As one of the largest social services agencies in the Midwest serving Asian Americans and other diverse populations, CASL understands its role in bettering the physical and mental health of community members so they can thrive and succeed in society. Over a year ago, CASL implemented a Behavioral Health & Clinical Services department to better attend to these growing social needs. Now, CASL is on its way to being finalized as a behavioral health clinic that can provide trauma-informed care and other key services for improving community health.
Winnie Lam, Associate Director of CASL’s Behavioral Health & Clinical Services (BHCS) department, is also a licensed clinical social worker who has dedicated decades of her career to working with members of the AANHPI community to improve their mental health. In this blog post, we share her and her team’s insights on the some of the most pressing challenges facing social workers and clinicians in social services settings today—and how we can take action to improve upon these issues.
Issue #1: We need more social workers, especially ones who are bilingual and culturally competent.
In the next decade, overall employment of social workers in the U.S. is expected to grow 9%. Major world events, including acts of mass violence, are occurring more frequently than in the past, influencing the world’s mental health in ways unlike ever before. People of all ages need long-term, intensive mental health support and access to resources that will improve their overall health. But if there are not enough social workers to help, how is that possible?
Based on recent studies (e.g. Hooyman, & Uniitzer, 2011; Lin, Lin, & Zhang, 2016) cited by the Quality Improvement Center for Workforce Development (QICWD), the social worker deficit will lead to more than 200,000 social workers needed to care for children, seniors and individuals with addiction and mental health issues. According to QICWD, this increased demand in specific areas of social work such as aging, criminal justice and education has led to less people taking advantage of key programs and resources like Title IV-E and Title IV-B education programs in child welfare. Additionally, anti-Asian hate crimes have risen 339%. Organizations like CASL understand the critical need for health providers that are culturally sensitive. A social worker’s role in the healing process following acts of violence or hatred is critical.
In her leadership of CASL’s BHCS department, Associate Director Winnie Lam knows that when hiring new team members, having cultural competency is critical, whether than is from experience working in another country or being trained to speak multiple languages. “I utilize my decades of experience in the mental health field and my firsthand knowledge of Asian culture to ensure that our mental health professionals have received training in the importance of cultural competency,” Winnie explains. “Our providers are proficient in multilingual speaking, which may be an invaluable resource for you to express yourself in the language you are most comfortable with, in order to overcome language barriers within the mental health field.”
An individual experiencing mental health issues needs a holistic plan to improve their condition, and that should always include a social worker. By encouraging more people to enter the field of social work, we will see this start to improve.
Issue #2: The issue of suicide is affecting mental health, especially AANHPI individuals, more than ever before.
Of all the most pressing mental health issues facing AANHPI individuals, the increasing rates of suicide are most alarming.
Despite the fact that statistics show that one in every six Asian Americans will be diagnosed with a psychiatric disorder during their lifetime, Asian Americans are less likely to seek help for their mental health concerns compared with other racial and ethnic groups (Shahid et al., 2021). Only 8.6% of Asian Americans sought help from mental health professionals, in comparison to 17.9% of the general population (Shahid et al., 2021).
“As a first-generation immigrant from Hong Kong 13 years ago, I was born and raised in Asian culture,” says Winnie. “The Asian culture where I grew up was collectivist—meaning that we placed individual needs behind and considered the needs of the community and family first. We were trained to have emotional self-control, which resulted in the suppression of identifying or presenting emotions that were outside of the social norms like anger, sadness, or anxiety.”
While care approaches to mental health issues differ significantly across cultures, the reality of growing suicide rates show us that some of these approaches may not be working as effectively as one would hope. The stigma associated with seeking help is a significant issue. In cultures where success is frequently connected with multiple people or an entire family system, the stigma can be especially difficult.
“Family recognition is frequently associated with achievement, particularly for immigrants to the United States who must work hard to improve their quality of life—not just for themselves individually, but for their family and the community as a whole,” explains Winnie. “This has led to a culture that places focus on academic success and career success while frequently sweeping mental health issues under the rug.” People don’t want to seem like a failure or bring their family shame, she adds.
Making progress to improve suicide rates means recognizing this and the stigma associated with different cultural approaches to mental health and mental health care.
“Historically, in all cultures, mental health has been under-recognized. It takes time and courage for all of us to take a stand against stigmatized mental health. If any of this sounds familiar to you, please remember you are not alone in this experience and seek help,” Winnie implores. Too many lives are being lost as a result of neglecting mental health issues because of stigma.
CASL would like to ensure you are not alone in this journey and that you have access to the care you needed. If you have questions about our mental health services, please contact us.
Issue #3: The issue of aging, and the issues that come with it like Alzheimer’s disease and related dementias, is also significantly impacting the general population.
The knowledge gap (on Asian American dementia caregivers) is especially troubling, as Asian Americans are the fastest growing ethnic group in the United States, but research is sparse (Sun et al., 2012).
As Asian Americans represent the fastest growing racial population in America, more people are competing to get the care they need for conditions related to aging, such as Alzheimer’s Disease and related dementias (ADRD). Cultural competency in providing care is also critical in this area, when you consider facts like in many Asian countries and cultures, there is a lack of words that describe dementia.
ADRD is not typically described as brain dysfunction in Chinese culture as it is in Western culture, Winnie explains. “The evidence on the impact of filial piety on caregiver burden and emotional well-being is mixed. However, stigma and cultural norms are thought to play an important role in caregivers’ willingness to seek out resources, support, and services. Culturally competent interventions to reduce depressive symptoms and relieve stress among Chinese-American family caregivers are certainly needed.”
With extensive experience working directly with caregivers over the last decade, social workers like Winnie recognize there is a strong cultural root for aging in place, or aging in the home. While caregivers try their very best to keep older generations healthy, they often need to invest so much time that they end up ignoring self-care needs, Winnie notes. She’s observed many clients approaching CASL at the brink of an emotional meltdown because of the mounting pressure associated with taking care of someone with a condition like ADRD.
We hope that more social services agencies like ours will work to provide culturally competent approaches to care so that prognosis of conditions like ADRD can be improved.
CASL provides person-centered, culturally competent and integrated home and community-based services that empower senior citizens to be active, healthy members of their community. CASL’s occupational therapy program includes a tailored activity program to engage those living with ADRD. Being engaged in physical and cognitive activities can help to slow the decline of brain function in those with ADRD. Some activities used with our community members include making dumpling wrappers, filling and forming wontons, utilizing familiar objects like mahjong tiles, and playing cards to engage in modified games or activities.
In addressing these three critical issues, more people can get the help they need and improve quality of life for individuals and their families.