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Mental Illness--Chinese Style

Social stigma towards mental illness exists in every society, including Canada and the United States of America. Yet the extent of such stigma varies according to the cultural and sociological backgrounds of each society. The purpose of this article is an attempt to examine the specific factors which lead to the social stigma towards mental illness in the Chinese community at large.

Culturally, most Chinese tend to hide their feelings in comparison to their western counterparts. Indeed, there is a famous Chinese saying which said that "family shame should be kept inside the house." The loss of face is important to many Chinese. It is a social phenomenon that mental illness is a shame. This ill-conceived notion has to do with their ignorance of "mental illness." According to Lin Chiu, a veteran pharmacist at the Castle Peak Mental Asylum in Hong Kong, "Many Chinese have a very vague idea as to what mental illness is. To a lot of them, they tend to relate mental illness to violence, with little knowledge that there are various degrees and types of mental illness." Dr. Ted Lo, a Chinese-speaking psychiatrist in Toronto and the founder of the HONG FOOK MENTAL HEALTH ASSOCIATION in Toronto, echoes with Chiu's opinion. He emphasizes that there is a lack of education among the Chinese towards mental illness and most tend not to admit that they are afflicted with the illness. This unwillingness to be "associated with mental illness" is understandable when there is so much social stigma within the community towards mental illness.

To my mind, the Chinese media plays an important role in stereotyping mental illness. Dr. Ted Lo also agrees with this view. In my own experience of reading Chinese newspapers, I hardly find any editorials which pay attention to analysing the causes of mental illness. On the other hand, they tend to use sensational headlines in their reports of the "mentally-ill" cases. For instance, big headline such as "A MENTALLY-ILL MAN TRIED TO KILL A STRANGER." In a recent incident in which a homicide occurred as a result of some family matters, the reporter just mentioned very briefly that the father is believed to have mental problems. In fact, according to a survey done in Hong Kong, only 1.4% of those who committed violent crimes are related to the so-called "mentally-ill" while 98.6% who committed violent crimes are considered "normal." Thus, such negative reports from the mass media undoubtedly increase the social stigma of the Chinese community towards mental illness. And of course, there is a popular local slang which adds to the existing social stigma. Phrases such as "you want to go to Castle Peak Asylum?" or "you must be CRAZY!" are often heard in the streets and in movies. Thus, under such a negative cultural environment towards mental illness, it is understandable that many potential mentally-ill people refuse to seek help.

Hong Kong, a small island, is crowded with over 6 million people, with a big contrast between the rich and the poor. With such a discriminatory attitude towards mental illness, it seems that there would be little hope for employment if the employer finds out that the employee has a psychiatric history. Dr. Lo said that when he left Hong Kong about 24 years ago, there were the Pro-Life Rehabilitation Program and the Hong Kong Mental Health Association who tried to line up jobs for the ex-psychiatric patients. But he also pointed out that to what extent is it successful, he does not know. Dr. Lo, who also knows about the psychiatric system in China, said that in China, little attention is paid to mental illness and that the social stigma exists even more so.

According to the Canadian Mental Health System, there is about one in four Canadians who suffer one kind of mental illness or another. However, in Toronto alone, there are about 380,000 Chinese-Canadians, yet there are only a few who seek help at the Hong Fook Mental Health Association. Does it mean that the Chinese immigrants are healthier mentally than the Canadians? Or that they are afraid of being "labeled?" Or is it to do with the lack of language skills. Dr. Lo again emphasizes the lack of education among the Chinese as well as the lack of services and funding from the Government. There are workshops being offered by Honk Fook Mental Health Association, yet the number of people who show up at these workshops is another matter. He agrees that the lack of language skills can hamper new immigrants to seek help, especially when a number of them do not know the hospital system here in Toronto. He sees that there are changes which have happened within the Chinese community, but that it is gradual and slow.

To conclude, it is important that the Chinese at large have to change their deep-rooted bias toward mental illness, to accept those afflicted with the illness without prejudice, before major changes can be done. Just like Dr. Lo said, "There is hope but it is gradual."

© Copyright 2000, Caroline Fei-Yeng Kwok

Caroline Fei-Yeng Kwok, B.A., M.Ed. lives in Toronto. She is the author of The Tormented Mind and numerous articles on mental illness in the Chinese-Canadian community.
She may be reached at carolinek@idirect.com.

Modified December 25, 2002