Nandini Ray: Hello, everyone, welcome to the Maitri podcast- Between Friends: Conversations with Maitri. I am your host Nandini Ray and today we are doing an episode on mental health and South Asian youth community. Mental health issues have frequently been perceived as nonexistent in our South Asian communities. We are least likely to seek help due to stigma and other factors. Even today in a rapidly evolving and modernizing world, most South Asians remain reluctant to address this taboo topic until the situation reaches a level of crisis. But I think it's high time that we start talking about this issue because mental health matters. We must acknowledge that any of us can suffer from mental health, illness and we must reach out for help or offer help if someone is suffering. As various reports have stated that South Asian Americans especially between the ages of 15 to 24, were more likely than average youth to have symptoms of depression or other mental health issues. So I thought it's important to discuss this topic with our youth community members. It's them who can initiate to bring the change that we all want to see in our community. So we have invited three college students, Saniya, Sapna and Ambar. Thank you so much for coming to our show. Can you please introduce yourself to our audience?

Saniya Soni: Absolutely. Thank you so much for having us. My name is Saniya. I am a incoming senior at Drexel University in Philadelphia, but I grew up in San Jose. I am studying psychology and criminal justice. And a lot of my work involves Research in autism, PTSD, trauma, and a lot of mental health advocacy both on campus and off campus specifically with students of color and Asian Americans specifically.

NR: Great.

Ambar Mishra: Hello, my name is Ambar Mishra. I'm an incoming second year student at UC Davis. I am currently studying statistics as well as minoring in computer science and political science. In college, I'm usually involved in more Student Government roles as well as mental health awareness. I am part of a club that is called Manmukti and it is helping South Asians in spreading mental awareness and I'm very grateful to be a part of this club. And thank you for having me on today.

NR: Thank you.

Sapna Ramappa: yeah, and thank you once again for having us on this call today. My name is Sapna Ramappa. I'm an incoming third year at UCLA. I have a major in human biology and society with the concentration in bioethics and public science policy, and I'm also very interested in mental health, public health, things like that. Some of my research that I do is mainly on global health, access to medicine, access to health care, and autism research as well. And so I have a lot of interest in advocacy and mental health and I hope to work in the healthcare field when I'm older.

NR: Thank you. In today's episode, we are inclined to know how South Asian teens and young adults are handling mental health issues. What are they doing to break the stigma associated with it? Are they facing roadblocks in help seeking? Do they have any suggestion for all community members in the de-stigmatizing the issue? Let's find out.

There is a reason I have invited all three of you today. I know you are not mental health professionals, you are not going to prescribe any therapy or medicine for our listeners, but in our prior conversations, I have noticed, I've seen that you guys are well informed about this issue and you are inclined to break the stigma associated with mental health illness. So I thought it is better if we do this conversation on a public forum. And it may help others to see things differently. It may help our community members to join us in raising awareness. So thank you for coming. So my first question probably it's a difficult question for you. Can you share an experience that you or any of your South Asian friends have faced with handling their mental health issues or help seeking?

SS: Sure, so I can start. So I grew up in the Bay Area, but I grew up in an abusive home so my father was abusive. I experienced domestic violence from a young age and my mother did as well. And when I was in around six grade was when I started to experience symptoms of depression. And that kind of compounded and grew as I was growing older especially because no one I knew talked about mental health. And you know, there is that typical Desi mentality of what happens in the family stays in the family. So no one really talked to no one really to help me understand what was going on. And when I got to high school, it was my sophomore year of high school and I was at, like my highest point of depressive symptoms, and I attempted suicide. I was hospitalized. And when I came out of the hospital, after my hospitalization, I was diagnosed with major depressive disorder and anxiety, generalized anxiety disorder. So since then, I am very experienced in just like, what living with mental illness is like and so since then my journey has been understanding what it means to live with mental illness. Understanding why there was so much stigma in my community. When I addressed my mental illness within my community I was very public about it. And I got a lot of lash back, I got some criticism from community members, from aunties, uncles, friends about why I was even sharing what I was sharing. And it was surprising because as discouraging as it was, I also got a lot of feedback from friends who said that they were experiencing the exact same thing. And post hospitalization I was required to go to therapy. And so I've been in therapy for five years now. I'm going to be a senior in college, you know, and it's my goal is to become a therapist, my whole academic career, I'm applying to grad school, my job, like I'm planning to provide therapy to the exact same people and the exact same population that I was a part of in efforts to, you know, reduce stigma, but also ensure that the people in my community know the importance of mental health care.

