According to WHO, mental illness affects one in four individuals.  More specifically how does this affect Asian Americans (and not Asian-Americans. In respect to Asian Americans and Filipino Americans, we will not be using a hyphen. In respect to non-binary Filipinos, we will be using the ‘Filipinx’ iteration.) 

In a study done on the cultural factors influencing the mental health of Asian Americans, key cultural factors act as barriers to Asian Americans when receiving health care: language, level of acculturation, age, gender, occupational issues, family structure and intergenerational issues, religious beliefs and spirituality, and traditional beliefs about mental health. However, a young, anonymous Filipinx American source, not related to the aforementioned scientific study, reached out to me personally and was unsure if they could pinpoint a single cultural factor that affected their revealing their depression to their parents. 

They stated, “I ultimately didn’t think they would believe me, so whatever category that falls under.” We will refer to this anonymous source as J.

They knew they had “a type of issue” because of their constant worrying. They can recall instances in elementary school of excessive stress over homework and behavioral discipline, which would not have aggravated other children. However, once they were a junior in high school, they realized they may need help once a friend reached out to a therapist and J found themselves identifying with a lot of the same struggles, emotionally and mentally. While this was validation of their own feelings, J still decided against seeking help for themselves. J refused to reach out to their parents was the underlying fear that their parents would not believe them. They acknowledged they lived a privileged life; there was no reason, logically, to “disrupt” their family life if there was no “real reason.” 

It took a catastrophic event for J to attempt to reach out to professionals, and even later to reach out to their Philippine-born Filipinx American parents. At the time, one of J’s friends committed suicide, which not only affected J internally and emotionally but their friend circle as well. J approached their mother first when their father was working night shift. J went to their parent’s room and despite the apprehension in revealing something previously so private, J confided to their mother that they believed they had a mental illness. 

J’s assumptions were true—their parents did not believe that they had depression, let alone any kind of mental illness.  After this confession, J’s mother informed their father. J’s parents told them that they didn’t need help. After reflecting on the situation, J now believes that their parents were dismissive of the confession because J approached their mother in a dismissive tone. J was having a panic attack, and their mother was doing her best to calm them down. While J’s mother was soothing J, she insisted that it was “just something they were going through” and that “this feeling would pass,” as opposed to accepting it as a symptom of mental illness.

Unfortunately, it took a desperate cry to catalyze change. What was once a staunch position against the mere existence of mental illness became a moment of clarity. J admitted to their mother they “wanted to die.” J and their parents went to a therapist together to talk about mental illness and what it means to be diagnosed with depression. In retrospect, J believes this is the epiphany her parents needed to accept J’s mental illness. The therapist described in detail the science behind depression and the options available to J to help combat depression. Once J’s parents were informed and in the presence of a respected profession, J felt that they were starting to believe them. 

Ideally, J’s parents would have believed them upon their initial confession. However, after speaking with J’s mother after the fact, she admits she was in denial. She was afraid of how their extended family members and friends would react to discovering J’s mental illness. She believed her child was perfect and felt that if J was diagnosed with depression, it would take away from her perfection and label her and her spouse bad parents. However, if it takes a meeting with a professional therapist to help dispel incorrect stigmas of mental illness, then sources and services should be in place to make access to this knowledge universal. 

All instances of depression are unique as all individuals are unique. While this source is Filipinx American, that does not necessarily mean their experience is synonymous with other Filipinx Americans experiencing depression. However, there seems to be a universal pause, a fraught reluctance to divulge a condition one would hope to trust the care and attention of to their parents. 

It could be due to the lack of knowledge. The study mentioned earlier by Kramer, Kwong, Lee, and Chung specified the data collectively as “Asian Americans” with data surveying multiple Asian groups in America. However, cultures within Asia are distinct; Asians are not a hegemony. As awareness of mental illness and the importance of mental care is surging and a resistance to the stigmas toward mental illness is forming, what stops Filipinx American families from accepting and seeking help for these mental illnesses? 

J approached their parents with their mental illness, and while J’s parents love J wholly and unconditionally, J was met with doubt and hesitation in regard to the acceptance and understanding of their mental illness. The barriers that affected J were primarily traditional beliefs about mental health. It seems that J’s parents’ initial reaction would be the opposite, as they are college-educated, white-collar, healthcare providers in the United States. So, if mental health awareness can slip through the cracks with two Registered Nurses, what can be said about those with parents who aren’t in the medical field?

While J’s parents are college-educated, Registered Nurses, they still adhered to an underlying, unsaid notion that speaking of mental illness just wasn’t done. And since this is unsaid, there are no conversations pinpointing any particular reason as to why. There is a term, utang na loob (ooh-tang – na – low-ob), which translates to “debt of gratitude.” To J’s father in particular, J did not have anything to want or worry. They lived a comfortable life in rich and powerful America. Reflecting back to his childhood in the Philippines and the arduous lengths it took for J’s father, his siblings, and parents to immigrate to the States, this seemingly “invisible” enemy within J’s mind was nothing in comparison to the physical labor, stress, and sacrifice he endured to provide a better life for J. Was J not grateful? Did J not have this understanding of utang na loob? But that in itself may not be the case for all Filipinx Americans. Some Filipinx communities have been in America since 1763.

For those Filipinx Americans who are religious, as the country is predominantly Catholic, one argument may be to refer to God, or that the reason one is afflicted is because they are not in “conversation” enough with God or the scripture. Or, maybe it’s simply tied back to the fact Filipinx families still attempt to present an image of unity and strength, and having a mental illness, to them, means they are not “mentally strong.” There isn’t a study to find and quote at the moment, but it can be universally understood that the idea of family is integral to the Filipinx and Filipinx American identity. However, it’s hard to hone in on exactly what it is that causes apprehension towards talking about mental illness. 

The Philippines is incredibly diverse. With the language itself, the country is estimated to have over 170 present. There are more than 7,000 islands within the Philippine archipelago, and the country is divided into three island groups: Luzon, the Visayas, and Mindanao. 

J’s mother is from Luzon, specifically Quezon City, and speaks Tagalog. While Pilipino and English are the country’s national language, Tagalog is the most widely spoken. However, not everyone speaks Tagalog. Within Luzon itself, the largest island of the Philippines, the people and languages spoken range from Ilokano, Kapampangan, Bicolano, Tagalog, and Pangasinense. Venture a bit south to J’s father’s family, who is from the Visayas. He and his family speak Visaya, or as it’s correctly spelled, Bisaya. But within the Visayas, people from Cebu, like J’s father’s family, or Cebuanos won’t say they speak Bisaya; they’ll say they speak Cebuano, as the people within the Visayas all speak their own language. J’s lola, or “grandmother” in English, once stated, “We do not speak Bisaya. The Waray, Boholano, us Cebuanos, we do not speak Bisaya. We speak our own.”  

The reason for this explanation is to detail just how vast and various the Filipinx experience is. Throw in the American and individual experience, and now the broad “Asian American” studies seem futile. The rise of studies aimed at the reception and acceptance of mental illness can and will help bridge the gap between generations. Fil-Ams don’t ask for help because there isn’t any help available. Filipinx Americans need studies regarding mental health specifically honing in on the different groups and languages available in the Philippines to illustrate and guide those who are a part of its diversity. 


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