’t know soch, let’s give a definition of soch, the word.
MC: I think Satwinder did an amazing job, but like definition-wise, soch means to think or a thought and for us soch is bigger than that. It’s a word that we’ve been using to really delve into the conversation about mental health, emotional wellness, your thinking, your emotions. And it comes across really well when you’re having the conversation between generations. I can have the conversation with my grandma, elders in my family and they’re like, what kind of work do you do? I’m like, I work in mental health. I think about the mind. Think about your soch, your mind and all the things you think about. And that’s the stuff, the challenging bits, and the happy bits. How can we manage that and keep that at a balance. It’s a short word, but it has a very large meaning. It was just like a random brainstorm at a Starbucks with me, Jasmeet and Harman, another founding member of Soch. And we wrote it down. And then we started asking everyone at the coffee shop, non-South Asian people. Can they pronounce this? Cause you want to pick a name that everyone can say.
SB: I also think, Vinita, soch has within it — is imbued with a sense of future thought. Soch is deeper than the moment. Soch is really about reflection and introspection. It’s about a moment of thinking and it can take you forward. I’m really a proponent of progressive thinking of inching forward. Regression is just not my cup of tea. And I’m sorry what’s happening in Afghanistan today. We’re all just heartbroken because the progress is so hard fought and especially of people who are vulnerable. Women, children, people are in abusive situations. People who are suffering from mental health or other incapacities. Soch is imbued with this idea that you can overcome your shortcomings, that you can go forward and make something of it.
VS: We talk about going forward a little bit and you mentioned Afghanistan and we talked about generational differences a little bit, but we haven’t really touched on gender yet. The notions of Asian masculinity, the idea of patriarchy and gender-based violence, these are all wrapped up together. What role does gender play, Satwinder, in all of these things that we’re talking about?
SB: I always feel gender is a fluid term and that it is forever being changed and challenged and manipulated. But traditionally, as you know, gender is seen as a binary and that there’s this or that, and we are nowhere in South Asian Canadian communities really ready to address all the differences between our genders. So as a result, I think the boundary of gender really defines who we are from when we are born to when we die. The rituals, the traditions of thoughts, the ideas, the beliefs, the expectations of roles and responsibilities are kind of part and parcel of everything that we’re socialized to do and to break those norms — every time I see someone who’s broken that norm, I’m in awe of that human to say that they have this courage and this strength of conviction to go against the grain. But in South Asian Canadian communities, partly because we, as all other communities on the planet, are mostly patriarchal, we’re in a bit of a trap. And to open that trap is something not everyone is able to do.
VS: I’m also talking about just the idea of the patriarchy, this idea of how this overwhelming patriarchy impacts the mental health of these communities and those impacted by that. I see Maneet you’re nodding your head.
MC: Yeah. Where we are stuck right now in the traditional sense in the patriarchy is that women really struggle with their mental health. And that is because you have loss of power, loss of voice, loss of autonomy within your home. There’s a lot of gender-based roles that play into your mental health and your wellness. You see caregiver roles are put on women and women have household roles. They are also working, they want their independence. They want equality outside. But then they are expanding themselves and stretching themselves out thin with caregiving. So that plays a huge role on women. And then we look at men in the traditional sense, on how they’ve been socialized to deal with their mental health and their challenges. We look at patterns of not talking about your emotions. Soch has been hosting a South Asian Men’s Forum, which we actually started with the beautiful work of therapy, which is the South Asian Mental Health Initiative in the U.K. So the South Asian Men’s Forum we created for South Asian men to come together, have a safe space with those that have lived experience, those who are professional, to talk about things that are very challenging for men to talk about. We don’t give permission to men to talk about their emotions. “Be a man, don’t cry. You can handle it.” These pressures also don’t allow for their mental health and the way they navigate to evolve. So what do they do? They drink, they get angry, there are outbursts that are happening at home because that is the cycle they’ve seen before them. And that is what’s repeating and it’s not breaking. So that still exists. It’s very heavy. It is being passed down to our generation, to our younger generation, because that is a pattern they’re seeing at home.
VS: I know that you both have seen the news, the sort of media reports about young South Asian men being impacted in a particular way and many of them turning to gangs. And I’m wondering what’s happening there.
SB: Yeah, it’s unfortunate that B.C. has seen over the last, I would say, 30 years, a real decline in wellness of young South Asian men, a certain group of South Asian men. Now, don’t forget, they’re a minority. They’re a small number. They do not define South Asian Canadian men. Generally, most of them are functioning at very high levels. They’re succeeding. They’re doing well. But there is a small group of men that are vulnerable and Maneet has shed some light on why they are vulnerable. But I think one of the things that’s happened is that as researchers and scholars, as practitioners, we really haven’t spent the time understanding men’s burdens and understanding men’s roles. And while we spend a lot of time talking about the shifting role of women from being caregivers, but also being breadwinners, we haven’t really spent the time to understand the burden that men carry generally. If I look at the literature, there’s very little on South Asian men. There’s lots of South Asian women, but very little on men. And we are nowhere near understanding the challenges that young men face. And we also have to understand the role of mothers and fathers and how they’re raising those young men, because they’re also raising them with expectations of the past as if they’re going to carry the burdens of family and breadwinning and always being there for everyone and looking after — that can be shared. It’s so much better if it’s shared between sisters and brothers. I have to tell you that men don’t understand their own privilege. They actually wake up in the morning without examining it. So there are challenges.
