March 29, 2024

Mental Health in the Asian American Community Episode Transcript

Return to Episode

Cindy Lopez: Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. Join our guest host Natalie Tamburello, Community Engagement Manager at CHC, as she engages in a candid conversation about the unique challenges and stigma surrounding mental health and the Asian American community with our guest experts from CHC, licensed psychologist, Dr. Emily Hsu and licensed clinical social worker, Thuy Tran. They discuss not only what they’ve experienced professionally, but also personally, as Asian American mental health professionals. Listen in to gain a deeper understanding of the unique challenges and learn about navigating language barriers, how love is expressed differently in Asian communities and how we can build cultural bridges with empathy and understanding.

Natalie Tamburello: I’m Natalie Tamburello, and I’m excited to guest host today’s episode discussing mental health in the Asian American community with Dr. Emily Hsu and Thuy Tran, who are both professionals in the mental health field. 

Natalie Tamburello:  Dr. Hsu and Ms. Tran, tell us a little bit about yourself and why this topic is important to you.

Dr. Emily Hsu: Hello, I’m Dr. Emily Hsu. I’m a licensed bilingual clinician. I work in the community clinic, which primarily serves the Medi-Cal population. I provide parent collateral. I’m also an evaluation clinician. I identify as a second-generation Chinese American. And this topic is important to me because I went into the mental health field because I wanted to understand what were some of the ways in which Asian Americans, the AAPI community, Asians in general express emotional distress and how do they seek help when needed. And this topic is very important to me because I think it’s great to facilitate a dialogue about the barriers and ways to increase engagement.

Thuy Tran, LCSW: My name is Thuy Tran. I’m a licensed clinical social worker. I’ve been in this field for about 16 plus years working with children, youth, and families in various capacities. What I’ve done in the past is I’ve actually worked with refugees, asylees and victims of human trafficking. So, I’ve seen quite a discrepancy between Asian American communities versus other ethnic groups. So this is partly why I wanted to be here today and share some of my experiences.

Natalie Tamburello: Thank you both. I’ve read that the U.S. Asian American population is 50 percent less likely than other ethnic groups to seek mental health support, and I’m wondering why you both think that is.

Thuy Tran, LCSW: Well, a lot of it has to do with stigma, shame, saving face. Mental health issues (or professions) is somewhat of a foreign concept. I’ve worked with a lot of Southeast Asian families who view individuals as–they’re either normal or crazy. And crazy people pretty much end up in a mental institution, and family members who suffer from something like schizophrenia, or bipolar are typically kept at home and said to be either possessed by spirits, or has a weak state of mind, or even minor personal problems. So the underlying message is unless you want to be labeled as crazy, possessed, or a contributor, you know, of shame to your family, then why would you be seeking help? So, obviously getting mental health services requires the individual to a certain degree admit that they’re crazy and a lot of families live in multi-generational units, where parents and their children, as well as grandparents, are living under the same roof. So expenses for such a big family are often taken seriously. So, it comes down to time and money. An example is in Thailand, a scarcity of mental health providers, which average about 1.2 licensed clinicians to 100,000 people and most of these providers are more accessible to private hospitals. And therefore services are hardly given to low income residents. As for Vietnam, they spend about 6.8 percent of their GDP on healthcare. And even then, community mental health was mentioned in three sentences out of a 51 page report from the Ministry of Health. And the majority of the mental health facilities focused mainly on schizophrenia, bipolar, or epilepsy. None of it has anything to do with depression. 

Last but definitely not least, I think a big huge barrier is language. And we’re not talking about language parents versus, you know, the Western language. I’m talking about within the family dynamics as well, like, we have first generation parents who barely speak any English, raising children who can barely speak any of their parents’ native language. So, in that sense, it’s very difficult for the youth to express the magnitude of their mental health struggles.

Natalie Tamburello: Yeah, that’s really interesting. I never thought about it as a black and kind of white issue when it comes to mental health. It’s like there’s extremes. You’re either fine or there’s a very significant mental health challenge. That’s really interesting. Dr. Hsu, do you have anything to add?

