It's difficult for most people to talk about mental health with their loved ones, but this lack of communication is especially prominent in the Asian community where the concept is often misunderstood.
Megan Simpson, a Toronto nursing student who has struggled with depression, knows this too well. In a blog she wrote for U.K. mental health charity Mind in February, Simpson revealed how challenging it was to talk to her Taiwanese mother about her diagnosis.
"For [my mom], mental health was a topic that was not openly discussed and when talking about my diagnosis she struggled to grasp that depression goes beyond 'just being sad,'" the Torontonian wrote. "Unfortunately, at the time, my mum couldn't understand why my brain was 'different' or why I was simply 'unhappy.'"
According to Toronto-based psychotherapist Jenny S. Cheng, the reason Asian families don't talk about mental health is because they just don't know how to.
"In previous generations, people just didn't have the words to talk about it. We all learn how to talk about certain things just from our upbringing and our social circles," Cheng told HuffPost Canada. "A lot of times, immigrant parents don't have a role model of how to talk about mental health."
There's also a lack of knowledge about what mental health is, Cheng added, and immigrant parents tend to "think of the most extreme examples" and view mental illness as "very black and white" rather than as having a spectrum. Plus, mental health isn't viewed as a priority in Asian communities.
"A lot of people [immigrate to Canada] because they want a better life, so when they come here it's just about survival," Cheng explained. "Job, work, school ... there are other things that are more demanding of their time. And I think that's in general, not just Asian culture."
Dr. Hiram Mok, a psychiatry professor at the University of British Columbia, agreed with Cheng. During a CBC panel in March, Mok noted that cultural values, such as stoicism, and the stigma around mental health prevent Asian families from talking about it.
Starting the conversation doesn't have to be so hard
If you've never brought up the topic of mental health with your parents or family members, it can be difficult to figure out where to start. But Cheng said that if you start small and keep it simple, you can encourage your family members to open up.
"Take the conversation slowly, especially if [you've] never talked to [your] parents about this or [your] parents don't enjoy talking about these things," she said.
The simplest way to start a natural conversation is to share something that's happening in the news, Cheng advised. She used the recent deaths of fashion designer Kate Spade and celebrity chef Anthony Bourdain — who both died by suicide within three days of each other — as examples.
Bring up the headline, whether it's a celebrity death, a government mental health initiative or something that's happening in other Asian cultures, and ask questions like, "What do you think about this?" or "What is your experience with this?"
But the conversation doesn't have to be limited to what's happening in the news. Mental health has been prominent in pop culture in recent years thanks to shows and movies like "13 Reasons Why" and "To The Bone," which tackle all types of issues from suicide to depression to eating disorders.
Using these kinds of topics as starting points can ease your family into the conversation of mental health, Cheng said.
How to tell your parents you have a mental health issue
It can be an emotional process trying to tell your Asian parents you're battling a mental illness and need their support. A Reddit thread from last year revealed the frustration and hurt many adult children experience in this situation due to their parents' lack of knowledge and understanding of mental health.
"Asian cultures have hard work ingrained into them and it makes parents think that if you're failing at something you're not trying hard enough," wrote one user, who is of Vietnamese-Chinese descent.
Another added: "I feel like Asian parents are very backward in that aspect... and it's really breeding a future generation of mental disorders from trying to 'just keep going' despite the obvious mental issues because that's one of the treasured Asian values, to be hardworking."
Cheng explained that if your parents are not well-informed on mental health, they'll likely "freak out and not know what to do" if you tell them you're struggling. That's why she insists adult children "arm themselves with information" before approaching their parents.
"First educate [yourself] about [your] mental health situation and look at what kind of supports [you] have," the psychotherapist advised. "Then go to your parents [and say], 'Hey, I want to just let you know what's going on with me.' And if this is a conversation where [you want] to ask for help, having information, giving parents [an idea of] the kind of help [you] need, I think that can be very helpful."
"There might be times where parents cannot help for whatever reason," Cheng added, "but at least the parents are informed and this would be a stepping point of 'when I feel more comfortable with this subject, I know how to reach out to you.'"
What if you notice your parent has a mental health problem?
As many as one in five Canadians experience a mental health issue in any given year, according to the Canadian Mental Health Association, and mental illness affects everyone differently. However, the signs aren't always obvious, as past celebrity deaths have proven.
That's why watching how someone adapts after a big change — either positive or negative — is one way to be aware of others' mental health, Cheng said.
"Big changes tend to disrupt someone's life," she explained. "If you're noticing things that they liked to do, they don't do anymore or there are certain things that they can normally handle and now they can't, those are signs to look at."
But after you've identified a family member has a mental health problem, you can't force help on somebody who doesn't want it. All you can do is let them know you're there for them when they are ready to talk. That's why Cheng says it's so important to "create a climate where asking for help is encouraged and welcomed and respected."
"I think a lot of the time people are scared if they ask for help, people will think they're weak or that they can't handle things," she said. "So I think if someone is interested in taking care of someone, [they just have to say], 'Hey, I've noticed you've just had this big change, you don't do that hobby you liked to do anymore. If there's something you ever want to talk about, I'm here.'"
Periodically checking in with parents and other family members makes it easier for those who are struggling to reach out when they're ready because they already know they will be supported.
It's crucial for families to talk about mental health
Mental illness can affect all aspects of your life, which is why it's so important to talk about it.
"It impacts our ability to deal with life, to enjoy life and to have good relationships," Cheng explained. "When families talk about mental health ... we [are creating] a culture where the people in there know if they need help, there is help and it's OK to say, 'I am not doing well.'"
While there are plenty of mental health initiatives in Canada that raise awareness and work to break the stigma, such as Bell Let's Talk or Elephant in the Room Anti-Stigma campaign, Cheng believes starting mental health conversations in family settings can be particularly powerful.
"When families talk about mental health that's like creating a new culture if that culture wasn't there before. [It's a] new way of people taking care of themselves," she said.
According to the psychotherapist, this is a "powerful group" to create because "[they'll] go out and they will influence their relationships" outside of the family, so "it's almost like a base unit to start social change to make sure we all take care of our mental health."
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