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Mental Health and Smashing the Stigma

In recognition of May as Mental Health Awareness Month we will be sharing stories about mental health as it relates to the South Asian Diaspora. Inspired by an event held earlier this year, TRC volunteer Inaya Hussain explores her relationship to mental health, therapy and how it can be a source of change within the community.

Back in January, I attended the South Asian Sisters Speak (SASS) panel discussion on mental health. Founded in 2016 as a safe space for South Asian women in the UK to share their experiences and explore culture and identity, SASS’s approach ranges from panel discussions and podcasts to their #BrownGirlsBookClub which focuses on South Asian female authors.

Left to right: Sanah Ahsan, Jennal Amin, Humma Andleeb, Aman Chohan and Sheetal Mistry, “Smashing the Stigma: South Asian Women & Mental Health,” 30 January 2020
Left to right: Sanah Ahsan, Jennal Amin, Humma Andleeb, Aman Chohan and Sheetal Mistry, “Smashing the Stigma: South Asian Women & Mental Health,” 30 January 2020

The following panelists, all who work in the mental health sector, shared their experiences and answered questions about mental health:

  • Sanah Ahsan, poet and psychologist

  • Jennal Amin, mental health advocate

  • Aman Chohan, cognitive behavioural psychotherapist

  • Humma Andleeb, mental health researcher

  • Sheetal Mistry, Co-founder of SASS

There was something both energising and hopeful about being part of a safe space where we could talk freely about the issues facing the South Asian Diaspora when it comes to mental health. The event was especially inspiring for me because as someone who has been to therapy in this country before, I can wholeheartedly empathise with the cultural barriers we face as South Asians seeking psychological advice based on Western practices.

While the conversation about mental health in the South Asian community has been ongoing, the SASS event really brought it to the centre of my attention. As I listened to the panelists speak, I couldn’t help but feel an overwhelming sense of relief, comfort and gratitude. To be sat in a room with people who look and think like me, discussing how we can better ourselves - not only for our own future, but the generations to come after us; the energy in the room was powerful.

Our Understanding of Mental Health

“We develop our sense of self from the mirrors held up in front of us...if we are constantly looking at broken mirrors, reminding us of our shortcomings, we begin to internalise this deficiency to the point where nothing we do will ever be good enough.” - The Liturgists Podcast

Panelist Sanah recalled a quote she had heard earlier that day from The Liturgists, an alternative American Christian podcast, and I couldn’t help but put it into context of my own experiences: a brown girl with English ways, navigating my way through the hills and valleys that form when these two worlds collide inside me. It’s not easy, pacifying the conflict, but it’s a necessary journey for the South Asian Diaspora to engage with if we are to overcome the cultural barriers that stand between us and a healthy mind.

My parents are second generation British Pakistanis, and with their parenthood came the same resistant brown parent attitude towards mental health. It took a lot of push back from myself and my sister to change their views. I now understand that their resistance came from their belief that if they provided the best they could for us, we wouldn’t have to face any such challenges in life. I am fortunate that my parents did, eventually, ease up. For many South Asians, mental health is a topic which is largely ignored throughout their life. Not only because of the cultural stigma attached to it (“What will everyone else say if they find out? Who will marry you if your mind is kharab?) but also down to the stark linguistic barriers between our family’s and community’s understanding of mental health and the Western diagnostics presented to us. For example, did you know there is no word for “depression” in South Asian languages?

There is an obvious and ingrained misunderstanding within our communities about the actuality of mental health disorders. Back in 2010, Time to Change compiled a report aimed at ending stigma and discrimination surrounding mental health in the South Asian community. This report found that many South Asians believed that black magic, the will of god or karma from a past life were the causes of mental illness, and that these illnesses are genetically passed to future generations. Many believe that the consequences of such mental health problems would manifest themselves as an obstacle to marriage, a threat to the family izzat [honour], and a point of shame. Furthermore, personal understandings of mental health and language or terminology barriers can make it extremely difficult for individuals to even recognise their problems as being linked to mental health, let alone to come forward and speak about this to a stranger.

Searching for a Therapist Who “Gets It”

As British South Asians, we are familiar with the conflict between South Asian collectivism and Western individualism when it comes to family, socialising, and even politics. What our community has recently realised is that this conflict extends to our healing processes too. Finding a therapist who “gets it” can make therapy accessible for the South Asian community instead of just a Western novelty. In fact, I recently restarted my hunt for a therapist, but this time I made sure the words “South Asian” preceded my google searches, as I felt that this was the only way I could receive the help that I needed.