NR: Wow, that's so powerful. Thank you so much for sharing. Kudos to you.

AM: As for me, my real obstacle and fight with mental illness actually came recently. It was last year in September. This was about three to four weeks before I was entering college for the first time and it was a weird gap because most of my friends were in semesters schools and I'm in a quarter system school so the gap in between was they left for college and I was basically kind of the only one back here in the Bay Area just being with my family. And it hit me in the first week of September, I think near labor day weekend where I just woke up feeling weird and just feeling unhappy. I was crying out of nowhere. And it was really tough for me to still talk about it because in high school, I did do work on toxic masculinity, but it was just hard to really open up even to your friends sometimes, like, Hey, dude, I'm actually crying. I'm breaking down. I don't know why what is going on. And it does take a lot of guts for sure to just even open up to my parents. And throughout those first two weeks of September, I was just crying almost every day. And I didn't know what was really causing it. It was just in my mind. And the worst part was, I was home alone because both of my parents work. My sister started school because she's younger. And I did confide to a couple of friends and it did help as they gave more advice, but I talked to my parents about it and my parents, thankfully, were a bit open minded about it and were willing to help me and everything. We went on a small family trip to Lake Tahoe the weekend before moving in. And it did relieve a lot of the stress but I think that's when it hit me that Mental Health is really serious and it should be taken seriously especially this past weekend one of my favorite Bollywood Actors committed suicide regards to mental health and that really hit home for me because he grew up in the same area where I am. And in comments on Instagram about like, the hate on suicide and the stigma around it that it's a coward move this and that, but I feel like as a community, it's really hard for people just like me or even how Saniya was saying her story. It's hard for us to open up at times and takes a lot of efforts but these two experiences especially the one this past Sunday, when I read the news just made me cry ‘cos it's sudden and it's just it hurts because you can relate it one on one. And yeah, that was basically my experiences about it.

NR: Yeah, yeah, he was all on point that there is a peer pressure for boys to be hyper masculine and media plays a very large role in this. With the boys you know image doesn't fit to media standard and it can create insecurities for boys and you know toxic masculinity that you have talked about- community members, we need to really think about this issue. Thank you for sharing. I'm glad that you got family support, but many teens, many youth, in our community, they really don't have that kind of family support that you got. I hope that this conversation will help people to change their perspective, and they will be helpful they will be supportive to their children. I'm just hoping but probably we need to do a lot of work in that direction.

NR: Yeah, what I'm understanding that the only way to reduce the stigma is for everyone to work together, whether it's parents, whether it's children, school, systems, community, everyone needs to understand that it is a serious issue, and we need to talk about this issue. We need to educate ourselves and all of us need to do their part in dismantling the stigma around mental health in our community. So thanks for sharing your perspective, Saniya. Now let's talk about the resources in schools. I was listening to some podcasts where it was discussed that many schools in this country are not well equipped to help students who are facing mental health issues. And even if they have resources, it is hard to find those resources when you need them. Could be lack of better advertisement, it could be lack of campaigning. So do you have any different opinion? Do you know any such schools that are doing a lot in terms of raising awareness, or providing help? Or is it a long way to go?

