Hope Starts With Us: Asian American and Pacific Islander Mental Health

In honor of AAPI Heritage Month, NAMI CEO Daniel H. Gillison Jr. speaks with NAMI National Board Member and Cambodian American Connie Mom-Chhing about Asian American and Pacific Islander mental health, the trauma of the COVID-19 pandemic lockdowns and rising hate crimes against the AAPI community.

“It was like a perfect storm from our perspective that hit our communities because of the combined effects of the increase in racial discrimination, the social isolation and with already existing underutilization of mental health care among the AAPI community,” she says.

You can find additional episodes of this NAMI podcast and others at nami.org/podcast.

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Featured Guest:

Connie Mom-Chhing

Connie Mom-Chhing, D.M., MPA is a member of the NAMI Board of Directors and a Senior Director of Regional Systems Integration at the Community Health Plan of Washington in Vancouver. She is a member of NAMI Southwest Washington where she has advocated for funding to support NAMI programs, services and events.

She hopes to support NAMI’s outreach efforts to underserved and underrepresented communities and increase awareness of mental health within communities of color.

Connie previously worked at Columbia United Providers where she was the Chief Behavioral Health Officer. She has more than 20 years of working experience in the areas of behavioral health administration, health care integration strategies, managed care operations, non-profit management, health care policy analysis, peer advocacy, and cultural diversity, inclusion and equity.

She has been recognized by the Washington State Governor’s Office with the Governor’s Recognition Award for Statewide Services to Mental Health Transformation.

She earned her D.M. in Organizational Leadership, University of Phoenix, AZ; MPA from Lewis & Clark College, Portland, OR; and B.A. in Industrial/Organizational Psychology and French, Western Washington University, Bellingham, WA. She also completed a Diversity and Inclusion Certificate Program from Cornell University.

For the 2022-2023 Board year, Connie serves as Chair to the Public Policy Workgroup and is member on the Youth & Young Adults Mental Health Outreach Workgroup and Justice Systems, Equity, Diversion & Inclusion Committee.

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DAN: [00:00:00:05 – 00:00:24:05] Welcome to Hope starts with us, a podcast by NAMI, the National Alliance on Mental Illness. I'm your host, Daniel H. Gillison jr. NAMI ceo. We start this podcast because we believe that hope starts with us. Hope starts with us talking about mental health. Hope starts with us making information accessible. Hope starts with us providing resources and practical advice.

DAN: [00:00:24:07 – 00:00:51:01] Hope starts with us sharing our stories. Hope starts with us breaking the stigma. If you or a loved one is struggling with a mental health condition and have been looking for hope, we made this podcast for you. Hope starts with all of us. Hope is a collective. We hope that each episode with each conversation brings you into that collective to know you are not alone.

DAN: [00:00:51:03 – 00:01:17:18] In honor of Asian American and Pacific Islander Heritage Month, today, I'm joined by NAMI National Board member Connie Mom Chong to talk about AAPI mental health. In addition to being a board member, phenomenal panel. Connie is also a senior director of regional Systems Integration at the Community Health Plan of Washington and Vancouver and a member of the NAMI, southwest Washington affiliate.

DAN: [00:01:17:20 – 00:01:50:22] She previously worked as the chief behavioral health officer at Columbia United Providers and has been recognized by the Washington State governor's office with the Governors Recognition Award for statewide services to mental health Transformation. Excuse me. Connie, thank you so much for being with us today. It's important to start out by recognizing that the AAPI community is incredibly diverse, encompassing a wide range of countries, ethnicities, nationalities and identities.

DAN: [00:01:51:00 – 00:02:21:04] The experiences of native Hawaiians may be quite different from those of Indian South Asian descent. Campbell Cambodian refugee survivors, second generation Korean families and so on. In many ways, this is why the concept of cultural humility is so important in mental health and why it's so important to refrain from making assumptions about people's backgrounds and perspectives. Connie is someone who has extensive experience working at the intersection of culture and culture and mental health and has lived experience in this space.

DAN: [00:02:21:06 – 00:02:33:01] Can you talk to our audience a little bit about some of the unique experiences, strengths and challenges? People who are Asian-American and Pacific Islander often face when it comes to mental health?

CONNIE: [00:02:33:03 – 00:03:15:11] Yes. Thank you so much, Dan, for including me in this program. First of all, I wanted to say thank you so much to NAMI as an organization and NAMI leadership, as well as staff for recognizing and celebrating the Cambodian heritage along with the Asian Americans and Pacific Islanders as well. So I also wanted to, you know, appreciate express my appreciation to NAMI for allowing me to be a part of the hope stuck with us and really appreciate the opportunity to share my Cambodian cultural heritage and the impact of mental health and social events such as the pandemic.

