Youth-Driven Community Program Works to De-Stigmatize Mental Health Issues in Asian American Communities

Los Angeles, Calif. (June 24, 2019) Changing Tides, a program of Little Tokyo Service Center, is tackling decades of ingrained culture and values to help improve the lives of Asian Americans with mental health issues.

The young women and men of the Changing Tides Crew are focused on de-stigmatizing mental health issues that have long been swept under the rug in Asian American communities, seldom openly discussed nor addressed, due to cultural values of “saving face,” and preventing shame.

The impact of decades of repressing dialogue about mental health result in statistics such as: 

  • In general, Asian Americans report fewer mental health conditions than their white counterparts, but Asian Americans young adults ages 15 to 24 and females 65 and older are more likely to consider and attempt suicide

  • Asian Americans are three times less likely than white counterparts to seek treatment.

  • Asian American college students have higher rates of endorsing suicidal thoughts than their college peers, and they are least likely to seek mental health care on campus.

“These are just some of the numbers and statistics out there, shedding light on what’s going on in our community,” says Dr. KoKo Nishi, a psychologist and counselor at San Diego State University. 

As a “Sansei, third-generation Japanese-Chinese American” born and raised in Torrance, Nishi understands all of these issues well. She grew up with the Japanese concept of “Gaman” (“Suck it Up” or “Endure”) and “Shikataganai” and “sho ganai” (“It can’t be helped) and (“It is what it is.”), which is how Nishi’s grandparents say they got through their time in the Japanese internment camps. 

So Nishi was taught that gaman was a good way to get through life’s challenges, and she admits “it has helped me overcome many challenges and help me be successful because I was able to suck it up and push through.”

But at the same time, Nishi says, she also learned that “we are human, we’re not meant to keep all of our emotions inside. It’s not always a good thing to internalize what we’re struggling with. It's not always helpful for us to gaman. We need some sort of outlet because we have these feelings.” 

“It’s a big reason why I decided to pursue a career inpsychology,” says Nishi.

Asian Americans typically don’t say “I’m depressed” or “I’m anxious,” says Nishi. “It shows up in other ways: lack of motivation, not wanting to hang out w/friends. It shows up in not wanting to eat, or over eating to cope with our feelings.”

This was something passed on in Nishi’s family. “I didn’t know how to talk about feeling sad or struggling.” My oba-chan (grandmother) would never say to us, ‘I’m really sad, or I’m depressed. She would say ‘my back hurts’ or ‘I have a headache,’ she would never say ‘I’m not feeling so great, I’m feeling down.”

Meanwhile, younger Asian Americans feel familial pressure to excel in life and careers.

“There is the ‘Model Minority Myth,’ says Nishi, coined in a New York Times article in 1966, this assumption that Asian Americans can work hard and they can push through and they can get thru any difficulty. There is this assumption that we don’t need the help,” Nishi says. 

“You’re expected to be a doctor, a doctor or doctor, maybe an engineer, maybe a lawyer, but a psychologist? No. We don’t talk about our feelings. We don’t throw around the words ‘mental health’," Says Nishi.

Through her work, Nishi has counseled students who come to her because they are struggling with how to go into a career field that the families don’t approve of, such as music or art.

 “So being able to create spaces to share stories, tell our truths and acknowledge each other without judgement, is important,” says Nishi. 

Alan Hino’s story confirms Nishi’s observances and provides a cautionary tale.A tall young man with a friendly smile, Hino describes himself as “a typical Japanese American, growing up. I knew about putting the family first, and never bringing shame to the family.“ But he had lost his father to alcoholism when Hino was three years old, which haunted and affected him as he grew into a young man. When Hino was clinically diagnosed with severe depression, he fought his emotions. He didn’t turn to his mother or his friends for help. He didn’t talk about his depression. “I bought into the idea of ‘Man up’” Hino said.

But after three years of struggling with alcoholism himself and feeling overwhelmed with hopelessness, Hino hit rock bottom. “I made the decision to take my own life. I began making all the preparations in secret.”
But he also shared his pain and his plan with a cousin, which saved his life. “I would not be standing here with you today without her intervention,” he says.