SR: I can definitely answer that. I noticed back in my high school, I went to a small Catholic High School in San Jose and our student body was about 600 kids. So definitely on the smaller end, and the way that our faculty members and teachers would encourage students to seek help is we had three counselors for the whole school, so about one counselor for like 200 students or so. And you had mandated appointments with these counselors once a semester. So by the time you graduated high school, you would have seen them about eight times. And anytime you met with them to speak about classes or anything else, you also had the opportunity to speak about anything else that might be on your mind. So this was by encouraging students to meet with their counselors in a mandatory way, it kind of encouraged them to have that space to speak out if something was on their mind. And then there were always resources if students wanted more, they could always email the counselor and set up an appointment, and it was pretty easy to do so. But definitely, that's not to say that mental health wasn't stigmatized, I think it still was, but they had the opportunity. All the students were able to reach out just by sending an email or even walking to the counselor's office. So interestingly enough, I went from a really small high school to a huge public school and now go to UCLA where there's over 30,000 undergraduates, so it's very different in terms of seeking out resources. What I found that was pretty interesting is everyone actually thinks that these resources are less accessible than they actually are. For me, it was a matter of reaching out to CAPS, which is Counseling and Psychological Services. It was a matter of going on an online portal, just saying that I want an appointment, doing a little questionnaire and then one morning, I was able to just go to the office and leave within 30 to 45 minutes. So I think it was very, very helpful that I took the first step and just reached out, I genuinely thought it was going to be a lot harder to get access to those services, but it was a lot easier than I thought. And I think my experience with CAPS kind of changed my mind about how accessible the schools really enable mental health services. And in terms of cultural awareness within these schools, I think there's a lot of resources too. At least at my school because there's such a big and diverse student population. There are clubs that focus even specifically on Asian American mental health or black students and their mental health just because it is so different in different communities. So I think that it's really nice that there is that cultural awareness in our schools as well. And then most recently, for example, I've seen that there was also a huge variance between professors, at least within the last few months with everything going on and doing remote learning, I've seen that some professors are definitely more open to being lenient and listening to students than others. But I think overwhelmingly, I've been very impressed with how our school is able to manage mental health considering that it's a big public university. But I think there are definitely ways that we can make it more accessible and encourage students to reach out more, because it's definitely a matter of students taking initiative in order to get there in the first place.

NR: Yeah, that's most important. People should know students should know that resources are there if they want they can take help. So that part, I don't know how many schools or how many universities they're focusing on. I would like to hear from Ambar and Saniya.

AM: Most of my thoughts are aligned with Sapna, especially going into Davis, it's a big school and there is a good amount of resources as she said with like, specific ethnic communities and like more resources as you dig deeper. However, I feel like it is the awareness is there in college and there is definitely a lot of awareness but for me speaking for Davis's behalf, the awareness is there but sometimes it can be hard to still schedule an appointment or even go through the whole process of just meeting a counselor. Because I know it's still hard to even make appointments with like academic advisors, but in terms of counselors, it's still can be hard because sometimes there's a lot of kids who they have to see per day and you have to get, like it might be a week, it might be maybe a month, until you get an actual appointment. I personally haven't opted for an appointment, but from what I've heard, it's kind of a bit hard. That's why I'm part of a senate staff, group and part of student government, and one of our goals was to maybe establish more peer group services so that students would feel more friendly talking to other students about their mental health issues or just talking in general and just have a small community in the college itself. So I feel that the awareness is 100% great, but from my college and what I can speak of the services might be a bit difficult and it's honestly kind of a bit hard to because there's 35,000 students and maybe a couple of counselors and just managing all of the students might be difficult. That's why I personally opt for more peer group types of services, just more recreational activities are there to friends or even just strangers, it's just nicer to get their minds off or even just open up more to their groups. So yeah, that's what I could say for my school's perspective.

NR: Wonderful. Power to you!

