By Mary Shen, M.D., M.Sc. and Gene Beresin, Executive Director

Posted in: Parenting Concerns

Topics: Mental Health

This article is also available in Chinese

“Did you hear that Xiaomian’s daughter is seeing a therapist?”

“I heard the son of the Nguyens’ family friend tried to overdose at his high school.”

“That family has mental health problems”

In recent years, you may have heard hushed whispers in your community about the growing mental health crisis in young people. You’re not alone. In the last few years, research shows that mental health issues have become more common among all youth, including Asian American Pacific Islander (AAPI) youth. A recent report demonstrates that young AAPIs feel that there are barriers preventing them from talking to parents about their mental health [1]. Such barriers are largely due to the stigma of mental illness, including the fear of burdening their parents, concerns of disappointing their families, perceptions that parents may not have similar beliefs about mental health needs.

But parents can be an important ally in helping their kids feel safe and supported when navigating their mental and emotional health. This article has general implications for many cultural groups but will largely focus on the Asian community and will address why mental health is important, why it might be hard for your child to open up to you as a parent or caregiver, and how to talk to your child about mental health.

Why is Mental Health Important?

Mental health refers to emotional, psychological, behavioral, and social well-being. While the concept of mental health might feel like a Western issue, it affects all of us in our countries of origin and in the United States. For AAPI families, mental health is often not discussed openly. While mental health struggles are are often viewed as a sign of weakness or a character flaw; they are an intrinsic and natural part of being human.  Just like physical health, mental health is complex, often involving inherited traits, and consequences of social and environmental influences we experience during life. We all appreciate that chronic stress can result in hypertension, so too may it trigger anxiety, depression or other psychiatric conditions. After all, the brain is an organ in the body, and is subject to internal and external insults, just as the heart or other organs. The fact is that 1 in 4 individuals at any one time have a psychiatric disorder and over a lifetime this reaches 1 in 2. About 50% of these conditions begin before age 14 and 75% before age 26. Thus, mental health conditions require care and attention, just as diabetes or other illnesses beginning in childhood. Ignoring them can lead to serious consequences, including lifelong anxiety, depression, stress, loneliness, and self-harm or suicide.

How Might Mental Health Problems Present in Your Child?

If your child is struggling with a mental health disorder, it may be subtle or dramatic. Symptoms might include:

• Physical complaints (stomachaches, headaches, loss of appetite)
• Irritability or frequent mood swings
• Sudden or gradual decline in academic performance
• Loss of interests and hobbies
• Problems with sleep, appetite, concentration, energy
• Isolation or withdrawal from friends and family
• Increased use or misuse of social and digital media

While some changes in habits, behavior, emotions, thinking and personality may be a normal part of growing up, if you notice your child, teen or young adult developing any of the above symptoms, it is extremely helpful to start some conversations with them. While most kids don’t want formal “meetings,” introducing progressive, gentle, empathic discussions over time, may be very helpful.

Why Doesn’t My Child Want to Talk to Me About Mental Health?

Your child may not be used to talking to you about mental health. Due to culture, beliefs, or family dynamics, it may be difficult for your child to talk to you about mental health [1]. After all, if you have not had these conversations with your partner or other family members, there is no precedent or role modeling for them to see this as a normal way your family interacts.  In fact, most Asian youth are likely to be reluctant to talk to parents/caregivers about their need for understanding and offering more support for their mental or emotional health for the following reasons. Let’s go through each and see what you can do about it.

1. Fear of being a burden – Many Asian cultures prioritize harmony. It is important to reassure your child that their feelings and experiences are important and that their emotions are valid and accepted by you and your family. You can express curiosity and reassurance by saying something like, “I may not have said this before in these words, but I want to know what is on your mind. I know that some kids might feel this way, but I want to make it clear that your feelings are never a burden to me.”
2. Worry that parents have different beliefs about mental health – Your child is growing up in a culture that may have different ideas about mental health than what you learned growing up. If your child says, “you wouldn’t understand,” try responding with, “I may not fully understand, but I’d like to. Can you help me learn?”
3. Belief that parents prioritize other things over mental health – You may be accustomed to a culture that values resilience, academic excellence, hard work, service to others, denying feelings, and “toughing it out” among other personal attributes. Your children may assume that you prioritize these qualities over one’s mental health. You can try saying, “I know we put a lot of emphasis on your performance, but your well-being and happiness comes first. How can I support you?” “I think we need to pay more attention to your and our emotional life. What do you think?”
4. Concern that parents would be embarrassed or disappointed – Mental health is often stigmatized in our cultures. You can normalize the experience by saying, “Just like we go to the doctor when we’re sick, it’s okay to get help for mental issues as well as physical ones. It’s a sign of strength to ask for help and I’ll always be proud of you.”

How Can I Start the Conversation With My Child?

Starting the conversation might feel awkward at first. Here is a five-step method to start talking to your child:

1. Choose the Setting: – Picking the right setting is important, opting for a private and quiet place. Pick a time when your child is up for the conversation, staying away from times when your child is hungry, tired, or stressed. Also as noted above, this should not be a formal meeting. It may be “in between the cracks,” such as driving in the car, cooking or hanging out in the kitchen.
2. Ask questions – It’s helpful to be curious rather than judgmental. Start the conversation by pointing out a sign you have noticed, along with one of the techniques above. For example, “I noticed you have been spending more time in your room. Is everything okay? I may not fully understand, but I’d like to. Can you tell me how you’re feeling?”
3. Listen – Rather than immediately offering solutions or trying to be positive, just be present and listen.
4. Validate feelings – next, when they express any feelings, try to validate them and empathize by sharing your own experience. You can say something like, “I’ve felt depressed before and I can see why you would feel that way,” or “that makes a lot of sense that you’re having those feelings.”
5. End with Support – At the end, your child may not be ready to take any action. Your job is not necessarily to fix the problem. Your goal is to open the conversations, and try to make this a series of ongoing conversations, and let your child know that they can be vulnerable and come to you with their emotional and mental struggles. You can say, “Thank you for opening up to me. Let me know how I can make it easier for you to come and talk to me. Your experience is important to me and I want to learn how I can support you.”

Mental strength comes not from ignoring struggles, but from facing them with support. By creating a safe space for open conversations about mental health, you are giving your child the strength to navigate life’s challenges with confidence and resilience.