During the panel, Humma spoke more about this, bringing our attention to the lack of BAME-specific responses within Western clinical psychology. Having such low levels of BAME representation reduces accessibility to these services by BAME individuals, and creates additional barriers to seeking help, in addition to the existing cultural differences that are experienced by those in need of support. The act of reaching out for help can be the hardest step for vulnerable individuals, and having to explain the cultural intricacies of their experiences can make it harder to get the support they actually need, making an already incredibly emotionally laborious process even longer.

Furthermore, the inadequacy of healthcare professionals to grasp cultural difference within the framework of multiculturalism in an accurate and unbiased way leads to the typecasting of victims within racialised stereotypes. We are portrayed as victim-subjects in need of protectionist responses, hindering our chances of receiving meaningful mental health support. This can often exacerbate the reluctance of BAME individuals seeking clinical support, and can explain their distrust in the system which is more likely to prescribe them medication than referring them to talking therapies, for example, or which is prepared to section four times more black British individuals than their white counterparts. Not to mention that living under intersecting discrimination increases mental health problems.

Facing mental health problems is hard enough while simultaneously navigating cultural landscapes, let alone with the added burden of dealing with a healthcare system that is designed to work against you. This makes it all the more important to recognise and resolve these problems from within our communities, identifying our pitfalls and coming up with solutions tailored to our community-specific needs.

The Asian Woman Festival recently compiled a list of resources for the South Asian community and includes mental health which may come in useful if you’re looking for support.

Intergenerational Trauma and Western Therapy

The topic of intergenerational trauma was discussed at the event in terms of its affect on our communities from as far back as Partition. Humma pointed out that these experiences support the epigenetic explanation of trauma - it can leave a chemical impact on an individual's genetics and subsequently be passed to future generations. This type of trauma can be inherited from two generations before and it can leave one predisposed to conditions such as anxiety and depression, and will continue to do so until it is properly dealt with. This reminded me of my great great grandmother, who was taken as a prisoner of war during Partition. Although she was eventually reunited with her family, she only survived a few months after her return, and never spoke of her experiences with anyone, carrying her trauma to her grave and leaving her wounds unhealed.

Fast-forward three generations - I think of the scars my mother inherited then I think of myself and the ways in which I can support my community in breaking the cycle and smashing the stigma.

Navigating mental health issues in a diasporic context is indisputably difficult, and is something only we, as a community, can understand and resolve. Yet, as difficult as it is, our context is also a blessing. The gap between the worlds we inhabit is constantly bridged and redefined inside each and every one of us. If we can externalise this and project it onto the mental health issues we are facing as a community, we can make a great change. Whether that be communal ‘therapy’ sessions, mental health conferences, or even a massive get together, we need to drive the change, not just for us, but for our ancestors who felt they had to stay silent, and those who are still struggling to vocalise their demons. I am reminded of Humma’s grandfather’s diary entries, which she shared with the audience. A time machine for us reading them almost forty years later, his words longing for an easier and brighter future for the generations to come. There was a collective sadness when she read over the entries, as many of his sentiments held weight today. We, as second and third generation British Asians, only have the chance to tackle these issues now because the generation before us was focused on surviving. They did not have the privilege of questioning mental health, because there were more pressing issues at stake; as Aman pointed out, “my parents didn’t have a chance to talk about their feelings, they were working seven days a week.”

In terms of solutions, the panellists emphasised the need to look to alternative methods of therapy and healing, outside the framework of Western language and medicine. By identifying what makes our experiences different, we can identify adequate responses to these experiences, and a good place to start is intergenerational trauma. Intergenerational workshops were discussed by Aman, brainstormed by her and psychologist Dr.Tina Mistry, where individuals could bring their mothers and experiences could be shared and heard. Activities like this would allow us to develop language we don’t currently have when discussing mental health and trauma, as well as bringing these issues to the attention of older family members.

In essence, we must collectively heal as we make any attempts to heal individually. Therapy is a deconstructive process - it has to allow you to reconstruct - but how do we engage in self deconstruction if we are never whole to begin with? The problem we face is twofold - not only do we need to create a unique space in which we feel safe to start healing, but we need to address unhealed inherited trauma before we even start that process.

I left the event feeling motivated and hopeful, and want to thank the SASS team, Aman, Humma, Jennal and Sanah, not just for opening the conversation up to me, but also for all of the work they engage in for the betterment of our communities.

Inaya Hussain is a volunteer at The Rights Collective. She is a recent graduate from SOAS University, where she studied International Relations & Social Anthropology, specialising in South Asian studies, and completing her dissertation on diasporic cultural identity. Her interests lie in social activism, politics and identity amongst the British South Asian community.

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