SS: I know Sapna shared her experience with how her high school dealt with mental health. I went to a public high school in evergreen, and it was a large public high school, we had about 3000 kids. And we had one to two mental health counselors for 3000 kids. So that was definitely a difficult situation, especially because I had experienced, so I'd seen the counselor at my school, and she wasn't very helpful, like looking back realized that she didn't follow the same protocols that counselors are supposed to follow. And when I looked back in the past year, I've done some research on this, just about how much funding that these counselors get in these schools, and it's close to nothing. And you know, these are counselors that are not working at schools 24/7. They are a counselor for maybe two to three large public schools and are going back and forth during the week. And unlike what they had at Sapna's school, which I think is great, these mandated meetings, we didn't have those. It was you can, you know, ask to see them or you just didn't know they existed. So that was high school. And I think high schools, specifically public schools have a long way to go in regards to mental health advocacy, mental health resources, and just mental health education. Now, when it comes to college, I kind of did the reverse of Sapna- I went to a small private college on the east coast. And there are resources. I'm very lucky to say that my school Drexel offers free counseling for anyone who's a student, and as long as they're a student at Drexel, which is wonderful. Most colleges do. Almost every single college will have a mental health counseling resource. The issue is that not all of them are fully subsidized. So there are some that exists where students don't have to pay. And there are some that exists that students have to pay, but it's a small amount. There are others where students are still fighting with the university to get those resources subsidized. It's also important to understand that counseling centers at colleges are not set up for long term care, just in their conception just in how therapy is provided long term, having three to four counselors, which is you know, what I've seen as the general trend across campuses, they can't support the entire university. And so it's set up in a way that you know, you have major counselors and then you have students studying underneath them who were trained to and they have short term. So at Drexel, the longest amount of care they can offer is six months now coming into college as someone who had been in therapy for two years at that point for long term therapy, and had serious issues that I needed to, you know, deal with, I was moving across the country, I had a diagnosed illness and a traumatic history. So I went there, they recognized that I benefited from long term therapy and continuing long term therapy. And they worked with me to give me a list of resources and therapists within my community that took my insurance, which I think is super, super important for students to know that that option also exists. You're not supposed to do it alone. This is probably the first time for many students to deal with their own mental health or like health insurance in general, and to know that colleges and universities have resources that are meant to be utilized by students. It's just about taking that action and initiative to ask those questions.

NR: Yeah, so many students are worried about the cost of insurance because they don't know whether they can get therapy that they need, whether it will be covered by an insurance. And also when I was listening what you were saying that one thing popped up that is culturally responsive, that the therapy or the services students are asking or getting whether it is culturally responsive or not whether the therapists who are providing the service, are they aware of the culture because many people, many teens, in our community, it is possible that they are facing family or peer pressure, and they are, you know, facing cultural conflicts gaps. And for that reason, they are facing mental health issues. And if the therapist, he's or she's going to that person that therapist doesn't understand the culture well, I really don't know whether that service, that help, is the right help or not. So that is another question. Maybe we need to think, I mean I'm not saying that all South Asian teams need culturally responsive therapy, but some may need and are they getting it? So what are the steps to get therapy for students? How can they get free therapy, if you know any of resources that you can trust or share?

SS: That's a great point that you brought up. There's actually a movement within healthcare in general in response to that that's called Cultural Competency, especially in mental health care. I work with an organization that is pushing more college campuses to employ culturally competent therapists, to employ therapists that are representative of their student body because exactly like you've said, there are cultural barriers to a lot of these things and unless the therapist knows what those are communication can be difficult and administering therapy can become a barrier. In regards to getting therapy, there are amazing resources that exist. And so we've talked about therapy as a student going to the Counseling Center. But I actually work. I'm a student ambassador with the Jed Foundation, which focuses on mental health education and suicide prevention among students and teens in the US, and they work with a bunch of other organizations to help promote education about mental health. And I feel like that's the biggest resource because until you can understand what's going on. You might not be sure what resources you need. They also put people in touch with therapists, all these resources. Now that we're in COVID, because of COVID we're all in quarantine and we can't, you know, see someone in person. There are Crisis Text lines, there is talkspace, and these are online therapy resources that you can text and utilize over your phone. And there's also Seven Cups of Tea, which I would recommend students checking out if their university offers, but it's also just a free resource in general. That's like a hotline, but it's not crisis related. And so you get connected with a listener who's trained. You can talk about everyday stressors.

