(birds chirping) KELVIN NGUYEN: I had a knife and I brought it into my room.
(knock at door) My family called the police.
(knock at door, knob rattles, emergency radio plays) I was having a mental health crisis.
Why would the police be called for something that I am suffering for?
TINA MCDUFFIE: Who do you turn to for help?
The folks in my area were all struggling with one thing or another.
I can't say that I was relevant, um, to notice.
MCDUFFIE: Are you seen, heard, understood?
NGUYEN: In the Asian American community, saving face is a really big thing.
For me, as a Muslim, I couldn't relate to mainstream behavioral healthcare.
I was so lost.
♪ I was just desperate for help.
They didn't have the training.
They didn't know how to treat my child.
MCDUFFIE: How can the mental healthcare system deal with the issues of stigma, diversity, access?
We are seeing disparate experiences of people based on their race, their gender identity, disability.
It is so multifaceted.
MCDUFFIE: These healthcare professionals are fighting to dismantle and transform the existing Eurocentric mental healthcare system.
NATASHA STOVALL: There's all of these ways in which the psyche is constantly being pushed, and pulled, and frustrated that we conceptualize as just normal life, but it really is normal life inside of a European-descended framework of living.
This isn't cross-cultural.
LINH AN: It's a Eurocentric system that emphasizes speaking English and speaking this jargon of biomedical objectives.
You are causing violence to people that don't fit into this model-- it is racism.
HOOMAN KESHAVARZI: Our research shows what the barriers are: language, culture, religion.
VIVIAN JACKSON: We're not going to close the gap unless we actually take an extraordinarily holistic perspective in fighting on all fronts.
MCDUFFIE: "Decolonizing Mental Health" on Local, U.S.A. ♪ (thunder rumbling) PAUL HOANG: Every second of my life, I thought about killing myself.
(thunder rumbling, people talking loudly) Every second of my life, I was angry.
I did not realize I had suffered severe depression.
For a kid, my mind was filled with anger.
My name is Paul Hoang.
I am a licensed clinical social worker within the state of California.
I am Vietnamese.
My dad and my two older sister, along with 27 other men, women, and children, escaped Vietnam by boat in the late '80s, after the Vietnam War.
We were on the ocean for about 30 days, struggling with starvation, near-death experiences, with Thai pirate attacks, with multiple perfect storms that just tossed us like a ping-pong, waves after wave.
(thunder rumbling) ♪ I've never realized how impactful that experience was on me when I was just seven years old until I entered a seminary post-high school.
That's when I've learned I had PTSD, I had depressions, I had mental illness.
♪ Did not know the concept of mental illness, and there's not even vocabulary to talk about mental illness in our culture.
It was quite... eye-opening.
It's an opportunity to better understand why, every time I see a person who's of Thai origin, that this whole rage within me would come up and I want to beat him up.
(thunder rumbling) Why, growing up, every time I see a stormy weather or cloudy sky, my whole body would shake and freeze.
None of my family member know what was going on.
I was very good at hiding.
I was still able to focus on school and get straight As.
♪ In Vietnam, when someone is seen or perceived or diagnosed to have a mental illness, they get lock up in a institution.
They are treated as subhuman-- not even human.
They will get whip, they will get punished.
Even family member would cage them and display them in front of the house as, like, a show.
These are the experiences that, as a culture, people are scared as hell.
I don't want to be anywhere associated or near to anyone who is seen as crazy, even to a location that would associate me to someone who's crazy.
♪ In my first year in the seminary, I wrote about my experience.
One of my professor was a psychologist, and he was a priest, referred me to my spiritual director, and she provided spiritual guidance and counseling.
That was the moment that really transformed my life.
♪ Working within my own community, I tend not to use mental health terminology.
That I need to be able to reframe it in a way that's culturally and linguistically neutral and more positive.
♪ And so in our cultures, not just the Vietnamese or the Asian community, we emphasize a lot on education and on success and on self-reliance.
All of us, whether we have a mental illness or not, we all want to have a successful life.
We all want to have a healthy life.
We all want to have a happier life.
Then we start breaking it down.
"Okay, what are the barriers for you to get there?"
And then we tackle each of that as behavioral, as practical concept, and concrete.
Because I can have people say, "I hear voices."
Great, you hear voices?
How does that voice contribute to your success?
I have clients who's, like, "Hey, I have, my, my voices is always pumping me up, cheering me on."
Great, keep it-- I want that same voice.
♪ I look at functionality.
I look at integrations of holistic health.
It's a matter of perception and it's a matter of what works for you and for the community.
Clinician tends to stereotype and generalize and take one mold and apply onto another, instead of personalize every individual for who they are and the subculture that that person is.
Even among the Asian community, there are so many different subcultures.
And that has been an ongoing challenge within the system of care, especially during this time of so much high tension of racism, and discriminations, and violence.
It goes back to this, in my opinion, this, this concept of, we all have to be the same.
There's no room for differences.
Treat each individual as an individual.
Treat the person as a person.
♪ ♪ JACKSON: As a young girl, I was thinking of service.
I mean, service seemed to be part of my DNA at the time.
