S1: Well , welcome in San Diego. It's Jade Hindman. On today's show , we are celebrating the culture and the trailblazers this Asian Heritage Month here. How mental health care can be more responsive for the community. Plus , hear from leading immigration researcher Tom Wong on his ideas around immigration , identity and America's 250th. This is KPBS Midday Edition. Connecting our communities through conversation. Navigating mental health care can be hard. Sometimes it comes down to access or finding the right therapist , but it can be even more frustrating when you don't feel seen or understood by the therapist you're speaking to. That's a common scenario for many communities of color. So today , as Asian , Native Hawaiian and Pacific Islander Heritage Month and Mental Health Awareness Month come to a close , we want to look at the experience of the community in getting care and how cultural values and obligations come into play. I'm here with Doctor Nelli Tran. She's a community psychologist and professor in the Sdsu Department of Counseling and School Psychology. Doctor Tran , welcome back to the show.
S2: Thank you for having me.
S1: So glad to have you here for this conversation. You know , last time we we talked , um , we actually had a conversation about traditional talk therapy and how it's fallen short for many Asian-American communities. Remind us how talk therapy works and why it might not be working for AAPI clients.
S2: So the first thing is the individual must want to go and seek help. And so that often means making an appointment , finding someone , often finding someone that your insurance covers and then having an initial meeting. We often say that it takes about six sessions before , you know , you really start to feel any amount of relief , and six sessions is a long time to be in pain and suffering. And so for a lot of folks from the Asian-American community , they're not seeking help until they are in quite a bit of pain. And so you can imagine then , that I'm finally taking the risk to to put myself out there to ask for help. And now I'm being told I need to be patient and wait six weeks. So then they're building a relationship with a therapist. And , you know , oftentimes there's not a match , right ? If a if a client , an Asian-American client doesn't feel understood is having to educate , the other person feels judged , they may not come back. And so you can imagine then they have to start that process again. And so it could be easier to seek help elsewhere with folks who understand what you're going through already , where you already feel validated walking through the door. And you know that this person can relieve some of your suffering and your pain quickly. Right.
S1: Right.
S2: Um , and so that becomes really difficult because now you have , you know , mental health practices such as mindfulness , but they're not connected to your culture , they're not connected to deep seated history , family traditions. And so that can be really difficult where you're feeling as though this practice that you're going to to seek help is actually pulling you away from culture , family , tradition , people you love and care about. And , you know , it's unfortunate that , you know , anti-Asian sentiments are still rampant within our society. And so you have mental health providers who have not been adequately trained on how to serve Asian-American community members. and so they're not well aware of collectivist traditions. They often carry biases about how families might have a sense of obligation towards their elders , how much young folks want to please and to care for their elders. And then so they're being pushed to separate right to individual to go and fulfill your passions right and follow your dreams. It's okay. Your family is toxic. So those mismatches may cause the individual to feel as though they have to choose. I have to choose between mental health , wellness and being with my family. And what I see is a lot of young people choose , I want my family , you know.
S1: In that case , like , do you not in the case of someone wanting to choose their family , but just in the case of therapy that that is not culturally responsive ? Um , can that be more harmful than. Absolutely and good. Yeah.
S2: Yeah. Access to mental health , uh , mental health care that isn't culturally responsive , culturally appropriate , is very harmful , is quite unethical. But the field itself is very slow to respond to this , to see how harmful it might be. So even in our research , we still see a lot of research that talks about the stigma that Asian-American communities hold about mental health. And what I often tell my students who do research in this area is that , well , you know , it's true. There is a lot of mental health stigma in many of our communities. And could it also be possible that the stigma that mental health holds within our community is appropriate ? How many of us have had counselors treat us as though we are less than have have tried to socialize us into something that we are not , have had to , that we have had to experience racism and microaggressions within the therapeutic setting that has been quite harmful. And so they've rejected the idea of this more , you know , traditional Eurocentric model of mental health care. Mhm.