CONNIE: [00:03:15:12 – 00:03:47:01] The anti-Asian violence and all of the global events, the war, you know, events that we're witnessing right now and how that impact, you know, the mental health of my own Cambodian community as well as Asian American communities. I do want to acknowledge, as you have mentioned, that you, the AAPI, represent a very diverse and fast growing population of, what, 23 million Americans that included, you know, roughly 50 ethnic groups, but groups in more than 40 countries.

CONNIE: [00:03:47:02 – 00:04:15:07] So so I was born in Cambodia, which is a part of the Southeast Asia countries that included, you know, other countries such as Vietnam, Mao's Thailand, you know, Singapore and many others. So and each country, as you had mentioned, has its own unique culture, history and religion. So so definitely we are very diverse. So. So I came to America at the age of 12.

CONNIE: [00:04:15:09 – 00:04:47:09] I and my family, we are survivors of the Cambodian killing fields that took place between 1975 and 1979. So the experi in that I and my family, along with other Cambodian families, have gone through or during that time has significant impact on our mental health. Yet my own Cambodian American communities, along with the other AAPI communities, do experience disparities the most when it comes to accessing mental health treatment and support.

CONNIE: [00:04:47:11 – 00:05:20:02] And part of it is because of the stigma attached to individual living with mental health conditions. So a person, you know, living with a mental health condition in my community is still regarded as dangerous, crazy, incompetent, shameful, an embarrassment and weak because a person is not capable of taking care of oneself or the family. So having a mental health condition is shameful because it takes away a person's abilities to care for their families.

CONNIE: [00:05:20:04 – 00:05:51:11] So, you know, one of the major struggle right now is that there is still a significant lack of understanding among families and friends that mental health is an illness and that it touches many people regardless of their race, ethnicity, culture or socioeconomic background. So so that's kind of one area. The other struggle that my community facing is really the pressure of living up to that model minority that stands in the way of seeking treatment from my perspective.

CONNIE: [00:05:51:12 – 00:06:17:19] You know, we have been characterized as intelligent, capable of taking charge of lives and therefore, you know, having to admit to having a mental health condition which is considered as weak or shameful, would be letting down the entire family or community. So those are some of the, you know, the challenges that my my family and my community and many of the AAPI community are facing right now.

DAN: [00:06:17:21 – 00:06:53:04] Connie, thank you so much. And to the Cambodian community, we would just like to say on behalf of of of of NAMI and to the entire AAPI community, your resilience is is such an example for so many. And we do recognize that the stigma and the expectations there, such high expectations and and within the families that it it really does create the the the the lack of a safe space to to talk about one's mental health.

DAN: [00:06:53:05 – 00:07:22:21] So thank you for sharing that. And over the. I have a question for you that's really focused on the last few years we've seen a rise in hate crimes, xenophobia and violence towards the Asian-American and Pacific Islander community, with one report showing that Asian-Americans who experienced racism were more stressed by anti-Asian hate than the pandemic itself. And that pandemic was so incredibly filled with uncertainty and doubt and fear.

DAN: [00:07:22:23 – 00:07:42:08] And the other metric is that one in five Asian-Americans who experienced racism displayed signs of trauma, psychological, emotional harm caused by racism. Connie, can you talk more to us about how you've seen COVID 19 and hate crimes over the last few years affect the AAPI mental health?

CONNIE: [00:07:42:10 – 00:08:20:13] Yes. So definitely than during the last, you know, several years has been really, really difficult for our communities across the nation. As you know, the lockdowns, you know, led to that feeling of isolation, you know, anxiety, depression, the distress that our use of feeling, you know, the workouts out of school, isolated from their friends and families. So definitely, you know, that has been a major impact in terms of the mental health of our community.

CONNIE: [00:08:20:15 – 00:08:55:22] And then, you know, we've also witnessed things on television, you know, the hate crimes against AAPI communities. So we are we are feeling and still feel traumatized, you know, by what we're seeing across the country. It was like a perfect storm from our perspective that hit our communities because of the combined effects of the increase in racial discrimination, the social isolation, and along with already existing underutilization of mental health care among the AAPI community.