NR: Thank you for sharing those resources. And speaking of suicide and teens, like various studies show that rates of suicide and attempted suicide among the worldwide diaspora foundation teens are very high. Do you have any comment on salvation teens and suicide?

AM: What I feel about that high rate, it really comes down to the fact on family environment and just see how the upbringing is actually going because it's definitely a startling statistic. And when I read that, it really hurt that "Wow, it's in my own community" but what sucks is that I can also see why it's within our community because you can see a lot of stresses especially Bay Area kids face daily when they're going in high school because in high school, you stress about your grades, your extracurricular, your basically future and just see where your interests are. And sometimes it really builds up every day for many South Asian teens. And then one day they just burst because it's building up so much that they don't set aside time for just contemplating or just thinking about what they're doing in their life for how they're actually doing. So that whole rate or statistic is really startling because that's also like in India, especially where mental health is really stigmatized, and it's not really taken to the top most priority, as it should be, because now there is starting to be more awareness, but there's so much factors such as academic studies, extracurriculars that come into play, especially for high schoolers and what's sucks is that in the system of this world, like, we're all in this system of going into high school and high school really occurs at an age which is really sensitive for all teenagers. Because the teenage is where you're really developing your hormones, you're growing. And when you're adding more stress and more of these external factors that can deeply affect your growth that just messes up your whole mental health in itself. And it sucks for me to even say that I see why. I understand why this statistic is so high, but it is something we're all taking steps towards now. And that's why I feel my generation or like our generation might and will step up towards this problem. And that's basically my thoughts on it. And I really don't like it that it's highest within our own community. It shouldn't be high in any community.

NR: Saniya and Sapna, can you add something that why women, why girls? are they facing any extra burden and extra fear so that they're taking their lives in order to community?

NR: The more I'm listening to you, the more you know, understanding that how important it is for all of us, especially for adult community members, like I am seeing that all people like whoever's teen South Asian teens and young girls, they are in a way ahead of us or others community members, they are understanding that it's a big problem and we must do something to fix it. But I think we adults we are, we have started realizing it, but we need to do more, we need to focus more on understanding. Like in our community, many parents are scared of community ostracism, like you just shared that they compare their children with other children and they kind of feel peer pressure that they need to present all-rounder children in front of their friend circle. So that peer pressure, under their that kind of pressure, they sometimes make mistake that and they don't even realize that I remember I was interviewing one South Asian college student for our podcast and she told us that when she felt that she needed help for her mental health wellbeing and shared that feeling with her mom, her mom got very scared and she thought that her daughter will be labeled as crazy or something like that. And what will people say- out of that fear the mom actually didn't let her go to any therapist at the beginning. This kind of thing is not an isolated case- it's happening. So how can teens communicate with their parents if they need help? Do you have any suggestion for teens and for their parents?

NR: So you are so right this kind of open communication and trust should be in all relationship whether it is parents-children relationship or between family members. So we should have trusted an open relationship. So I just want you to give one or two tips to how community members can help in de-stigmatizing mental health.

NR: Thank you Saniya, Sapna, and Ambar for sharing your perspectives your experiences and vulnerabilities with us. I hope who are listening to our show today, they will about this issue deeply and do something in their power to break the stigma. We hope more people will speak openly about what they are experiencing and seek professional help without the fear of judgement, discrimination, or harassment. Listeners, please keep listening Maitri podcast- between friends: conversations with Maitri. You will find all of our episodes on SoundCloud and on different podcast apps. Please search ‘between friends, conversations with Maitri.’ Please like share and comment. We are doing this podcast for you, for our community members. And please keep listening and share our link with your friends and stay in touch with us through Maitri Bay Area Facebook page and Instagram, or visit our website. Sending you all the love and big virtual hug. Stay safe and stay healthy. Thank you so much. Bye.