Dr. Emily Hsu:  I agree with everything that Ms. Tran stated. My experience is with the Chinese American population. My family is unique, and so I’m going to speak more on my experiences and the communities I work with, and that even though I identify as Chinese, my father is Chinese and my mother is also Chinese, my parents were born in different regions of China and my mother immigrated to Taiwan, and anyone hearing this is going to understand why I’m talking about where my parents are from, because I do think that really influences their experiences. And then why I think anyone who shares similar stories or experiences, why they may not seek mental health treatment, but to go back to my parents, my father is Chinese, but he was born and raised in Busan, South Korea. So we do have a Korean influence in my family as well. My mom was adopted and my father is a refugee from South Korea, and his parents are refugees from China and also from South Korea. And so I think in general, going off of what Thuy said and I appreciate what she talked about, you know, just some of like the stigma and how individuals manifest challenges. I tell you this background because I think there is that perpetual foreigner stereotype, where you don’t look like the majority.  I get people telling me, wow, your parents speak English so well. And so there’s that perpetual otherness. I think that still continues. I mean, to this day, even as a mental health clinician, I think there is that perpetual otherness. And I also think, going back to my parents’ experience, there’s a lot of trauma, you know, from conflict areas. And it’s not just even trauma from war, it’s trauma from immigrating and leaving everything you knew to come to a country that is completely different, being asked to take on their cultural norms, but also being rejected because while you’re trying to speak the language, which is English, trying to wear the clothes that appear more Western. We know from history of how Asian Americans were treated. And I do also want to note, when I say Asian Americans, I also mean the AAPI community, which as we know is the Asian American Pacific Islander community. They were rejected. There were laws that were literally created to stop Asian Americans from immigrating. And so I think I’m touching upon trauma, which didn’t stop with the generation before me and identified second generation came in. So there was trauma. There was the concept from trauma of ‘I need to survive. So I’m not going to talk about my mental health.’ And Thuy talked about language. I appreciate her mentioning that because I don’t even think there’s a language for mental health issues, depression, anxiety. There is no language for that. There is emerging language for that in the past couple of years, but I also think about how we talk about stigma, and yes, but I think that stigma in seeking mental health services was also born from the survival mentality and from trauma, which is, I have to work hard to prove that I belong here, and why would I go to an institution that was traditionally not for me, didn’t want me here in the first place? So I think there’s multiple layers to unpack.

Natalie Tamburello: With some students that I’ve worked with they often mention that they feel like their mental health challenges aren’t significant enough compared to what their parents went through who are immigrant parents, Asian American parents who weren’t born in the United States. Is that something that you feel like resonates with you in your story too?

Dr. Emily Hsu: I think it does. You touched upon something that I was thinking of talking about later, is the idea of suffering. Suffering is suffering, right? And I think there’s this idea where, from the older generation, we’ve suffered, suck it up. Stay in that job, even though it’s causing you distress. Get a pension because that means success. Get a college degree. Struggle through it, because struggling and suffering has been–in my experience, and I’ve seen this in other ethnicities, and I was speaking about Chinese, Korean, and Japanese, the Filipino culture when I’ve consulted, because I really wanted to get their perspective. Suffering has been equated to being successful. If I’m not suffering, I am not successful. So I have seen that difference of a lot of individuals who identify as second generation, third generation, fourth generation, feeling as though I should be better or even if they leave that job because they’re not happy, they’re getting feedback from some of their parents, the older generation, why don’t you just stick it through, you know, like if you just do this, it’ll be okay. And so I do think that there is that my suffering compared to my parents and my grandparents, it’s not true suffering. And there’s also that feedback of, you think this is suffering? I survived war. So there is, I think, both things going on. And I think it’s because at the end of the day, suffering– I don’t think I realized this until like more recently when I was having conversations with other individuals who identify as AAPI in preparation for this podcast, just how much suffering and equating that with success has been embedded in our culture.

Natalie Tamburello: Yeah. Ms. Tran, does that resonate with you? 

Thuy Tran, LCSW: Absolutely. Absolutely. I think there’s also the capacity to understand. I mean, if we’re talking about parents who were raised in a culture where mental health doesn’t exist. So it’s almost like speaking another set of language, right? And obviously there’s a poverty component as well. If you are poor, you’re focusing on more survival. So it’s a different state of mind. Like I don’t have time to, you know, hem and haw, how exactly–it’s more like–let’s make sure we have enough to eat. And all the needs are being met. So that’s why even love languages, for them, they show love as in, “Oh, what are you craving for? What do you want me to make today?” Right? So in that sense, it’s difficult for them to understand what is the concept of feeling depressed or feeling anxious and not realizing that anxiety is just an extreme form of stress.