Now, “I am becoming more comfortable with my emotions and struggles,” says Hino. He has learned “it is OK to embrace and share your emotions. It is OK to reach out to others for help.” 

He learned about the Little Tokyo Service Center and made new friends when he attended a pop-up art gallery hosted by the Changing Tides program, and now Hino seeks ways to pay it forward and be a “kind stranger” that reaches out to others in need. "I will gladly listen if you need someone to talk to,” he says.

He wants to let others who are struggling know that “there is hope, and it does get better, but it’s a huge step from acknowledging that and going forward.”

Dr. Nishi expressed appreciation and support for the efforts of Little Tokyo Service Center’s Changing Tides program, which she said is “helping change the tides of how mental health is viewed in our community.”

The program was spearheaded by Courtlyn Shimada, daughter of Margaret Shimada, Director of Social Services at Little Tokyo Service Center. 
Courtlyn was inspired to do something about mental health issues that were not being addressed at her high school, nor her college campus.

“My mother is a clinical social worker and has been involved with LTSC for much of her life. So within our family, mental health was something that was pretty easy to talk about, it wasn’t taboo.”

But growing up in Palos Verdes, attending a high-achieving high school, she knew her fellow students felt pressure to persevere, “keep going, make it through to college,” says Courtlyn.

When she started college at UCLA, she got involved in the Nikkei Student Union and peer support groups on campus. Talking about mental health issues wasn’t taboo on campus, but she realized that actually going and getting help was still very stigmatized. 

“It was OK to say anxiety was a thing, or depression is a thing, but it was not OK to say ‘I have that,’ or ‘my family has experienced this’.”

“I was able to get a feel for how different students were feeling about mental health and why they still felt pressured to not talk about these issues. I realized it was a huge issue in the Asian community at UCLA and in general.”

Through her conversations with peers, she felt there was more that could be done “to provide people spaces to talk about mental health.” She approached her mother to get her thoughts, and Margaret agreed there was a need. That launched the idea to provide a youth-driven program at LTSC, focused on de-stigmatizing mental health issues.

A key goal was to break down barriers to getting help.

“UCLA has a pretty great counseling and psychological services center, but they are really overbooked, so it’s really hard to get services. And the cultural differences that really play into mental health was something that probably wasn’t going to be addressed at such a large university,” Courtlyn says.

Another barrier: communities that don’t speak English being unable to communicate with doctors or even figure out the health care systems available.

So the Changing Tides Crew launched a series of events to raise awareness about mental health issues in the Japanese American and Asian American communities of Los Angeles County and facilitate open and honest dialogue.

The first event was focused on an intergenerational conversation around mental health. At that event, three speakers talked honestly about their experiences with mental health issues:

  • A Changing Tides crew member shared his experience with anxiety and the pressures of school

  •  Dr. Michelle Furuta, a psychiatrist, provided statistics about the state of Asian American mental health

  • A resident of one of LTSC’s senior living facilities talked in Japanese, with a translator’s help, about her suicide attempts.

“All three speakers were very open about their own stories, how they found resolution to those stories,” says Courtlyn.

“After that first event, we realized the young adult component was something that we really needed to do a deeper dive into and explore some of these issues with the young adult population,” says Margaret.

That led to the creation of CT Crew pop-up art gallery events that draw people in and engage them in conversation and friendship. For one event, the CT Crew reached out to 23 Japanese American artists who created pieces that represented and reflected mental health, plus musical performances. The pop up was open nine hours a week and “people would come in and hang out and ask questions.” said Courtlyn. 

“Art is something we definitely try to program about,” says Courtlyn. We also hosted a youth paint night, where the instructor was able to talk us through painting while also adding in his experience with mental health and how art helps him.”

“We always try to keep it as unintimidating as possible, giving people ways to engage with mental health without having to directly jump in.” More about Changing Tides


Little Tokyo Service Center is a social service and community development organization that has been creating positive change for the people and places in Southern California for more than 35 years. We preserve and strengthen the unique ethnic communities of our region and help people thrive. Starting with our own home in Little Tokyo, we build and strengthen communities throughout Southern California where people, culture and our collective future matters.

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Nikki Kealalio Sutton (she/her)

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Little Tokyo Service Center

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