CONNIE: [00:08:55:22 – 00:09:36:21] So they're also facing and still facing unique challenges when it comes to accessing mental health, you know, especially during the COVID pandemic because of language barriers and the anti-Asian violence. So even one staying home, we were fearful of going out. So when the mental health system, I remember, shifted to providing care, you know, using telehealth. Mm hmm. We have community members that do not know how to navigate services virtually or have access to a computer or Internet or, you know, culturally appropriate services.

CONNIE: [00:09:36:23 – 00:10:04:23] So there is no, you know, specific Asians, I guess, American providers. But in the communities, you know, to be able to seek help from at least in my own community here. So so I think from what I have seen, speaking from my own community is, you know, the rate of suicide and suicide attempts among our youth have gone up.

CONNIE: [00:10:05:00 – 00:10:22:15] The witness of violence against the AAPI and the black community created a secondary trauma. It's like a depression for us. So, yes, you know, COVID 19 has a profound impacts on our communities. Yeah.

DAN: [00:10:22:17 – 00:10:48:23] And we call the we call this vicarious trauma, because it's trauma through what we've seen. Maybe we didn't directly experience it, but we're now carrying that trauma because we've seen it in someone we know or someone watched has experienced it. So it's very compelling and it is is paralyzing. So it's it's it's really interesting to to look at what's the way out.

DAN: [00:10:49:01 – 00:11:11:01] So with that said, and thank you so much for that description because it really gave us a visual of of what it is like from the standpoint of technology and telehealth for some, but not for all. And there's this assumption that telehealth and and technology can can benefit all communities. And that's not necessarily the case. So thank you.

DAN: [00:11:11:03 – 00:11:22:15] So with that said, Connie, I want to ask you, what advice do you have for others in the AAPI community looking for help with mental health? I have a set of questions, but I'll start with that one and then I'll go to the other two.

CONNIE: [00:11:22:17 – 00:11:50:06] Yes. Yeah. So, you know, so for us, you know, for those that are that made a decision to seek help, I would like to say, you know, congratulations on your decision because they are not alone. You know, as I mentioned, mental illness touches everybody, regardless of race, ethnicity, educational background or class, you know, So seeking help can feel lonely.

CONNIE: [00:11:50:06 – 00:12:15:14] But I feel that NAMI at the national and local levels are here to help people and their families in terms of learning about community resources. So I definitely encourage everyone to check out the resources that NAMI at the national and other local level has to offer. So the website is wonderful. You know, I feel there's so many resources that people can learn more about.

CONNIE: [00:12:15:16 – 00:12:48:00] I also wanted to encourage everyone to kind of seek help from trained professionals, as well as other support systems such as close friends, families, spiritual leaders. So and, you know, I think it's important to to to end the assignment by speaking about it and share your story, you know, your recovery story. And last, you know, you know, it seemed fitting to share this statement from my mother who had kind of instilled in me when I was a very at a very young age.

CONNIE: [00:12:48:00 – 00:13:04:02] You know, she often we said, do not lose hope. Without hope, there is no teacher. So that's really the message that I wanted to share. But those that are that have made the decision or a hope that you made the decision to seek help. Yeah.

DAN: [00:13:04:04 – 00:13:33:08] Thank you, Connie. And as Connie just said, do not lose hope. Her mom's message is so critically important. You got to hold onto hope, because if you don't, you know, we want you to be hopeful. And that hope less. So we need you to hold on to hope. So, Connie, as you as you think about practitioners, advocates and allies looking to support the AAPI mental health community, what advice would you have for them?

CONNIE: [00:13:33:10 – 00:14:07:15] I think understanding that, you know, traditions, villages, culture and families are all important factors that influence a health belief system. So, you know, there are very types of religious belief in the AAPI communities. But for my own Cambodian American community, some of our community members, you know, believe that illness is caused by the lack of harmony of emotion or by evil spirit or result of bad luck or pass, you know, bad behavior.

CONNIE: [00:14:07:17 – 00:14:33:00] So we tend to delay seeking professional treatment or not treat or not seek, you know, professional treatment at all because, you know, it may not be thought of as a will illness. So it's important as professional to recognize that that's the kind of mentality that some of my community, you know, are having still. So it's important to recognize that.

CONNIE: [00:14:33:02 – 00:14:59:01] And then, you know, when we do seek help, you know, recognize that we tend to reach out to faith based leaders such as Buddhist Hmong for spiritual consultation or, you know, other rituals such as holy water blessing. So we also tend to try to additional healing methods as well as traditional herbs, meditation. So offering food to our ancestors for exchange for good health, peace and harmony.

