Mental health: One size does not fit all | Windows and Mirrors

The challenges of providing mental health services for communities of color.

Mental health: One size does not fit all | Windows and Mirrors

Despite increased awareness and open discussion, there is still a stigma surrounding the topics of mental health and mental illness.

Who knows why that is?

Is it because it shows signs of weakness? Or maybe it’s because many mental illnesses are not always obvious and may not be visible. You can’t always see when someone is struggling with a mental illness as you would if they were struggling with a physical illness.

It’s a bit like that thought experiment: If a tree falls in a forest and no one is around to hear it, does it make a sound?

Similarly, if someone is struggling with an illness we can’t exactly see, are they really sick?

The short answers (at least mine) to the questions are, I don’t know and yes, respectively.

But just because a person is sick, that doesn’t always mean they have access to or are willing to get the help they need to get better.

Cultural understanding

While the stigma of mental illness is prevalent in all demographics, it can be more so in communities of color.

In East King County, there are a number of agencies and providers working to making mental health services more accessible and help people understand that it is just as important as physical health. There are also those working specifically to inform, educate and serve communities of color.

While doing her three-year residency in the Flushing neighborhood of Queens, New York, Yu Han said her patients were about 35 percent of Asian descent. Han, who is Chinese herself (having received her master’s degree in radiology in China) and now works as a primary care physician at Overlake’s Newcastle Primary and Urgent Care clinic, said it is important to be culturally sensitive with patients.

For example, in her work at Overlake, Han works with adults and since she started in June, she has also been working with the local Chinese community. One of her patients is a Chinese woman whose 18-year-old daughter recently moved out. Now the mother is experiencing anxiety and constantly calls her daughter. Han said suggesting therapy can be seen as a taboo and not compatible with the woman’s culture.

So while some people may be willing to take prescription pills, they may not be open to therapy — to talking about their feelings.

This is something I can relate to. Growing up in my family, conversations about how we were doing were pretty non-existent, and I know this is common among many Asian households. We don’t talk about our feelings and the words, “I love you,” are rarely uttered.

“When you speak the language, they feel closer to you,” she said about patients — both literally as well as when it comes to understanding their culture and how that might affect the kind of care they’re open to and willing to receive. Han added that patients may also be more open to what a doctor says and willing to offer up more information about themselves.


But just because the providers want to help and offer culturally competent services to communities of color, it’s not always possible.

Cynthia Goodwin, director of the city of Mercer Island’s Youth and Family Services department, said data shows that the youth in the community would like to have the option of working with mental health providers of color. And if they are not able to provide this, Goodwin said her department will work to connect clients with the right providers to meet their needs.

But one of the problems they face is the lack of representation of people of color in the social services field.

Goodwin said one of the reasons for this is that you don’t make a lot of money in the field, making it difficult for people to support themselves and their families.

And as it can often happen, if young people do not see themselves in a given field, they’re less likely to want to pursue a career in said field — thus perpetuating the cycle of under-representation.

“I think that’s a challenge across the board,” said DeAnn Adams with Friends of Youth (FOY) about the compensation issue in social services leading to a lack of representation for people of color.

Adams is the director of specialized residential services for the nonprofit — which serves several communities throughout the Eastside in various capacities related to youth and family services.

In addition to the less-than-ideal pay social services offers, Adams said the Eastside itself can act as a geographic barrier.

This is because as diverse (or not) as we think they may be, our communities may not appear so to people coming here. And as a result, potential providers of color may want to work in a community that is more diverse and has more people who look like them.

Adams added that with the cost of living being higher on the Eastside compared to other areas in the Puget Sound and the fact that people in the mental health field are underpaid, there are fewer clinicians of color living on this side of the water.

It’s not exactly easy to recruit and/or retain employees when you have to factor in a long commute — because we all know traffic will almost always be an issue for anyone trying to get anywhere in the region.

Adams also acknowledged the fact that in a field that is predominantly white, agencies also need to put in the effort to make their workplaces welcoming to staff and potential staff who are not.

“That work needs to first start internally,” she said.

Adams said FOY is very intentional in the work they are doing to ensure they are creating a welcoming workplace.


Difficult work as this may be, there have been some successes.

Han has given talks to Asian parents in the community about the importance of building trust with their children so they feel they can turn to their parents without being judged.

“They were very happy there are physicians who speak their language who can provide professional help,” Han said about the attendees.

At FOY, Adams said their youth engagement team’s pilot program, the Youth Homelessness Demonstration Program (YHDP) — in partnership with All Home King County — has had great success.

The program is county wide and provides mobile services to homeless youth — a group in which youth of color are disproportionately represented. Adams said the program provides services in a less traditional model with its mobile nature allowing them to bring their services to the youth rather than vice versa.

The YHDP just completed its first year and is now in its second year of the pilot program.

Windows and Mirrors is a bimonthly column focused on telling the stories of people whose voices are not often heard. If you have something you want to say, contact editor Samantha Pak at

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