Mike Navarrete: CHC’s Voices of Compassion podcast is made possible by the generosity of people like you. To learn more about supporting CHC, go to  Also make sure to follow us on social media for more inspiring and educational content from CHC.

Natalie Tamburello: We’ve talked about this a little bit, but how do family dynamics influence conversations around mental health and or seeking help for mental health?

Dr. Emily Hsu: I think that it’s one of those things where Ms. Tran touched upon, this is, like most cultures, the Asian American family dynamic is not just the immediate family, it is the extended family. And I think that depending on what generation you identify with because every family is different, there has been traditionally one of those understandings that, for example, Eastern families, when I say Eastern, I mean Asian families are a little bit more authoritarian. There’s been that stereotype, and what I mean by that is there’s a certain weight in order to parent. The Western community has been stereotyped as being a little bit more authoritative. And I want to highlight those two, authoritative versus authoritarian kind of styles within the household, because I think that doesn’t capture the fact of how, and I think Ms. Tran touched upon this, how we express our care in the Asian family. Care is not expressed stereotypically speaking again. This depends on which generation in terms of saying, “I love you. I’m proud of you.” Labeled praise is not something that we typically see within a family unit. Our love language is. “Are you hungry?” or, I’m going to switch to Mandarin Chinese: 你吃过了吗 which is, “Have you eaten?” I’ve seen that in familial conflict being a way to show that a parent is being, like, “I’m sorry,” and there’s even a meme about how sorry a parent is by how big the fruit is that they bring to their child, right? The bigger it is, the more ornate it is, the sorrier they are, but there isn’t that idea of maybe explicitly saying, “I’m sorry that I yelled at you.” There isn’t that kind of language to really process it. And this type of parenting also focuses a lot on academics. And again, a lot of people might think that’s authoritarian. There is no love, it’s cold. And I would say that’s not necessarily true. It’s just a different way of expressing language, where in my experience and from what I’ve heard from, and I’m speaking about the Chinese, Japanese, and Korean culture. And specific from my experience, if this is a mother-father unit, or any type of family unit, there is an emphasis on education and the parent typically it has been the mother is the one that really, this is definitely seen in Japanese culture, focuses on making sure that the child is set up for academic success. I remember growing up, my fun time was going to Kumon, getting tutored at the Sullivan Learning Center. There was just this strive for if you are successful academically, you will succeed. And so I think that’s what the family dynamics is where love is shown in that way and everyone has a role to fulfill. And there are other things that I can add to it if that would be helpful, but I do think it’s one of those things where there’s a lot of focus on success academically, which then moves to success in terms of the family unit, which could be marriage, having a child so that you can build. And also we take care of our own. That’s something that I also hear in most Asian cultures, where it is typically expected where you take care of individuals like your parents, whether that’s moving in with you, and they typically live in the family unit with you.

Natalie Tamburello: Ms. Tran, any additions?

Thuy Tran, LCSW:  The thing here is how do you address an issue if you refuse to believe of its existence, right? So mental health has always been a mystery to a lot of cultures. So therefore, what conversation are you referring to? There isn’t any in a lot of families. So, you know, I do believe that people are just fearful of things they don’t really understand or are fearful of the unknown, right? So fear can perpetuate ignorance. So it has kept a lot of communities hostage. And back on education that I think Dr. Hsu had mentioned is that stereotypically Asians are known to be very academic oriented. I mean, there are even jokes and comments about it, like, ooh, you know, ‘if it’s not an A, I fail’ type of deal. And not realizing that that is a form of love language from parents. It’s their way of saying, I wish you good health. I wish you good life. And the only way you are able to achieve that is through education because again that ties back to poverty, right? So they would equate academic success as you won’t be as poor as me because if you get those educations, you are able to access resources I never got a chance to access, right? And obviously I don’t want to sound like I’m stereotyping here, but Western culture tends to emphasize more on individualism, you know, whereas with Asian American cultures or Asian cultures in general is more collectivistic. It’s what you can bring and contribute to your family. And so that’s why we, you know, we joke amongst my family is that children feel like they’re their parents’ 401Ks. Because during retirement, it’s the children that’s expected to provide for their parents. So you see what I mean? So there’s definitely a discrepancy there.

Natalie Tamburello:  It sounds like from the examples you’ve given that love is shown through concern, like concern for your health, like your eating habits and concern for your academic success. How is concern shown or is concern and love kind of the same?

