Two mass shootings in California in one week have highlighted the complex mental health issues faced by older Asian Americans who may have been traumatized in their homelands and who — after building new lives in the United States — now find themselves facing additional challenges as they age.
Some first-generation Asian immigrants, especially those who emigrated from conflict zones, arrive with trauma issues that often go untreated during the push to find work, housing and a community, according to experts.
Depression and loneliness are major problems among elderly retired immigrants whose limited English skills impose limits on developing social circles of friends and acquaintances. Generational differences between the immigrants and their children, who are native or near-native Americans, create another layer of isolation for older immigrants, according to numerous studies.
Some Asian community leaders say more attention needs to be paid to the multifaceted mental health issues of older Asian American Pacific Islanders (AAPI).
Congresswoman Grace Meng tweeted, "I wonder how things could've been different had there been a strong mental health and social service network. Yes, it's about gun safety laws, yes, it's about stopping Asian hate, but also a generation of #AAPI elders with a life of unaddressed trauma."
Sylvia Chan-Malik, an associate professor in the departments of American and women's and gender studies at Rutgers University-New Brunswick, told VOA Mandarin that the mental health problems of AAPI elders were often neglected when they were younger because they were busy working. Upon retirement, the problems cannot be papered over by work.
"You might have a lot of trauma and even issues around depression and anxiety that you've never really dealt with because you were always working or trying to achieve something and trying to just move forward,” Chan-Malik said. “Then suddenly you don't have to go to work, you're at home, you are by yourself and you feel depressed or sad or unhappy in a way that you didn't.”
Raymond Chang, president of the Asian American Christian Collaborative, said, many elderly people in the Asian American community struggle with the sense that they are a burden to their families economically.
“It’s so challenging and in a society that values 'production,' you're not able to produce as much the older you get,” he said.
COVID pressures
The COVID-19 pandemic, caused by a virus first identified in China, and the subsequent hate crimes against Asians during this period have increased the mental and economic pressure on AAPI elders.
According to a 2021 report from the National Asian Pacific Center on Aging, which is part of the National Institutes of Health, 59% of Asian American Pacific Islanders said the United States has become more dangerous for their ethnic group during the pandemic.
Chan-Malik pointed out that like other Americans, many AAPI elders go online for information, and algorithms may push content to them that heightens their sense of danger.
She added, "They take a very partisan, very ideological approach to thinking about what's happening in the world because their YouTube feed or whatever is being curated for them. The algorithm is just giving them more and more of the same viewpoint all the time."
Yet it can be difficult for AAPI elders to obtain effective mental health assistance. Part of this is due to the influence of Asian cultures that stigmatize mental health issues, experts say.
But in the U.S., where only 27.7% of all mental health care needs are being met, according to the Kaiser Family Foundation, AAPI elders tend to seek help from family and friends rather than professional institutions.
A report from UCLA Medical Center says, "Embedded in collectivist culture and traditional views of body and mind as a unitary entity, older Asians … tend to [suppress or discount] psychological or emotional symptoms, which often makes it challenging to apply psychiatric diagnoses based on Western views."
Other restrictions on seeking timely treatment for mental health problems include health insurance limitations or the lack of insurance, immigration status and language preferences.
Reluctant to seek help
Compared with Americans of other ethnic backgrounds, Asian American Pacific Islanders are the least likely to seek mental health services, three times less than whites, according to the U.S. Substance Abuse and Mental Health Services Administration.
Kathleen Cameron, a senior director of the National Council on Aging, told VOA Mandarin that therapists who understand Asian languages are critical to providing better mental health treatment for older Asians. But, she said, language isn’t the only issue.
"It's not just the language but understanding the undertones of what they're experiencing and being able to pull out what someone may be feeling,” Cameron said, saying therapists could perhaps use body language and other cues to understand what people cannot articulate.
The January 21 Monterey Park shooting, which left 11 people dead and nine wounded, may have brought new trauma to AAPI elders because it took place in a popular Los Angeles-area dance hall — a familiar social space. Community centers, dance halls and churches are among the few settings where AAPI elders may feel comfortable expressing their emotions.
According to the New York Times, the Monterey Park ballroom where the shooting took place had parties almost every night where often more than 100 AAPI elders sang, danced and socialized. The ballroom was hosting a Lunar New Year celebration on the day of the shooting.
The other recent mass killing left seven people dead on two mushroom farms in the northern California enclave of Half Moon Bay.
Last May, an Asian man opened fire at a Taiwanese Presbyterian church in Southern California, killing one and injuring five. The church in Laguna Hills is one of the largest Taiwanese churches in the United States, with hundreds of members, and they were holding a welcome back event for a pastor who had been working in Taiwan for two years.
Chang said that since the church shooting last spring, his organization has discussed with federal officials how to strengthen security protection for the church. The challenge is that the protective measures may make AAPI elders feel uncomfortable.
"When you start putting security guards and metal detectors and armed guards at the front, what ends up happening is that strangers who are often looking to be friends feel like they're viewed with far more suspicion because they now seem more like a threat," he said.
After a spate of mass shootings and years of collective trauma in the Asian American community, Cameron worries that even more older Asian Americans either will not seek help nor receive appropriate treatment.
"For some Asian Americans, that's going to prevent them from maybe carrying on the things that they want to do or bring them joy in their life for fear that something might happen to them," he said.
Adrianna Zhang contributed to this report.