S1: Mhm. Like , you know , are you seeing a difference between generations. Right. And how they're thinking and talking about their own mental health. Yeah.
S2: Yeah. You know , I come from a generation , my parents were refugee boat people. And so I really felt this sense of obligation. They , you know , they risked their lives for me to have opportunity. And I have to remember , I think that we have now in America , not just first generation or refugees. We also have second generation , third , fourth , fifth generation Asian Americans. And so there is , um , there are lots of different experiences , and each generation is carrying the traumas of the generation before them. And so I see a lot of my students now who are second and third generation , and they say that they have this sense of obligation , what they want to do well by their parents , they want to fulfill their parents dreams of them doing well. But then they also tell me. Well , my parents actually want me to be happy. They told me to follow my my dreams and my passions. And so then I tell them , so what is your dream in your passion ? And they're still reporting that they want to do the thing that they think their parents want them to do , right ? So like , they want to become the doctor. And I'm like , I never heard you say your parents wanted you to become a doctor. You know , my generation , we said that a lot. And it turns out one of the assignments I make my students engage with is talking with their parents and tracking their career generation , where they have to track labor and work through the generations , and they come to find that they have held on to that. But their parents don't actually believe that their parents truly want the freedom that they could not have in choosing their their future direction. And so I think that's the important part.
S1: That's so interesting. You know , we talked about , um , about collectivism , which is a core part of so many Asian American cultures.
S2: Right. So that's part of our sense of obligation to our family. And it kind of goes into our larger collectivist ideals. But I think this , you know , idea that we do respect our elders , right ? And that in the US here we flatten the hierarchy or we attempt to many , many people attempt , especially in the college setting and even in the therapeutic setting on occasion , try to flatten the hierarchy without the understanding that actually we respect elders , we respect those with wisdom. So you carry a lot of power that must be acknowledged. And so a counselor has to be able to acknowledge the power they hold over others. When I walk into a room , my community members want me to be called doctor because they respect the title , whereas I go into other spaces where Vietnamese people might not be plentiful. They want me to drop the title because they think it's , you know , that's too arrogant , right ? We're all the same. So I think that's a piece that's really important that those who are working with our young people have to remember that hierarchy isn't all bad , right ? There is a very important role for the auntie who gets to say things that the parents don't. And I think that's true of many of our communities that we really have to think about. Yes , collectivism is its own thing , but I think hierarchy is not always bad , right ? Having people of different generations in our lives that we can have different types of relationship with is very important.
S1: Right , right.
S2: Right. And so to me , that's what it brings up , is that there is an inherent power that you hold when you are in a therapeutic relationship , someone is paying you for services. And when I train counselors , I often say , you know you want to help , but helping in a professional sense is very different than helping your neighbor , right ? Your you hold power over the other person. You have to be very careful about the language you use , right ? You have to be very careful about what you share about yourself. And it's very different than a relationship I hold in my neighborhood where I want to be more open. I want to reciprocate information. So I do think that , um , collectivism in our communities can look different , right ? We can celebrate each other. We can share information with each other. We don't have to have a wall between us. Right. I don't have the luxury of not serving people who might speak Vietnamese , for example. Right. Because how many , how many therapists do we have in San Diego who speak Vietnamese ? Very few. I can probably count them on one hand , in which case , then it is very likely that a Vietnamese speaking Therapists will have a community connection with the people they must serve , right ? You have to acknowledge that in the room and that person still deserves services.
S1: You know , like last time we we also spoke about , you know , ancient cultural traditions and how more and more clinicians are making that part of their practice.