Dr. Emily Hsu: I would say it’s both. It’s both. I can count on one hand how many individuals who identify as AAPI have come into my office. By the time they come in, it is a crisis. And typically when they come in, now that I’m working at a children’s agency, it is because of, “My child is failing.” And then we kind of find out from the intake, failing is a manifestation of the problem, but what’s actually contributing to it from the foreground if we zoom out is depression, anxiety, and a lot of the pressures that it takes to be able to perform at your best in these high caliber schools in the Silicon Valley. And then we unpack the familial dynamics and how that contributes. So I think it’s both and we do see generational differences. I’m curious, Ms. Tran, what do you think?

Thuy Tran, LCSW: I’m pretty much on the same page as you, Dr. Hsu. Love languages, right? And, Natalie, you asked, like, how is it shown? A lot of nagging. A lot of nagging. “Don’t forget to do your homework. Don’t forget to do your homework. Don’t forget, I’ve experienced this before. I’m trying to pave the way so that way you don’t trip, you don’t fall.” And therefore, it’s almost like tunnel vision in a way where it’s like I want to bubble wrap you in my own way and not recognizing that by bubble wrapping, there’s not a whole lot of room for growth.

Dr. Emily Hsu: Mm hmm. If I could actually add to something that Ms. Tran had stated, which is the idea of academic success and why our community, the AAPI community, has been stereotyped as the model minority. I think that comes from, again, trauma. I also think it’s one of those kinds of things where we were told, we were shown, it was demonstrated that if you work hard enough to better your life, you will be successful and do that no matter what. And for me, you know, my grandfather, he is a refugee from two countries. He told my older sister in Chinese, if you don’t get your doctorate and you don’t speak another language, you will not survive. And you think about the language that he used, and I think that kind of goes back to love language. He was basically saying, this is how I show my love for you by doing, versus I love you, I think it would be great if you could learn a second language. If you think what that kind of takes, to recognize that my words of care, going back to what Ms. Tran said about nagging, this is something that my grandfather would call my older sister about every day, like, “Are you getting your PhD, you know, like, are you on track? Is everything okay?” …which is, I love you, I’m worried about you, but it was never said in so many different words, which could seem like nagging, and my sister, you know, she did get her PhD, but it was one of those things where, yeah, that is our love language. That is the concern and because of this is how you survive, whether it’s academics, getting that job, getting that 401K, getting that pension, making sure that you are set up for success. I think that kind of goes into love language concern and how we see care being manifested in the Asian American community.

Natalie Tamburello:  I just thought it was interesting to look at love as concern instead of love as praise, which I think is what Ms. Tran said, you know, like more in American cultures love is shown as praise and admiration and being individualized whereas in the Asian American community, it sounds like it’s more about showing concern for your child is how you show love. So you both ended up in the mental health profession. Why did you decide to pursue a career in mental health? 

Dr. Emily Hsu: I knew from a young age that I wanted to work with other individuals. I wanted to be in the helping profession. I’m very blessed in that my parents did whatever they could to make sure that I would have the best opportunities possible. And they let me kind of figure that out on my own. And as I was finding out on my own, because I was like, I want to be some sort of doctor. I realized, you know, this is something that is still near and dear to my heart, but why I decided I’m going to be a psychologist, I’m going to be a clinical psychologist is because, and this is still happening. This is still happening now. I was trying to understand why individuals who identify as Chinese, Korean, and Japanese, why were they dying by suicide? I wanted to understand from a cultural perspective, and I was in two research groups to kind of understand how do Asian Americans manifest distress. When we do a suicide risk assessment, are we asking in a way that makes sense to the Asian community? And I did another study where Asian Americans more likely to seek help and stay in treatment if there was an ethnic matching. For example, I’m Asian, you’re Asian, I identify as black, you also identify as part of the black culture. And so I wanted to understand why individuals were feeling that the only way for me to not inconvenience my family, end this distress that I’m feeling, is by suicide. And I wanted to figure that part out. And that’s the initial catalyst that led me to deciding to be a clinical psychologist.

Natalie Tamburello: What have you learned, so far? 

Dr. Emily Hsu: About the Asian community in suicidology?

Natalie Tamburello: They felt, as you said, not existing would be better than burdening your family.

