Time for an Awakening: Overcoming the Adversity of Culture and Stigma
CW: suicide, dist. thoughts
In March 2016, international student Zhikai Liu committed suicide by jumping off the balcony of his 21st floor apartment. Travelling more than 9000 kilometres from China to study in Melbourne, Liu found himself in an extremely challenging situation. He was unable to keep up with his study load, had difficulty socialising with local students, and became more and more distant from his long-distance girlfriend. As a result, Liu started to experience serious insomnia and depression, occasionally expressing suicidal thoughts when he was alone in the apartment. Unfortunately, he refused to seek any medical assistance, and insisted he was fine.
On 5 March 2016, Liu expressed his desire to focus on improving his English, rather than spend time at university. He was then told by his father to give the decision some thought. The next day, after a conversation about Liu’s academic and life predicament, Liu’s sister heard him walking towards the kitchen and muttering to himself, “Why is life so difficult? Why do we always have to make difficult decisions?”.
Then the tragedy happened.
In investigating Liu’s suicide, Coroner Audrey Jamieson instructed the Coroners Prevention Unit (CPU) to analyse suicides of other international students in Victoria. To find out what might be distinctive about the deaths, the CPU studied the circumstances of the 27 international student suicides and a cohort of suicides among Australian-born students. The findings by the CPU include the following:
A lower prevalence of diagnosed mental illness among the international student suicides (14.8%) than in the Australian-born student suicide cohort (66.7%)
Only 22.2% of the international student suicide cohort attended a health service for a mental health related issue within six weeks of death. By contrast, 57.1% of the Australian-born student suicide cohort had such an attendance within six weeks of death.
Studies have also found that international students in Australia are less likely than domestic students to seek assistance for mental health issues because of cultural, financial, linguistic and other hurdles. In a paper published by Dr Helen Forbes-Mewett and Dr Anne-Maree Sawyer, three factors are identified to heighten the stress experienced by international students:
The experience of new and often unfamiliar academic practices;
The broad range of knowledge and practical skills needed to manage day-to-day living in Australia;
The tendency to delay professional help-seeking for mental health problems.
What we can learn from Liu's story
When I first came across the news about Liu’s suicide, I blanched and pondered deeply over his last words. Reflecting on the very beginning of my time in this country, I experienced a similar type of anxious feeling. Why is life so hard? Why are there so many choices? Why are there so many decisions that need to be made?
Famous existentialist philosopher Søren Kierkegaard described this anxious feeling as the dizziness of freedom, that of crippling possibility, of the boundlessness of one’s existence. Reading the existentialist philosophy was an enlightening process for me. I view this as a precious opportunity to fully grasp my own choices, responsibility, freedom and true being. Anyway, this is slightly off our topic. What is more important here is the cultural stigma international students are facing.
Liu’s suicide shows how international students are particularly vulnerable to mental health issues. There are way more students out there sitting in their own room desperately in need of help. They either don't know how they can seek assistance, or they simply to refuse to talk to anyone about their issues. Writing from my experience as a native Chinese, the problem for students coming from Asian cultural background, I believe, lies in our inherent conservative cultural values regarding mental health.
Mental health has always been regarded as a taboo in many cultures. Particularly in the Chinese culture, the focus is always on physical health rather than the health of our mind. Emotional or psychological symptoms associated with mental health issues are rarely the topic of conversation. This probably has to do with the “keeping face” culture in Asia, where people fear that talking about their mental health would be a sign of weakness, and could bring shame on themselves and their families.
What's even more disappointing to me is how some people still express their resistance to the 'western' way of treating mental health. They believe it wouldn't do anything to solve 'eastern' problems. This stigma would further undermine one’s confidence of his or her ability to overcome their mental illness. It will lead to people to define themselves by their illness rather than who they are as an individual.
Based on that, here are some of the ways I've learnt to deal with the stigma:
Get the medical assistance you need as soon as possible. The effects of mental illness, if not dealt with in reasonable time, would lead to further harms to your physical health.
Do not let mental illness define who you are. Rather than saying ‘I’m depressed’, say ‘I have depression”. In order to find your true self, you should view yourself as a confident and capable individual.
Don't pay attention to the negative and stigmatising comments. Mental illness is not a sign of weakness and is rarely something you can deal with on your own. Talking about your mental health issues with healthcare professionals will help you further along on your road to recovery or management. Remember that other people’s judgements often come from a lack of understanding rather than anything else. These judgments are typically made before they get to know you, so don't believe that their views have anything to do with you personally.
Connect with others. Joining a mental health support group can help you deal with feelings of isolation and make you realise that you're not alone in your feelings and experiences. You can also talk to your close friends, relatives and families about your issues.
Written by Dave Yan Sima