First-generation Canadian, or ‘first gen’, is an identity that carries its own benefits and challenges. A benefit is that it is often associated with opportunity. However, one challenge is that of being “in between cultures” – finding the perfect balance between embracing and maintaining ancestral traditions while adopting “new” westernized, Canadian values. This is especially the case when first gens seek an understanding of their health and health resources, which are largely shaped by the values of the society in which we live. Mental health is no exception.
We often hear about stigma and barriers when we talk about mental health. Culture is one significant player in those kinds of topics. Culture affects the way we understand mental health. It affects the way we perceive ourselves and others in regards to mental health and methods we use to overcome mental health problems. While culture is often associated with positive tones, it can be limiting in the mental health conversation.
Collectivistic vs. Individualistic Cultures
As a first gen whose parents were born and raised in China, I was essentially raised in two different cultures: the Chinese collectivistic culture when I was at home, and the Western individualistic culture when I was at school. In the Chinese collectivistic culture, the focus is on the well-being and balance of the group rather than the individual. In terms of health, this meant that, growing up, I rarely expressed feeling unwell. Since the family also plays a significant role in decision-making, any such expression could create an “unnecessary” responsibility or burden on my family. While it is much harder to hide physical illnesses (where the symptoms are visible) from your family, it is much easier to hide mental illnesses where the symptoms and signs may not be so obvious.
This train of thought conflicts with the Western individualistic culture, which focuses on the individual and encourages autonomy. Mental health and illness are complex. A focus on the individual leads to a better understanding of the person’s experiences and thoughts, as well as the support they need and want. But the group focus of collectivistic cultures may make it easy for someone to forget to focus on him or herself.
The Limiting Nature of Culture and Language in Mental Health
I could go on for quite a while and talk about how limiting culture can be in the mental health conversation. So I welcome all of you to give me your thoughts. But one limiting factor of culture that I have observed is language.
Different cultures perceive and understand mental health in different ways. Naturally, the language available for this conversation would reflect what each culture understands and believes – from the vocabulary (both professional/technical and layman/slang) to connotations of the available vocabulary.
The available vocabulary not only affects how much we understand the complex spectrum of mental health, but it inevitably affects how we access treatment and support. If a particular culture perceives mental illness as a weakness, the language will reflect this. The words used may have negative connotations to other things that are considered negative. Or they may historically have been used to explain or describe something bad. For example, an everyday conversation about mental health in the Chinese language will still use the term for “mental illness” instead of “mental health”. In the Canadian context, we know that these two terms mean different things. Our conscious efforts to select one term over the other in everyday conversation reflects our progress, or lack thereof, in moving away from stigma. So this shows how the choice of words reflects the stigma that still exists in the Chinese culture.
The vocabulary or terminology may also simply be lacking. For example, in the English language we have concrete definitions for concepts such as anxiety, but this is not the case in the Chinese language. A lack of appropriate and commonly-understood vocabulary makes it difficult for someone to adequately express what they are experiencing so that they can get the help they need. The terminology for one concept can also have different connotations in different languages. This creates another challenge for first gens when they are trying to understand their own mental health while explaining it to family who are not familiar with the terminology and concepts.
As you can see, culture and vocabulary have a strong impact on how, and if, someone receives the support and treatments they need. And when someone like me – a first gen – has to balance two cultures and two languages, you can imagine how difficult it can be to explain mental health and illness to someone, like a parent or grandparent, who does not have the same vocabulary I have from being formally educated in a different culture and language.
A lot of the mental health conversation right now is about stigma. But for a lot of first-gens like me, the conversation sounds a lot more like educating our families about vocabulary they are not familiar with. Our conversations involve a lot of bridging the gap and establishing mutual understanding.
There are a lot of barriers to mental health and illness support. For those who experience two different cultures, such as first gens, newcomers, and refugees, culture can complicate the way we talk about mental health and illness. It can also affect how we seek appropriate health and support services that meet the middle ground between the westernized values they are founded on and other cultures’ values, beliefs, and understanding.
One of the perks of growing up and living in such a multicultural community is the opportunity to understand different cultures. With regards to mental health, by no means does one culture “have it right”, nor is one culture more progressive than another in mental wellness pursuits. The cultural limits I have discussed exist in a context where there are conflicts between different cultures’ values and beliefs. However, each culture’s unique way of understanding mental health or providing support still help many people. Understanding how another culture supports people with mental illness may even help you find a new, more suitable treatment or therapy that you had not known about before. In a multicultural society like the one we live in, it is important to understand how different cultures work together to create unique mental health experiences for different individuals. The challenges I have talked about show how important it is for mental health education and resources to be culturally relevant. This is especially the case in Canada where mental health education and resources are strongly grounded by western values.
Personally, I hope that cultural relevance and awareness will be a greater part of our efforts in reducing mental health stigma. Culturally-aware services in mental health not only benefit the individual receiving those services, but also their families who may need help understanding mental health from an alternative perspective.