Understanding Mental Health Stigma in Asian Communities

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On July 5th, I was going about my morning routine and skimming through news headlines on Asian media sites. I froze when I saw the headline on the death of singer Coco Lee fill the page of entertainment news. Coco Lee wasn’t just any pop star. She has been widely popular for the past 30 years and has won countless awards, as well as shattering many Asian stereotypes. She was the first Asian singer to sing on the stage of the Oscars; she was also the first celebrity from Asia to claim a place on the Billboard 100. Similarly, Coco Lee’s significance in the Asian American culture is similar to Michelle Yeoh's in the movie side of entertainment. She wasn’t just any pop star. In fact, she was my teen idol growing up. I still remember vividly how excited I’d be when a new album dropped and how I’d tried to mimic the way she dressed and styled her hair. Coco Lee’s songs were the must-sings in our karaoke lineup back when my friends and I would hit popular KTV spots on the weekend.

Since her passing, media coverage in Asia has been filled with speculation and much of the “so-called” insights around why and how she chose to end her life by suicide. According to Coco Lee’s family, she was diagnosed with depression a few years ago. On top of her mental state, her life was challenged by the further diagnosis of breast cancer and a foot disfigurement that required major surgery and left her with substantial work of recovery, including having to learn to walk again. With all the sympathy and sadness around the tragic passing of this enormous bright star, I can’t help but feel a little surprised by her chronic depression. Although I am aware of the prevalence of depression in our world, Coco Lee has always come off as someone who is full of life and energy. She is constantly smiling in all the programs and always puts on her best performance. The last time I saw her was in a Chinese variety series from two years ago, where she seemed like the Coco that is loved by millions, full of light and boundless energy. Just like other shining stars such as Robin Williams, her light was dimmed too early, too soon.

Since the news of her illness broke out, I’ve been thinking a lot about the disparity of depression and mental wellness between the East and the West. According to research, there is an average of 16% of people in Asia said, “They have had mental health challenges of their own.” This is compared to the 25% in Western countries. This approximately ten percent of difference is augmented by the rapid pace of living (having to spend more time traveling to and from work, as well as longer hours of work.) The lower number of mental health issues in Asia does not represent a better state of wellness, but on the contrary, mental wellness is not acknowledged or sometimes even frowned upon by traditional Asian standards.

While mental health stigma in asian communities is prevalent, the stigma of mental illness can indeed vary across different cultures, and the influence of collectivism versus individualism is one factor that can contribute to this variation. While it is important to recognize that not all Asian countries exhibit high levels of mental health stigma and not all Western countries have low levels, we can explore this issue from a general perspective.

Collectivism and individualism are cultural dimensions that influence how societies prioritize the needs of the group versus the needs of the individual. Collectivist cultures, commonly found in many Asian countries, place a greater emphasis on social harmony, conformity, and maintaining the reputation of the family or community. In such cultures, mental illness may be stigmatized due to several reasons:

1. Interdependence: Collectivist societies prioritize strong interdependence and interconnectedness among individuals. Mental health issues can be seen as a threat to the group's well-being, as they may disrupt social harmony and stability. Consequently, individuals with mental illness may be stigmatized to prevent potential disruption to the collective.

2. Loss of face: Many Asian cultures value "face" or maintaining a positive public image. Mental illness can be perceived as a source of shame or embarrassment, reflecting negatively on the individual and their family. Stigma arises from the fear of losing face and damaging one's reputation, leading to the avoidance or concealment of mental health issues.

3. Duty to the family: Asian cultures often emphasize the duty to prioritize family needs over individual needs. Seeking help for mental health issues might be viewed as neglecting familial responsibilities or burdening the family with additional concerns. Consequently, individuals may hesitate to seek treatment to avoid upsetting their family or appearing selfish.

In contrast, individualistic cultures, which are more popular in Western countries, prioritize personal autonomy, independence, and self-expression. Mental health stigma may be less pronounced due to the following factors:

1. Individual rights and privacy: Individualistic cultures tend to place a stronger emphasis on personal rights, including the right to privacy and seeking appropriate healthcare. This can create an environment where individuals feel more comfortable discussing mental health concerns without fearing judgment or stigma.

2. Personal achievement: Western cultures often value personal achievement and success. Mental health is increasingly recognized as a barrier to achieving one's full potential. Therefore, there is a growing awareness that addressing mental health concerns is essential for optimal individual performance, which helps reduce stigma.

3. Openness to diversity: Individualistic societies generally exhibit a greater acceptance of diverse perspectives and experiences. This inclusiveness extends to mental health issues, fostering an environment where individuals feel more comfortable discussing their struggles and seeking support.

It is crucial to note that these are broad generalizations, and individual attitudes and experiences may vary within cultures. Although mental health stigma in asian communities remain, mental health stigma is a complex issue influenced by various societal, cultural, and historical factors beyond collectivism and individualism. The passing of Coco Lee serves as another reminder that depression and mental illness must be acknowledged and treated with care, despite which culture we are in. Efforts to reduce stigma require a multifaceted approach that involves education, awareness, public policy, and fostering supportive environments that prioritize mental well-being. #ItStartswithYou