My father grew up in Western Virginia.
His father was a farmer, and a preacher, and an activist for issues that related to race in that community.
♪ I was at Georgetown, and there was a conversation about disparities, but very generic-- very generic.
And it was as if, if you had Black providers, that would fix disparities, or if you had Asian providers, that would fix disparities.
And I said, "No."
(laughs) I said, "No, it's more than that."
♪ The six As, for purposes of our conversation, we have split them apart.
In reality, they all work together.
They, they all intersect with each other.
♪ Does the service exist at all in my area?
We can't do anything about disparities in terms of mental healthcare if the services do not exist where people are.
♪ As I think about a mother who has three small children, and has an appointment to take one of those children to a mental health visit, but don't let her be late, and then be blamed for being late when she did enormous amount of effort to try to get there, and it's not her fault.
♪ So the, the service may actually exist in the community, but if they don't know that the service is actually there, they're still not going to be able to take advantage of it.
♪ The service can be there, the service can be known to you, but they're asking for $15 copay, and you don't have it.
So now what?
♪ We're constantly confronted with the fact that the care that is offered may not be high-quality, and may not incorporate the cultural twists that comes with, with our work.
So we need to be really mindful that, that we want people to get what it is that's appropriate for them.
♪ Culturally, first of all, we need to be on the same page, that there is an issue that needs to be addressed.
What is the "it" that is the problem?
We have teachers who will refer children for mental health services when the family's going, "Nothing wrong with that boy."
Because the cultural frame around when you need help may be different.
♪ Why we are seeing disparate experiences of people, based on their race, or their gender identity, or disability, it is so multifaceted that we're not gonna close the gap unless we actually take an extraordinarily holistic perspective in fighting on all fronts.
♪ ♪ (children laughing) ♪ STOVALL: I love this metaphor of whiteness being like Christmas, but it's also Christmas that never ends.
You're just constantly in this, like, Groundhog Day of Christmas.
Psychoanalyst Melanie Suchet, who's South African, talks about, that, "You can never get out of whiteness."
(children laughing) I always knew I was white, from a very young... Like, I didn't grow up in colorblindness.
I grew up in Washington, D.C., which, when I was growing up, was a majority Black city.
My parents were very sincere about wanting to be part of the solution of racism, and were both involved in the civil rights movement.
I think I just grew up with an understanding of myself and my family as being part of the solution, not part of the problem.
♪ But I think the thing that's important for the work that I'm doing now is that, despite the fact that my family was sort of more conscious of race and racism and not wanting to contribute to that, nonetheless, the patterns of our family in many ways reinforced the larger structure of white supremacy without much thought.
♪ I was working in a state psychiatric hospital.
There's a big economic and structural component to why people are there in the first place.
Usually, people in state psychiatric hospitals are poor.
By the time that they get there, they've usually been failed by social systems many times, for many decades.
Whether it's education, housing, incarceration, violent communities, lack of access to healthcare, there are all of these ways that people are traumatized by the social structures that are supposed to be helping, but also that these social structures are sort of actively interfering with people trying to get better on their own.
♪ I was encouraged to reflect on my own experiences and my own what we call "social location" and my own background, and to understand why my experiences were not really translatable-- that I was gonna have to learn a lot about how the world worked, about how these systems worked, to become more realistic myself.
I had a lot of training about being a culturally competent therapist for people who were not white.
But when it came to working with people who were white, there was no such thing as cultural competency.
♪ When I transitioned to private practice, it was almost like a switch flipped.
I was working with this completely different demographic of people, mostly professional, mostly white-collar, and mostly white.
♪ One thing I immediately noticed is that social systems were not something that we discussed.
Whatever the situations were that were causing people stress, like relationships, family, work, illness, grief, trauma, none of this in any way was related to the social structure.
And it certainly wasn't related to race.
The therapy that I was doing was just totally colorblind and race-blind, and that felt strange, but it also felt suspicious.
Like, it didn't seem realistic to me.
I didn't necessarily completely believe that that was honest, but I felt that people were very...
Were really socialized not to talk about race, and with another white person, especially, there was no reason to.
There's all of these ways in which the psyche is constantly being kind of pushed and pulled and frustrated that we conceptualize as just normal life.
But it really is normal life inside of a European-descended framework of living.
This isn't cross-cultural.
This need to define, to advance, to rise above, to kind of keep on moving.
You know, the difficulty sitting still, the anxiety, the kind of defeatedness when there can't be constant progress, which is the depression.
You know, the rage that comes from feeling like I, I... You know, I'm not getting what's coming to me, what's due to me.
(people shouting) STOVALL: There should be more attention paid in the training of psychotherapists of how they're gonna work with race with white clients, as opposed to just maintaining this kind of colorblind therapy that is the norm.
Yes, there's resistance, but there's also a hunger for white clients in therapy to be able to use the space to actually talk about things that they find difficult, or that they want to do differently.
♪ (birds twittering) ♪ NGUYEN: I had a knife and I brought it into my room.
(knock at door) My family called the police.
(knock at door, knob rattling) I was having a mental health crisis.
DISPATCHER (on radio): At this time, we have you at Lee 3431.