Dr. Emily Hsu: In general, and I recognize that I’m saying this across different cultures and there may be cultural nuances. I do want to say that everything is in the family unit. Ms. Tran touched upon collectivism, and there’s this idea of, I don’t want to inconvenience the people in my unit, the people in my family, which we know could be not just your immediate family, extended family, the people you consider friends, also family. This idea of contributing, not being the squeaky wheel. There’s that saying in China, I’m not going to quote this perfectly and I do apologize: “The nail that sticks out gets hammered down.” And so I think from my research, there has been this idea of I’m having distress, which again, we don’t have a language for, traditionally, or I’m saying, I think I’m depressed and people are responding in a different way, whether it’s invalidating, which I think does tend to happen across cultures, but again, coming from that trauma perspective, I do think that there’s that ‘I don’t want to negatively affect the other members.’ This is, in Japan, it’s considered an honor. I am keeping my family’s honor. I am helping them save face by taking myself out of the equation. There’s also, going back to language, in my research on suicide in general, there’s this idea of this kind of pain called psych ache, where that pain is so painful that the only thing I can do is just end it. So I think that’s also embedded in it, in addition to the collectivistic mentality. And there’s also no words. And then it goes back to our topic, why would you seek mental health treatment if I might be seen as crazy? That might bring shame to my family. So I think there’s multiple layers that we’ve identified in the research community.

Natalie Tamburello: Ms. Tran?

Thuy Tran, LCSW:  I was seven when my mom inadvertently told me that her older sister was taken by suicide at age 18 because the topic of her death was so tabooed in our family that even my mom doesn’t know the cause of death. And so it wasn’t until my late teens when I realized that a lot of people, not just within my family, but also within my community, were just struggling with just stress, anxiety, depression. And the interesting part is, it was actually very unsettling for me to conclude that if anyone in my family were deemed crazy, they become this polka dotted individual in the room that nobody wants to acknowledge.

Natalie Tamburello: Hmm.

Thuy Tran, LCSW: And so, my goal in being a therapist was to have those polka dotted individuals be seen, rather than just everybody tiptoe and pretend they’re not there. And so to make sure that they exist regardless if they’re walking around with polka dots, stripes, checkered, chevron patterns. It’s whatever you think of as long as they are seen. And a lot of times, being a therapist, obviously I can’t help fix the past, but it’s not just about listening to my clients. It’s having them to feel understood. It’s one thing for people to be listening to you, but to feel that they truly understand how you feel, that is an example of being seen.

Natalie Tamburello: I wonder what advice you have for teachers and practitioners or professionals who work with this population regularly and what they should be mindful of if they’re not themselves a part of the AAPI community.

Thuy Tran, LCSW: Well, it comes down to, you know, how they word things, right, avoid using terms like depression, anxiety. Start with stress because every parent knows what it’s like to be stressed and somehow that into these stressors can impact academia. Therefore, due to poor concentration in the minute, you get them kind of understand like, “oh, yeah, no, I know what stress is. Oh, I didn’t realize that my child is so stressed that he or she couldn’t even concentrate. Okay, I get it now. In that case, Ms. Tran, can you help my daughter be able to concentrate, be able not to feel sad, be able not to let anything, like any sort of stressors, impact her ability to learn.”

When I started off with that word, stress, I can see parents slowly putting their guards down because to a certain degree, they feel like their children are the extension of them. So if the child, whether, you know, he or she’s depressed, or what do you mean, you know, she wants to die or whatever, there’s no reason she’s got iPads, iPhone, i-whatever, you name it, right? But the minute you said “stressed,” all ears are perked up. And that’s when you can see their love language come out.

Natalie Tamburello: Dr. Hsu?

Dr. Emily Hsu: I agree with everything Ms. Tran said, I think it’s the language, you know, we’ve seen in research, and this is not just in the AAPI community, this is in the Latino community, from the research I’ve also done in understanding suicide risk and assessment. It’s the language that you use. It’s understanding what these individuals might have come in doing that careful assessment before being like, I have been trained to, yes, to Ms. Tran’s, point to look for the signs of depression, look for the signs of suicide risk and self harm without saying, are you self harming? Do you have thoughts of killing yourself? I’ve been trained to ask it adjacently where you’re asking the same question, you’re just using more words. 