S2: I think more and more clinicians want kind of ancestral knowledge within their practice. I have mixed feelings about this because , you know , therapy costs money. Generally speaking , it costs money. And the practice people require making a living. But many of the traditions that people are incorporating are services that have always been free. Right ? They've belonged to the community. They have belonged to a Buddhist temple. You can still learn mindfulness by going to the temples in Escondido and , you know , in North Park And walking in and asking to be a part of the community there. It does not need to cost money , so there's something inherently different when we pluck that out of the community , and then we ask to be paid to do something that many people are not fully trained in , right ? People will incorporate mindfulness in their practices without any certification , without years of training. And actually , research has shown now that that has resulted in a lot of damage , that meditating for three hours when you don't know how to meditate , and simply telling someone to just clear your mind to someone who is is in deep pain right now. That could be one of the most dangerous things to do. And so and people don't like to look up that research , right. And see that , you know , yes , these practices have benefits and when used incorrectly are have adverse effects as well.
S1: That makes a lot of sense. Yeah. How would you empower those who are wanting to seek care but may still just kind of feel turned away by the stigma and the barriers. Yeah.
S2: Yeah. You know , I don't think that therapy has to be the first step. You know , there are lots of there are lots of ways that you can step into therapeutic work or healing work. I think that our faith based centers are great places to start as well. So if you belong to a faith based community , it's , you know , asking for help in that space is also important. Many of our professors , teachers , mentors are good spaces to turn to if you want to seek professional help. There are many agencies in San Diego that offer low and pro-bono services. We have a training clinic here in City Heights. The the center for Community Counseling and Engagement , where we also offer low and sometimes free services for families , couples and individuals. So I think picking the right entry point that feels comfortable. Right.
S1: Right. And is that where you suggest folks start , if they're in particular , looking for care that is culturally responsive , which is more of a need and not necessarily not like , you know , an extra add on , not cherry on top of.
S2: It is.
S1: Not that is a necessity.
S2: I think for most of the people who come to me , they're asking for specific types of people they would like to work with. And I think it's important for providers to acknowledge if I , as a client , say that this is a necessity , it's a necessity. No questions. Right. So I would go to our , um , our ethnic centered communities. So Upwork is one that offers services. You can also go to national organizations like the Asian American Psychological Psychological Association as well.
S1: All right. Well , thank you so much. I've been speaking with Doctor Nelli Tran. She's a community psychologist and professor for Sdsu Department of Counseling and School Psychology. We'll link to any resources mentioned on our page at KPBS. Doctor Tran , as always , thank you so very much.
S2: Thank you for having me.
S1: Coming up here about Tom Wang , he's a leading researcher on immigration in the United States and one of our AAPI Heritage Month trailblazers. KPBS Midday Edition is back after the break. Welcome back to KPBS midday Edition. I'm Jade Hindman. This month , we've been featuring conversations with important San Diego voices to celebrate Asian-American , Native Hawaiian and Pacific Islander Heritage Month. Over the past decade and a half , Tom Wang's work has explored how immigration has really shaped the US and the ways race and identity play into that story. He's a political science professor and founder and director of the U.S. Immigration Policy Center at UC San Diego. He was awarded the ACLU Presidential Prize for his work on immigrant immigrants rights in 2022. Tom Wong , welcome back to Midday Edition.
S3: Thank you for having me.
S4:
S1: And congratulations on that award , by the way.
S3: Thank you.
S1: Um , how you know , we are we're having this conversation during aa , NPI Heritage Month. Can you share a little bit about the history of that term and what makes it important ? Yeah.
S3: So I talk to my students a lot about , you know , how one can be represented. And in order to be represented , you have to be counted. And so when we think about , you know , just different racial and ethnic categories , uh , we can sort of learn a lot about who we are as Americans through our naturalization laws that tell us who can and cannot become a citizen , or through our census categories in terms of the sort of checkboxes for race and ethnicity. So , you know , Asian was a sort of political term. Asian Americans in the 1960s that emerged as more Asian Americans were advocating for rights. And when you kind of think about Asian as a whole , it's multiple cultures , multiple countries of origin , different sort of traditions , etc. , and it was important to be able to sort of say we are Asian American in order to be counted and therefore get things like political representation , resources , etc.. And then you have Pacific Islanders saying , hey , you know , we need to be counted as well. Um , our histories are a little bit distinct from Asians. And so that's why you see kind of Asian on the census , but Pacific Islander as a different sort of checkbox. Um , and then you have Native Hawaiians saying , hey , respect our indigeneity. Um , we have , you know , different histories and different relationships with , uh , you know , the United States government. And so we have sort of evolved from , uh , sort of arguing that we are white in order to be represented in the United States at the turn of the 20th century to Asian and now ANP. So , you know , during the Obama administration , I worked at the white House Initiative on Asian Americans and Pacific Islanders. So just from then to now , it is now the white House initiative on a.