NGUYEN: Why would the police be called for something that I am suffering for?
Am I a criminal for, for feeling this way and having these inclinations of not wanting to live?
(sirens blaring, footsteps running) That was a very bitter taste about what mental health crisis intervention looks like.
♪ There was a lot of stigma within my household.
And so, when I was in high school, I wasn't actively aware that, that therapy would be a good benefit for me, because that conversation was never had.
In the Asian American community, there is a lot of resistance for finding care that is... Is n...
I guess... Not abrasive to other family members.
And so, saving face is a really big thing, especially the culture that I come from.
♪ When we look at how can we find the best type of care, a lot of times that type of care is passed through word of mouth or recommendation.
And a lot of those types of interactions are not happening because of this social taboo, or the mental health stigma of sharing about one's issues, or the issues about their children, to find the best services for them.
It becomes an endeavor that I feel like the parent feels that they have to do themselves, or they can't trust anyone to help them with that.
♪ I went to University of California, Irvine.
I sought out counseling for the first time in my life, now that I had the resources.
So it was through the university's insurance plan that I was able to get services for mental health.
That was that safety net for folks like myself, who come from a background of not being able to even seek dental help, or even seek normal health, let alone mental health.
From that experience, I realized how, how nurturing it can be.
♪ I am currently the board president of Viet-CARE, which is a grassroots non-profit addressing a lot of mental health issues, and reducing the stigma within our communities.
We're a 100% volunteer-based non-profit, and every single one who comes out to our events are community members, and so we're all homegrown.
We're just young, scrappy, and hungry to create change.
(birds chirping) It's been a very great learning experience for, for myself through mental health.
I wouldn't have been here if it wasn't for my mental health challenges.
It wasn't until I was pushed to my very last moments of crisis that I, that I sought after these resources.
The U.C., Irvine system for mental health services, we are only allowed to, to have, I think, 12 weeks of sessions.
That mental health treatment for me stopped then.
Right now, I feel like a lot of my self-care comes from caring about others, but I'm finding that balance.
We're still learning, right?
We're still realizing where we are and where we're going, you know, but, yeah.
That's, that's right now.
♪ (singing in Spanish) - (slowly): My birthday... - "My birthday..." - ...is May 16th.
- "...is May 16th."
How old you going to be this May?
Anything else or should I go?
- You go.
My name is Rosalba Calleros, and I'm Alan's mom.
I've been working in Texas Parent to Parent for 11 years.
We are a non-profit organization.
- (laughs) - And we provide information and support to families who have kids with disabilities.
And you can see that Alan is very proud of that.
(laughs) ♪ He is my first child.
He was born with cerebral palsy.
He is extremely social.
He loves to be around people.
(band performing, audience clapping along) ♪ Baby, hablando in Spanglish ♪ A couple of years ago, something happened and his personality changed completely.
We didn't have any signs of why he was behaving that way.
So we started exploring mental health.
After having a child with cerebral palsy for 19 years, I was pretty good on following up with all his treatments, whatever they were, but I had no clue what to do with mental health.
♪ Because of the work that I do, I always refer people to their local mental health authority, and they did an assessment on him.
I don't think that they, they adapted the assessment to his needs, because obviously, before the mental health issues, he has a developmental disability.
And they were not asking the right questions.
They were asking questions like, "Okay, when you're feeling this way, "do you feel the impulse of "buying stuff or driving fast, or maybe crossing the street without paying attention?"
Like, he uses a wheelchair for mobility.
He's not going to do anything of that.
And he was given the diagnosis of bipolar.
He was very edgy.
And with those kind of questions, they lost him, completely.
He had an incident there that was very dramatic, when he started, like, destroying things at the office.
And basically, I was walked outside with my child.
He did some damage with his power chair on a car in the parking lot.
I was totally ashame.
At the end, I realized that it was the nurse car, the one that walked me out.
(laughs) I'm sorry, I wasn't supposed to be laughing at that, but... - I'm sorry.
- That, it's... Good.
I mean, it's not good, but you were not yourself.
You would never do something like that.
- (murmurs) - In the right mind, right?
He knows really good the difference between good and bad.
And he's an awesome guy.
♪ I was so lost.
I was just desperate for help.
I think that they didn't have the resources.
They didn't have the training.
They didn't know how to treat my child.
Probably they felt lost, the same way that I, that we were feeling lost.
♪ They need to have better training and better knowledge of developmental disabilities, and a better way to communicate with them.
He understands and he's bilingual.
But you need to be patient and creative on talking to people with developmental disabilities.
You can't just go to, "Oh, let's see how it works."
Because it's not going to work.
You need to get training.
You need to get the tools.
♪ I had a very awesome network of support at work.
But what about if I didn't have them?
Probably I would be completely lost right now.
MAN: Here we go!
(laughing and cheering) ♪ ROSALBA: Having a child with a disability comes with many challenges.
This is another one.
But with the right support, we can, we can go through this.
- Yes, ma'am.
- "Yes, ma'am."
(laughs) ♪ I'm sorry for the dog-- hey, get down!
♪ ♪ ♪