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Why Some Asian American Teens with Depression Aren't Getting the Help They Need

Cultural stigma about mental health services and an emphasis on stoicism are often at the roots of the problem.
 
 
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It was late on a school night—3 a.m.—and Tracy’s 17-year-old son, Jason, was still playing video games in their one-bedroom apartment in Flushing, New York. The noise infuriated her and kept Jason’s younger brother awake. 

The family had uprooted from Hong Kong to move here a few years ago, and Jason had become angry and withdrawn. When he wasn’t arguing with his mother or brother, he would retreat into endless hours of video games. 

That night, Jason blocked all of her attempts to shut down his game, Tracy says. “We were fighting over the TV. I’d turn it off and he’d turn it on again. I got so angry that I threw the TV antenna out of the window.” 

Tracy had arrived with such big hopes for her boys—a shot at one of New York City’s top public high schools, a chance for college. But making a new life in Queens was tougher than she had imagined. “Life is very hard here; to get used to the new environment, the finances, the economic problems,” she says. While her husband remained in Hong Kong, she got up in the mornings to work at an office job and then came home to take care of her children like a single mom.

Her younger son had adjusted smoothly, but not Jason. He refused to go to school. He had few friends. His angry outbursts rattled the household. “I though he was being rebellious,” she says. But eventually, Tracy learned the truth: Jason was deeply depressed. 

Depression in Asian American teens is a problem that few people glimpse, let alone imagine. But it’s a reality--a painful one that’s often obscured by stigma, misinformation, and shame. 

Jason’s social worker, Chi-Kit Ho, sees depressed teens who are referred to his mental health clinic inside the Charles B. Hwang Community Health Center, located just off Flushing’s bustling main artery of shops, banks and Asian restaurants. 

Inside his office, Ho, whose affability helps him to connect with teens, says that it can be hard to spot the ones who are depressed. Yes, some, like Jason, isolate themselves. Some also cut themselves, drink or abuse drugs to cope. But many are adept at hiding their depression, he says. “From the outside, they may look popular and fabulous, but deep down, they may feel so bad about themselves.” 

Ho’s young patients don’t use the word “depression,” he says. “But they will say that they feel bad all the time and don’t see the point in doing anything. Or some of them feel that they are a disappointment to their parents, so they don’t actually feel depressed, but guilty.” 

Make no mistake: most Asian American teens are emotionally healthy and thriving. But government statistics suggest that a substantial number struggle emotionally. Among Asian American high school students, 29 percent have reported feeling “sad or hopeless” for at least two weeks in a row during the past year, enough to interfere with their daily lives, according to a recent national youth survey conducted by the Centers for Disease Control and Prevention (CDC). That figure is slightly higher than that of teens from all racial groups, 28 percent. 

With suicidal thoughts, the gap widens. When the CDC asked Asian American students if they had seriously considered suicide during the past year, 19 percent answered yes, compared to 16 percent of all high school students. About four percent of Asian American teens reported a suicide attempt within the past year that required medical attention, compared to two percent of all students. 

Of course, not all teens who report sadness and hopelessness may actually be clinically depressed. But in 2003, social worker Teddy Chen, Ho’s colleague at the Charles B. Hwang health center in Manhattan’s Chinatown, conducted a survey in which 1,032 healthy Chinese American children, ages 12 to 18, had undergone a professional mental health screening. In a finding that Chen calls “alarming,” the screening discovered that 12 percent showed signs of depression. 

And yet, these children’s parents often declined help. As Chen noted in his assessment, “The high refusal rate reflects the significant barrier to providing mental health care to Asian American children.” 

 
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