S1: And I'm so glad you broke that down , because I don't think a lot of people realize how important it is , um , to really have those that understanding of identities and categories , as you mentioned , and how big of a role that plays in our politics and democracy. Um , on the importance of being counted. As you mentioned , the latest category that is being added to the next census count is Mena , Middle Eastern , North African. What does adding a new category mean for those communities ? Yeah.
S3: So this has been a fight for several decades. So , you know , when we think about racial and ethnic identities as being social constructs , we can really see it in the census. So something like Hispanic is also just a recent term in terms of the racial and ethnic categorizations and Latino being thrown in as well. So for the Mena population in particular , uh , there was no way to say I am Arab , potentially , or from the Middle East or North African. Uh , they basically checked white. And when you only have white to check , then your community and your needs are obscured. And so for a community like in San Diego County , where we have a fairly large Mino population , a resettled Iraqi population , for example , now we are going to be able to better see and then represent those communities in the 2030 census.
S1:
S3: So when we think about , you know , Asians and Pacific Islanders and Native Hawaiians and then , you know , Hispanics and then Latinos and now Mina , this is about communities wanting to be seen in order to again be represented. And when we sort of think about , you know , the other side of this conversation , there is a kind of the US is a colorblind society , and we don't need to disaggregate , we don't need to count. Um , that perspective is usually taken by those who don't have to scratch and claw and fight in order to be seen and to get , you know , a fair shot at , you know , this , this , this big apple that we have. Um , so , yeah , it is it is deeply political. And it is not just a sort of , uh , modern artifact of our senses. This has been part of the sort of conversation about what it means to be an American , uh , for centuries now. Mm.
S1: Mm. Over the past year and a half. Immigration enforcement and policy. Have gone through these immense changes. Can you put those last 18 months into historical context for us ? Yeah.
S3: So , um , my censer , um , and I have some of the best research assistants. Um , uh , we just recently completed a set of projects in Minneapolis and Saint Paul. So when we think about the second Trump presidency , it is largely defined thus far by the mass deportation agenda. And when we think about interior immigration enforcement , the administration itself described that operation in Minneapolis and in Saint Paul as the largest deployment of federal immigration enforcement agents in modern history. So the Department of Homeland Security was only created in 2003. And yes , we haven't seen anything this large ever since 2003. Sorry. Um. And. Yeah , 3000. You know , Ice and Border Patrol agents. Uh , over the course of a couple of months , uh , what we found was that the kind of large scale , aggressive immigration enforcement actions. Like what ? You know , Operation Metro Surge was had these sort of implications for day to day behavior , not just for undocumented immigrants targeted , but for the broader community. So we were able to sort of document huge economic losses for businesses , for example , not just businesses that had to close down. Um , because of the enforcement activity and the subsequent protests. But people changing their consumer habits in fear of leaving their house , for example. Um , you know , lost wages also huge. And then other things like public health effects. So people don't really think about this as an immigration enforcement issue. But when people are scared about whether or not , you know , Ice or Border Patrol is going to , you know , detain them , not just if you're undocumented , but also we heard stories about US citizens being stopped and detained , then you may be less likely to go out. You may be less likely to go to that scheduled doctor's visit. You may miss a scheduled vaccination because of everything that's happening. And so from the economic implications to public health implications , immense impact on schools to the civil rights and civil liberties issues that , you know , I don't know anybody who has not sort of seen a real of Rene Goode or Alex Pretty being killed , you know , as a result of enforcement actions. Um , so , you know , Operation Metro Surge is unique in the Trump administration's sort of broader toolkit. Um , and , you know , we saw LA a little , you know , smaller scale midway blitz in Chicago , a little smaller scale. And I think the sort of pushback against what we saw in Minneapolis is giving the administration pause about how it's going to conduct immigration enforcement moving forward.