And I would say for teachers, practitioners and professionals, just be aware of that and for teachers, because this is typically where, in my experience, in my consultation with teachers, as part of my parent collaterals that I provide, it’s noticing, you know, how your student is doing because I cannot tell you how often I hear, oh, but the student is achieving so well. They’re in AP honors classes. And again, I think it’s one of those things where it’s become a shock to some parents, and this is occurring in my Southeast Asian communities as well, not just in my Eastern Asian community that I’ve seen, where there’s a shock where they’re doing so well. They’re getting A’s and so I would say, and I tell my parents this, you know your child the best teachers you know your student very well. Are you seeing anything different in terms of their demeanor, their behavior that deviates from their level of norm? Any changes in practices, any loss of pleasure in things they once enjoyed, like if you know that your student loves track and field, but they’re starting to skip practice. And–collecting more data–is that a sign or a risk factor for my child, my student, is their mental health is starting to decrease. And I think it’s one of those things where in working with high caliber schools, I’m really glad that a lot of schools are focusing more on mental health. And I’m also seeing because of the demand to do well in Silicon Valley, and I think this is across cultures and especially emphasized in the AAPI community. This is what I’m dealing with, with one of my clients. There was no room to intervene in the client’s schedule when my client was suicidal as a result of how he would do on finals. There was literally no space. And I was thinking about how, and I understand schools are strapped. There’s a lot of challenges and changes that schools are facing. And I’m also wondering, can we work to find a middle ground of supporting them academically through supporting their mental health? Because learning comes from a place of joy. That’s something that I said in my learning disabilities parenting group. I think this is also something that could maybe be changed or revised.

Natalie Tamburello: You touched on this a little bit about what you’d advise a parent to do, but I wonder what advice you’d have for an Asian American parent who maybe is on the cusp of seeking support for their child or is a little hesitant to do so, and what they can do to be more comfortable with conversations around mental health.

Dr. Emily Hsu:  I get really excited when someone comes for therapy, especially if they identify as AAPI, and I also get really nervous, because I know that it probably took them a lot to get here. I tell all of my parents, if you are concerned about your child, just like you would like to support them academically, you find that tutor. You pay extra for them to be in a class of excellence. You provide whatever opportunity, you ask questions, you network with parents. I would say we can also apply that to seeking additional support, that’s how I couch it, and I encourage them to ask that question, like, if you’re concerned, and this is even at the physical level of health, if you are concerned that your child’s physical health is not doing well, which is typically how we see, at least in my experience, when I was working at the Kaiser Intensive Outpatient with adults, a lot of people came in due to physical challenges. And it was really their mental health, I’m not going to use those words like mental health, I’m going to use words like Ms. Tran said, stress. How is this affecting your body? You know, how is this affecting your ability to sleep? How is this affecting your ability to concentrate? Because parents know that children need to be able to concentrate, sleep, eat well, in order to be their best, whatever that is defined with. And so I would praise the parent, assess, and be like, it’s kind of like having a checkup of different areas of how we can support your children and you’ve come to the right place.

Thuy Tran, LCSW: So with my approach, whenever a child comes in and obviously with Asian American backgrounds, I focus a lot of work on the parents, believe it or not, or at least at the beginning. And I come from, you know, the mindset of being very curious to understand kind of their upbringing as well and, what are some of the challenges that they themselves experience growing up. In that sense, it’s much easier for me to speak to them in a way where they can connect the dots and understand, oh, okay, I can see why my child would feel that way.

The other thing with parents is they, too, want to be heard, right? And so when they don’t feel like they’re being heard and there’s a disconnect, they might let their child, you know, continue therapy, but at any point in time if a subject that was brought up during therapy that doesn’t sit well with the parents, they can pull out their child, in a heartbeat.

And so a lot of times with therapists, we’re always walking on ice and just tiptoeing, always afraid that if this doesn’t sit well with this child’s parent, what’s the trajectory of this case, like, does that mean this child will, won’t be able to come back? So for me, it’s a lot of buy in from the parents in order for, you know, my work with the individual to be effective.

Natalie Tamburello: So, if there happens to be any students listening who have some mental health challenges, what advice or support would you give them?

Dr. Emily Hsu: I’m going to quote from Dr. Jenny Tsumei Wong. I don’t see how her characters are written, so I hope I’m pronouncing her name correctly. She has an Instagram page called Asians for Mental Health. This is what I would say to students who may be listening and to parents who may be listening, if I could extend that question a little bit: “to the child of immigrants who has grown accustomed to pushing yourself to your utmost limits as a way to express your eagerness or enthusiasm, but also to prove that you are not irresponsible or lazy, please know that pushing yourself too far, too frequently, and far too long can cost you greatly in many spaces of life. May you give yourself permission to not even graze the edge of your limit, and in fact to build enough cushion so that you have the capacity for unexpected things that life invariably brings.”

