Considering Ethnic Perspectives - Part II

In a recent blog piece, I reported on some of the things that came up at a one-day conference I attended on ethnic diversity in the older mental health community. The conference was put on by the Senior Mental Health Partnership, which is a program of NAMI San Diego. To continue ...

Martina Portillo RN, MPH, who is a member of the Hopi Tribe and has had a distinguished career in the Indian Health Service, reported that 57 percent of 3.3 million American Indians/Alaskan Natives now reside in urban areas. “This is a complete reversal since I was little,” Ms Portillo observed. Indians are moving to the cities for the same reasons the rest of us do - jobs and education.

Indian life expectancy, at 72.3 years, is about four years less than non-natives, a “complete improvement” according to Ms Portillo. Where the death rates are significantly higher: TB (750% higher), alcoholism (550% higher, but lower among older men than their counterparts among other races), diabetes (190% higher), unintentional injuries (150% higher), homicide (100%), and suicide (70%, very high in the young population but lower in elders than the general population).

Elders in the Indian population recall their culture being looked down upon as “bad”, with forced boarding schools, banned spiritual practices, and loss of land by the allotment system. Barriers to mental health include differences in cultural beliefs about mental illness, cultural labeling of different emotions, lack of mental health professionals in the system (101 per 100,000 compared to 173 per 100,000 in non-native populations, lack of large scale studies, and lack of cultural orientation for providers (such as in the healing traditions). Rarely do elders seek out available mental health services.

Shifting gears ...

A panel of presenters - Dixie Galapon PhD, Agnes Hajek MSW, and Emily Wu PsyD - from the Union of Pan Asian Communities (UPAC, which serves a vast range of Asian and Pacific Island communities in San Diego) reported that, among other things, Asian elders are confronted by a difference between how Asians and Americans view the elderly. The family matriarch, for instance, rather than enjoying an exalted seat of honor. may suddenly find herself a stranger in a strange land, even within her own family, especially if dealing with Americanized children and grandchildren.

Asian Americans whose families experience a high interpersonal conflict have a three-fold greater risk of attempting suicide compared to the general Asian population. This is true even among those who never had a history of depression. As the panel noted, this points to the strength of family values in Asian communities. Family harmony, they noted, is a value coming from Confucianist (stressing values) and Taoist (stressing balance) beliefs.

An intervention UPAC is working on includes “Problem Solving Treatment” aimed at older adults. Since depression is often caused by problems in life, the object is to help clients regain a sense of control and thereby improve their mood. For instance, people who are engaged in social activities at least two times a week have less depression than those not engaged.

Wrapping up ...

Look around you. Look within your family. The view is probably much different than it used to be. Lot of things to consider ...