CONNIE: [00:14:59:03 – 00:15:34:01] So recognizing that, you know, cultures shape how we express and how we recognize our mental health condition. So another thing for a professional to recognize is that we keep the issue inside the family because of the pressure of saving face with a family in the community. So so it's important to to recognize that as well. In terms of the family structure, you know, we are part of extended families, so we have two or three generations living in the same household.

CONNIE: [00:15:34:03 – 00:15:58:05] So major decision making arrests with the father in consultation with the grandparents. So when it comes to, you know, decision to seek treatment or not seek treatment, that kind of decision can be influenced by the family. So that's really what I wanted to kind of share with them. Yeah, that they need to understand our culture. Yeah.

DAN: [00:15:58:07 – 00:16:26:03] Yeah. The culture humility is so critically important and less and it's almost you have to walk in someone else's shoes before you assess or assume certain certain things, certain behaviors. And this what you're sharing is so is so wonderful. I wanted to ask before we get to the last part, is that you you you came to the United States at the age of 12, as you said, from the Cambodian killing fields.

DAN: [00:16:26:03 – 00:16:59:03] And you if you know, we we probably here can't really think through what that the power of what you just shared. And where am I going with that is as follows. I wanted to ask about your navigation here from the standpoint of your mental health, is there anything you'd like to share with our audience in reference to your mental, your mental health as you've navigated over these years here and and you navigating for yourself and navigating for others?

CONNIE: [00:16:59:05 – 00:17:29:01] Yes. So, you know, having gone through the war where I was separated from my family at the age of, what, nine years, so and were able to reunite before, you know, before the end of the war. And then, you know, walking from Cambodia three days, three nights through the jungles to reach a refugee camp. So adjusting to life in refugee camp and then, you know, a year or so afterward, you know, settled in Brooklyn, New York.

CONNIE: [00:17:29:03 – 00:17:56:11] You know, the language that I have to learn, the culture that I have to learn. You know, it was very traumatic from what I have gone through. And I can't imagine, you know, anyone in my family or my community that have experienced similar extreme what I've gone through. Of course, we all experience mental illness, you know, mental health condition.

CONNIE: [00:17:56:13 – 00:18:17:06] So at one point or, you know, in our life, but the fortunate part in my family is that we talk about it. You know, my mother always encouraged us to talk about it. So part of healing is talking about it and showing our story, you know, So we reflect on on how we get to where we are today.

CONNIE: [00:18:17:08 – 00:18:37:11] And part of that reflection, you know, serve. So there's a process for healing for us. So when we talk about it, you know, we recognize that, oh, I did not realize that this is impact you and therefore, how can we support each other as a family member? You know, and then we share that story with our community. We realize that you're not alone.

CONNIE: [00:18:37:12 – 00:19:03:10] There's other people feeling the same thing or, you know, having the same experience, you know, having, you know, anxiety, PTSD. So how do we then help each other out? So I think for for us, the process and the ongoing of talking about our story help help us heal. And I'm still talking about it every day. Definitely. Yeah. You know, I was at the pandemic is a great example.

CONNIE: [00:19:03:10 – 00:19:26:00] It's you know, it's a it is a PTSD for me having witnessed what's happening, you know, the loss of a year. So so yeah, but we talk about it, you know. So also, how do we help each other? Yeah. How how do we overcome the fear of of the need to go out and get grocery store, groceries, food and things like that.

CONNIE: [00:19:26:00 – 00:19:29:19] So. So it's important to talk about it. Yeah.

DAN: [00:19:29:21 – 00:19:50:20] Yeah. It's so very important. It's it's, it's, it's, it's much needed. It's healthy and it's critically important. And I remember when we were talking some time ago, Connie, last year, and that there were so many in the community that wouldn't leave their homes when the when the violence was occurring at such a high rate, they wouldn't even go out to go to the grocery store.

DAN: [00:19:50:22 – 00:20:20:03] And, you know, sometimes we don't think about the trauma, the vicarious trauma that that creates in terms of what does that stress and what does that trauma look like and what does that depression develop into? So, you know, we appreciate your leadership and what you're doing. So as we as we come almost to the wrap up, I wanted to ask, as you as you know, the world can be a difficult place and sometimes it can be hard to hold on to what you talked about, hope.

DAN: [00:20:20:05 – 00:20:33:07] That's why each week we dedicate the last couple of minutes of our podcast to a special section called Hold On to Hope. Connie, can you tell us what helps you hold on to Hope?