Natalie Tamburello: That’s lovely. Thank you. Ms. Tran?

Thuy Tran, LCSW: For me, it’s a lot of emphasis on communication and strengthening of relationships. And I’ve worked in school-based services before. And I tell the students, I said be heard, be understood. And in order to do that, not that I’m putting the onus on the child, but be curious. Be curious. Why is your parent being like this? Because I get that a lot. I don’t understand why they just don’t get it. And so when I depersonalize it, and be like, not so much, oh, try to understand your parent. It’s more like, try to understand your culture. What is your culture like? And so therefore, when I ask questions, they’re like, huh, I’ve never really thought about that.

And so as they, you know, do kind of like their own personal homework, and then we kind of revisit it during therapy, they go, yeah, apparently in my culture, you know, blah, blah, blah, blah. And that was the aha moment they got like, oh, that makes sense. No wonder my parents are such big naggers, right? And so because of that, it’s much easier for them to go, all right, so if my parents view academics equates to success then I want to be understood in a way where it’s not doctors, lawyers, you know, scientists doesn’t equate to success always, right? Success could mean just pursuing your passion and trying to have my parents understand that if I pursue my passion, I am successful. So there’s definitely curiosity, communication, and therefore the strengthening of the relationship between the parent and the child.

Natalie Tamburello: Any final encouragement or any other advice that we haven’t been able to touch upon that you would like our listeners to leave with?

Thuy Tran, LCSW:  What I’ve noticed, you know, over the years is that there’s more Asian community centers that are popping up. And I think it’s mainly due to the Bay Area and being so progressive, but I think it’s wonderful. I mean, there’s a Vietnamese community center here in San Jose, and I’ve noticed that there are a lot of groups happening, whether it’s Zumba groups and all that stuff, but to whoever’s out there, you know, being open to funding those type of community centers and eventually incorporate groups where parents would kind of congregate and even express their concerns and their frustrations about their children. And finally, understand the concept of what it’s like to speak to someone else about your stressors, right? And to experience that firsthand relief of, ah, somebody gets it. So in that sense to be able to make that connection, so therefore, they finally have an idea of what mental health services is about. What the goal of therapy is about. Not so much to sit in and be like, I hope my son or daughter doesn’t talk negatively about me in their sessions, but it’s more like, oh, okay. It’s just nice to be heard. I can’t emphasize that more, Dr. Hsu?

Dr. Emily Hsu: I agree with you, Ms. Tran. You said it very well. I think lasting thoughts is, as parents, you know, we want to provide every opportunity for our child to succeed and not experience the same struggles. And so I would say seeking extra support by going to a psychologist, going to a licensed clinical social worker, a marriage and family therapist, that is seeking support and hopefully adding these individuals to your community. And so I would say, in not doing so which we understand, which is why we’re here, we recognize that it’s a big ask. We’re asking you to trust a system that was not created for you initially, but my hope from this is that in recognizing that asking for extra support, that leads to magical opportunities to access as communal beings. And my hope is that we can learn to ask for help, for support, not just because we can’t do it on our own but because we shouldn’t have to be alone in the struggle, in the stress.

Natalie Tamburello: Thank you both for such a deep conversation. I know we’ve only scratched the surface of this topic, but I think it’ll help a lot of our listeners here today. As a reminder to our listeners, CHC is always here to help and you can check out our website at for any of our services, therapy, evaluations, etc. Thank you so much. 

Cindy Lopez: Visit us online at  Make sure to subscribe to Voices of Compassion so you never miss an episode,  and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at We’re here for you when you need us.

It takes a village.

Receive weekly updates about mental health, education & news with CHC Virtual Village

Sign up for the CHC Virtual Village to receive weekly email updates about upcoming news, events and resources related to your interests.

Enjoying this podcast?

Consider a Gift to the help CHC’s Community Outreach extend further than ever

Enjoying the CHC Voices of Compassion Podcast? Please consider supporting CHC’s Community Education and outreach efforts, like this podcast and CHC Online Resource Library, with a gift today.