S1: We're talking about immigration. Also , the U.S. Supreme Court is expected to release its ruling on the Trump executive order that targets birthright citizenship.
S3: Declarant. Um , so when we think about , uh , just empirically what that would mean for , you know , people , um , you know , taking citizenship away from people , you know , children born in the United States. We can kind of think about outcomes , integration outcomes for , you know , foreign born versus native born. And we can basically simulate what life would look like for a child born in the United States that did not have citizenship , but otherwise could have , you know. But for a change in birthright citizenship and the sort of outcomes are really stark , it doesn't take a lot to close your eyes and imagine that life for that child is going to be very different. If they fear deportation , if they can't work , potentially can't go to school because they can't afford it , because they can't work. And so empirically , we have a really strong sense of what may happen if the Supreme Court rules in the administration's favor. But I think as a matter of law , I mean , I'm I'm not a lawyer , but as a matter of law , I think what I've heard is that we have this long uh , settled um via Wong Kim Ark uh long settled law. When it comes to , uh , if you were born in the United States , so would Wong Kim Ark. Even if your parents are not citizens of the United States and may have loyalties to another country. So in this case , Wong Kim Ark , born in the United States , parents , Chinese citizens , the fact that you were born in the United States gives you U.S. citizenship. And I think the , uh , the 14th amendment is is is pretty clear on that.
S1: There's a lot of through lines here. Um , when you connect it all , I'd like for you to name it for me , like , put a bow on it here. When you talk about , like , resources , you talk about identities , you talk about our immigration policy and even birthright citizenship. As we come up on 250 years here in the country. What do you think all of this points to ? what is all of this saying about how our country is changing ? Yeah.
S3: So for me , this is about a the question is about who belongs. And I think one of the sort of things about this idea of the United States as a shining city on a hill , uh , this , you know , more general idea of an American dream has always been about belonging. And the US being a place where you can have nothing , come here and become anything that you want to. When I think about the sort of modern immigration debate , so it's not about sort of who enters how many and under what conditions. It really is about who we are as a country. And I think right now we have very , very different views. I mean , from sort of one extreme , you have literally white nationalists , you know , with the ear of this administration , um , talking about what our immigration policies should be. One of the things that I show my class when I teach the politics of immigration is that during the first Trump term , you had then-Attorney General Jeff Sessions answer a question about what our ideal immigration policy should be. And he said we should go back to what we had in 1924. In 1924 , we had something called the National Origins quota system. So during this time , immigration from the African continent off the table , we had something called this Asiatic barred zone. So East Asia through the Middle East , off the table , Western hemispheric immigration. So sort of Mexico , Central America was circular , so no permanent flows. And then we sort of take away the opportunity for all southern and Eastern European immigrants to come here as well. And so 1924 , there is a white , Western and northern European , uh , sort of image of what it means to be an American. And that's some people's view. I think what San Diego represents is a very different view.
S1: Hey , I've been speaking with Tom Wong. He's a professor at UC San Diego , and he's the founder and director of UC , a U.S. Immigration and policy center at UCSD. Tom , thanks so much for being here. You heard that music come in hot. Yeah.
S3: Yeah. No , it's all good. I talk too much.
S4: Thank you.
S1: And you are great. Thank you so much for the conversation. This one will continue. And thank you for joining us today. If you missed anything , you can download KPBS Midday Edition on all podcast apps. Don't forget to watch Evening Edition tonight at five for in-depth reporting on San Diego issues. You can always send your feedback or segment ideas to midday at KPBS or call us (619) 452-0228. I'm Jade Hindman. We'll talk again tomorrow. Until then , make it a great day on purpose , everyone.