CONNIE: [00:20:33:09 – 00:21:07:18] You know what? Help me hold on to hope. It's really, you know, the families and friends that are supporting me along the way. You know, I do dream I dream big. Because without dream, there is no hope, you know? And without hope, there is no future. So it's a dream that things will get better and at the same time, not just dreaming, but but actually taking action, You know, what can I do to make things better?

CONNIE: [00:21:07:20 – 00:21:30:23] And that could be making a decision to seek help. So you know what? Hope what what helped me in terms of holding on to hope is that, you know, that there are people out there that are available to help me out so that I'm not alone, basically, you know, and that are people that have experienced what I have gone through and that I can learn from them.

CONNIE: [00:21:31:01 – 00:21:34:20] So those are the things that, you know, that give me a sense of hope.

DAN: [00:21:34:22 – 00:21:59:17] Yeah, that is that is wonderful. And we we all need to carry that message for and kind of you also have mentioned your mom a couple of times and it makes me reflect on this organization. And it was started by moms and the advocacy of of of mothers who started this organization to this point of 44 years later is is significant and it's not lost on this conversation.

DAN: [00:21:59:18 – 00:22:31:05] Is is there anything you would like to share and as we talked about in the Cambodian community as well as other communities and you mentioned that there is such a large population of 23 million and over 50 groups. But with with all of that, we know that suicide and suicidal ideation is high. How do we help someone who may be listening and or watching this know that their life matters and that we want them to be hopeful?

DAN: [00:22:31:05 – 00:22:38:12] What what what could you say to inspire them to to hold on, to hope?

CONNIE: [00:22:38:14 – 00:23:15:08] So, Dan, you know, my family, my community, you know, the last year has been impacted by the suicide rate. So, you know, my family is part of that statistic. What I wanted to say to them is that, you know what they have gone through what I have gone through, that I'll live forever change, but that I hope that we utilize the experience, you know, to help other so that hopefully they would not be come.

CONNIE: [00:23:15:10 – 00:23:49:05] Part of the statistic that my family had have been, you know, part of recently. And I just wanted to say to to my families and my friends and my community that it's so important, you know, to open up and talk about the challenges in the family, you know, especially when it comes to suicide. You know, that is so important to talk about it, you know, because without talking about it, you know, we cannot take the next step in terms of seeking help.

CONNIE: [00:23:49:06 – 00:24:14:02] So we have to accept that, you know, that mental health touches many people, regardless of their background, and that there are people out there that are available to help us out and that we also have to accept and willing to seek help. So so I would probably suggest, you know, start out by talking about it, you know, talking about it.

CONNIE: [00:24:14:02 – 00:24:28:08] It is it is a very helpful process for healing, you know, So it's a wonderful opportunity to connect that other that that experience, similar experience. So and helping each other out along the way. Yeah.

DAN: [00:24:28:09 – 00:25:00:00] So thank you, Connie. And we're so sorry for your loss and thank you for sharing with us. And before we wrap, I want to say thank you for your leadership. We think about three components leadership, tone and execution. And you do all three of them at the highest level. You set the bar incredibly high with your leadership, the tone that you set in the community, the mental health community and the Cambodian community in society is incredible.

DAN: [00:25:00:05 – 00:25:25:04] And then your execution, how you operationalize it, how you how you actually put the work in place, is so incredible. And we so appreciate what you do. And thank you. And your leadership on the NAMI National Board is stellar and you represent us in so many different areas in terms of our committees and our work group. So we appreciate that and we want to make sure that we acknowledge that.

DAN: [00:25:25:09 – 00:26:11:22] So say thank you. And as we wrap up, I'll close with this here. This has been Hope starts with us, a podcast by NAMI, the National Alliance on Mental Illness. If you are looking for mental health resources, you are not alone. To connect with the NAMI helpline and find local resources, visit NAMI, talk forward slash help Text helpline 262640 or dial 800 950 NAMI or 6264 to find Asian American and Pacific Islander specific resources, visit NAMI dot org forward slash AAPI or if you are experiencing an immediate suicide substance use or mental health crisis, please call or text 988 to speak with a trained support specialist or visit 988 Lifeline Dawg.

DAN: [00:26:12:00 – 00:26:14:23] I'm Dan Gillison. Thank you for listening and be well.

About the Host:

Daniel H. Gillison, Jr.

Follow on Twitter: @DanGillison

Daniel H. Gillison, Jr. is the chief executive officer of NAMI (National Alliance on Mental Illness). Prior to his work at NAMI, he served as executive director of the American Psychiatric Association Foundation (APAF) in addition to sever…