VS: If I could give you a magic powder, magic dust, where would you start spreading that dust? What needs to happen to improve the situation? I’ll start with you, Maneet.
MC: I think in terms of Satwinder shared, we’re kind of second tier in terms of a lot of our community not thinking that they deserve it or it’s their right. Because I think coming to Canada was like a ticket, like it was you won the lottery. Magic dust would be that South Asian mental health, culturally, linguistically appropriate mental health services and supports. It’s everyone’s right. It’s there. It’s not something that we’re fighting for. We have to advocate for. We have to sit at the table and beg for funding for, that stuff is just there. That is where I would start. The other thing I would start with is at schools. Schools should have mental health from the very beginning. Why are we not talking about this? And it should be mandatory for them to have mental health courses, mental health training and mental health in the curriculum. We need to start young. Mental health first aid should be mandatory. I think that staff should be out there.
VS: Did you say mental health first aid?
MC: Yeah, mental health first aid. So as a first aid for CPR and saving lives, there is mental health first aid for knowing your foundational mental health. But obviously having that in different languages for different cultures. Mental health training was not mandatory during my nursing education. And I’m baffled about the fact that you’re supporting someone who might be at end of life or they’re terminally ill or they had this horrific accident happen to them. But you have no mental health training under your belt to support them during this transition and this horrible experience. I can continue to probably go on. But I think right now, in terms of the bigger picture, I really feel like if you have that language from as soon as you’re born and you come into the world and you’re given the permission that you have in mind, and we all have a mind and we have emotions, and that is the human experience. That’s the beauty of it. And please experience it to your fullest. And if you’re struggling, reach out for help. Just reach out. Don’t suffer in silence like that is the vision of the community that I look forward to seeing at some point in my life.
VS: Amazing. Thank you for that. And Satwinder I’m going to give you the same dust, the same magic dust.
SB: You’re so generous, I thank you for that. I hope we can make some impact. I guess I have two areas that I think really need attention. One is we really need a very strong overhaul of the education system to address mental health. And we need it at all levels, as Maneet has said. And the second piece is really for policy-makers. If I had magic dust, I would like to see at every policy table that there be culturally sensitive and appropriate services being designed for every single thing that we do. Canada speaks about being a multicultural community, but does it act it out? Does it, in everything that we do, or do we address multiculturalism? Do we address the idea that so many cultures live under one roof, in one country, affected by these policies? I’m sorry, the policies are still very Eurocentric. They are colonial driven. They don’t even address Indigenous issues, let alone migrant issues. So the magic dust, it might be wonderful. It’s just not — I’m not saying it’s impossible, but it needs a whole shift in mindset, a whole shift in idea making, a whole shift in paradigms of how we function as Canadians. And we all need to do that. It can’t be a prime minister and his cabinet who does that, although we put them there. And once we put them there, let’s hold them accountable.
VS: Guys, I felt that physically, even though we’re just virtual. That was very powerful and very beautiful. Thank you both so much for the time that you’ve given today. I really, really appreciate it.
SB: Well, thank you for creating this platform and thank you for allowing us to share our thoughts. And Maneet, lovely to meet you.
MC: Thank you Satwinder and thank you, Vinita. Honestly, I think this conversation, it helps for myself to kind of sit back and reflect on why I’m here, why are we doing this and what work do we still need to do. We deserve this. We demand this and we need a better tomorrow, especially when it comes to mental health for South Asians.
SB: And Vinita I love that your podcast is called Don’t Call Me Resilient, because I think in that idea of resilience comes this idea of there, there, you know, condescending, patronizing ideas of, you know, you should be able to overcome this. Some things we can’t overcome. We need help to overcome those. But this idea that immigrants will always be resilient, they can take racism, they can take assault, they can take all kinds of discrimination and stereotyping, and they should just bounce back. I think that’s a really unfair characterisation of what we can and what we’re able to accomplish. I want to be resilient, of course I do, but not at the cost of somebody else’s ability to then just shove me down and expect me to bounce back.
VS: Thank you so much. Thank you both so much. I really appreciate it.
That’s it for this episode of Don’t Call Me Resilient. I’d love to hear what you’re thinking after that conversation. I’m on Twitter @writeVinita. And don’t forget to tag our producers @conversationca. Use the hashtag #DontCallMeResilient. Don’t Call Me Resilient is a production of The Conversation Canada. It was made possible by a grant for journalism innovation from the Social Sciences and Humanities Research Council of Canada. The series is produced and hosted by me Vinita Srivastava. Our producer is Susana Ferriera, our associate producer is Ibrahim Daair. And special thanks to our intern Vaishnavi Dandeker for her help on this episode. Reza Dahya is our incredibly patient sound producer and our fabulous consulting producer is Jennifer Moroz. Lisa Varano leads audience development for The Conversation Canada and Scott White is our CEO. And if you’re wondering who wrote and performed the music we use on the pod, that’s the amazing Zaki Ibrahim. The track is called Something in the Water. Thanks for listening, everyone, and hope you join us again. Until then, I’m Vinita. And please, don’t call me resilient.