• Priya Patel

Finding the Words: Is Mental Health Stigma Deep-Rooted in Our Languages?


Graphic by @kaneekakapur

I have always found it difficult to find the words in Gujarati to describe my general well-being, let alone talk about mental health.


Within the South Asian community, the feeling of stumbling while talking about our mental health is often a shared experience across our languages. The words either don’t really exist or, when they do, can sound scary and get lost in translation.


I have always felt this contributed to the stigma in my culture. The lack of words facilitate silence, feeding prejudice, ignorance and stigmatisation of mental health. It means first generations British South Asians find it hard to speak to their parents about their personal mental health and our immigrant parents can struggle to understand us.


"A lot of us in the South Asian community share the struggle of not being open about our mental health, with the fear of our parents ‘just not getting it’."

People can use language to establish ways of constructing reality, on the other hand, language can be perceived as reflective of, rather than decisive in forming the actualities of culture. But what we do know is that the relationship between language and culture is complex. Language adds meaning to our experiences and this isn’t always shared across cultures. For speakers of a linguistic community, language can both reflect and shape how the world is interpreted. This means that language enables cultures to form within communities that have a shared meaning of the world. So, it’s not a surprise that as British South Asians, being bilingual and navigating our dual cultures, we have two, sometimes conflicting, realities.


We feel a secure command of the English language to talk about our well-being to seek support and information. Whereas in our mother tongue, it is difficult to find the words, and so it goes unspoken.


But it’s much more than a language barrier.


"Whether we speak Gujarati, Hindi, Punjabi, Urdu, Bangla, or Tamil, it can be easier having these conversations in English."

Because we are able to express ourselves and talk about mental health in English, we have created culturally structured narratives, values and norms, which enable us to be open minded on these issues and more importantly, challenge prejudice on a personal and interpersonal level. The language around mental health in English enables us to create norms such as having counsellors in school, mental health mentors in the workplace and an abundance of resources that can be accessed on the internet. These norms enable us to create a culture where our wellbeing should be valued above burnout and how pastoral care in schools should foster a supportive learning environment. It is as simple as having the words to talk about a topic, in order to develop a culture around that subject.


Whether we speak Gujarati, Hindi, Punjabi, Urdu, Bangla, or Tamil, it can be easier having these conversations in English. A lot of us in the South Asian community share the struggle of not being open about our mental health, with the fear of our parents ‘just not getting it’. Concerns are often trivialised and despite coming from a culture where family is valued and often the core of our support system, the deep stigmatisation of mental health holds us back from being open. The words in our languages often don’t exist to help us facilitate this dialogue, it’s the first roadblock in trying to converse on the matter.


"Because much of mental health care is relied upon direct communication, rather than any physical test, English proficiency mixed with acculturation can lead to the problematic disparities in mental health treatment amongst minority and ethnic communities."

While I have found there to be an increased understanding of some of the more clinical and medical terminology around mental health, I often crave for colloquial language. I want to talk about my well-being over a morning coffee or at the end of a particularly hard day. But creating a culture of open conversation on mental health isn’t merely about translation. It’s about using words to create a safe environment to share your thoughts and feelings, and be understood. We haven’t quite mastered this, and language holds us back from creating that culture.


Many of our immigrant parents have had to go through a period of acculturation when they migrated, balancing two cultures whilst adapting to the prevailing culture (and language) of their society. Acculturation is known to impact definitions of mental illness, stigma, and perceptions of mental health care. Because much of mental health care is relied upon direct communication, rather than any physical test, English proficiency mixed with acculturation can lead to the problematic disparities in mental health treatment amongst minority and ethnic communities.


This recognition can be extremely important for us to change the way we approach these conversations with our parents. It requires patience, because they may not be accustomed to examining their personal mental health or know how to respond to their child’s mental health struggles.


It can be very easy for us to blame our parents or culture, but we are also a part of the cultures and environments we live in. While the onus is on us to create new norms of talking about our wellbeing with our parents and encouraging them to do the same, it is equally important to set boundaries. So don’t dive into this head first if it brings up too much trauma for you or your parents. How we decide to normalise this is individual to our own circumstances and families. But, as a collective, I believe we can shift the culture by evolving our language.


So whilst I may find it difficult to express my thoughts in Gujarati, I am beginning to be mindful about introducing these conversations. Because no matter how awkward or uncomfortable the translation sounds, having the conversation is what matters. For me, it's asking my mum if she would like to try a new camomile tea I just bought for myself, that could help the anxiety and lack of sleep she experiences from time to time, she says no, naturally. So I tell her:

“Tarthi complain toh thai che, pun anxiety manage carvanu try carvu pade nai?” You can complain, but you need to find ways to manage the anxiety, right?

She didn’t end up trying the tea. But the point was that I needed to encourage her to trial-and-error different coping mechanisms. My mum, like many first generation mums, hasn’t grown up with tools to manage her mental health or be encouraged in a family environment to do so. What she ended up finding is that sharing her thoughts was the best remedy for her.


But normalising conversation like this has enabled her to reflect on what she didn’t get to talk about with her own mother and the stigma that was associated with women and mental health. A while ago, when we were talking about her experience with postpartum depression, she made one of those connections. During this conversation, she suddenly realised that the stories her mum told her about women that would ‘get possessed’ after having a child, were likely to have been experiencing postpartum depression too. These stories were the only way for people to make sense of these experiences, as the knowledge and language weren’t available to them. So when my mum talks to me about her own experiences, it’s both to advise me as much as it is an outlet for her to break down and destigmatise the myths and fears she grew up with.


I can’t say I always get it right so it’s important to laugh when the translation is completely wrong, because we can’t take ourselves too seriously. It will be trial-and-error and even quite difficult emotionally, but that one awkward conversation or moment of laughter can cultivate new norms, destigmatising mental health. In our culture, silence is often the prevailing norm in the face of difficult conversations around mental health. The power of conversation shouldn’t be underestimated.


 

References


Mudakiri, M.M. (2003). Working with interpreters in adult Mental health. In R. Tribe & H.Raval. (2003) Undertaking Mental Health Work Using Interpreters. London: Routledge


Sentell, T. et al. (2007). Access to mental health treatment by English language proficiency and race/ethnicity. Journal of general internal medicine, Vol.22 (2) pp. 289–293.


Tribe, R. and Lane, P. (2009) Working with interpreters across language and culture in mental health, Journal of Mental Health. Vol. 18 (3) pp. 233-241


 

Priya wants to encourage public discourse, particularly within the South Asian community, to spark debate, share new perspectives, and educate. She is passionate about encouraging individuals to engage with their culture and identities in a way that is authentic to them. Professionally, Priya works in Public Policy at a national children’s charity, lobbying change for vulnerable children across England. Outside of work, she is an Ambassador for the Pad Project, advocating to break the stigma surrounding menstruation. You can follow her work on twitter.