With the COVID-19 vaccine rolling out to the public, there are concerns about vaccine mistrust and misinformation. Generally speaking, there are issues with WhatsApp or Facebook chain messages circulating misinformation within our communities. Because of that, we wanted to address some ways to talk to your family, relatives, aunties and uncles about the vaccine.
This might mean scheduling time in advance to chat about the vaccine and about the individual and their family’s health. It could also mean bringing the topic up after spending some quality time together when you feel connected and both parties know that they are on the same side.
2) Keep calm
Avoid a judgmental or condescending tone. If the conversation turns into an argument, state that you want to refocus the conversation on the facts that are important to discuss and that the conversation is not meant to be an attack on one another. Spend enough time listening (without interrupting), so that the other party feels heard. If the individual you’re speaking with feels that you are shaming them or mocking them for their beliefs, that can end up reinforcing conspiracy theories or misinformation. This will also make it difficult to talk to them about anything.
3) Empathy is critical
Reiterate how much you care for them and their health and that you want to focus on keeping them safe.
4) Be curious
Having a productive conversation requires being truly interested in how the other person came to hold their views. Are there specific people who are feeding them misinformation or are they seeking out the misinformation on their own via the Internet? If the latter, are they aware that major news sources argue the opposite points that they believe? If yes, why do they trust certain websites or blogs over major news sources?
This will allow the individual to recognize shortcomings in their information. For example, are there any contradictions in their views? Where are they getting their facts from? How do they know if their sources are credible? Have they thought about the counter-evidence? Helping the person come to the realization that their information may not be accurate is usually much more helpful than bombarding them with facts.
6) Encourage critical thinking
Is there misinformation circulating that the individual does NOT believe? Maybe they believe the vaccine was rushed but they don’t believe that the government is putting microchips in the vaccine. Ask why they don’t believe X but they do believe Y. Helping people examine their own beliefs is a good first step.
7) Conversations generally have to happen more than once
People don’t change their beliefs with one conversation, so it’s important to be patient.
Commonly reported concerns about COVID-19 Vaccine and ways to address them
Now let’s shift to the reasons that some South Asian folks are concerned about the vaccine, and how we might address those concerns.
If someone is concerned that the vaccine was “rushed”
We have had vaccines for more than 200 years. The smallpox vaccine was invented just before 1800. Scientists understand vaccines very well — how they work and how to develop them. The COVID-19 vaccine isn’t necessarily that different from vaccines we’ve used for other diseases, so developing the hundredth vaccine we have is much easier than developing the first or second vaccine. Also, this was the first time the whole world was focused on the same thing. That’s rarely happened in the past, but every country was touched by COVID-19. Finally, part of what was “rushed” was the production and distribution elements of the vaccine — factories and distribution centers were getting prepared for the eventual vaccine before the vaccines were even approved, so that part of the chain happened more quickly, giving the impression that the vaccine was rushed. Given these three pieces of information, is it really that surprising that this vaccine was able to be developed more quickly?
If someone has concerns about the side effects of the vaccine, long or short term:
Additionally, we know that there can be long-term side effects of COVID-19 itself, which include fatigue, memory problems, loss of smell/taste, and other effects that we won’t know until years down the road. We don’t know the long-term effects of COVID-19 yet because the disease simply has not been around very long. We know much more about the vaccine and its potential effects. There’s a risk either way – either the risk from the vaccine or the risk from getting the disease itself, and it’s up to all of us to make that choice. The overwhelming majority of medical professionals have made the choice to get vaccinated, so hopefully, that is an indication in favor of the vaccine.
If someone is a victim of misinformation on WhatsApp/Facebook/etc:
An important thing to educate family members (especially older family members) who fall victim to misinformation is how easy it is for anyone to spread misinformation. Millennials and GenZ-ers are aware that anyone can start a blog or publish content online. Helping convey that or even show the older generation how easy it is to publish content can help them develop a healthy skepticism regarding what they read online.
Often, the information in WhatsApp forwards does not have sources. They often say things like “Harvard research shows XYZ” but they won’t cite a specific researcher or a study. Asking questions about how the individual knows the content of the messages is true or asking them to elaborate on the sources of the information can prompt them to examine their beliefs.
Finally, find common ground and acknowledge which parts of their theories may be true. Conspiracy theories and other forms of misinformation often have a kernel of truth to them. Also, identify where you believe the theories veer away from fact and into fiction.
If someone wants to rely on “natural” remedies or “natural” immunity:
Call on relatives to recall a time in recent history where folks would have eight or ten children, and maybe six would make it to adulthood. This happened between two and four generations ago, and we can all look to our grandparents’ or great grandparents’ generation to see that. Childhood illnesses like smallpox and polio used to kill children and vaccines changed that. While natural remedies have their place and their utility, vaccines and antibiotics reduced infant mortality. We see this because infants today don’t pass away from illnesses at the rates they used to. Explaining this to our elders can hopefully provide some context on why our quality of life and healthcare is much better today because of vaccines than in our ancestors’ lives.
If someone is concerned about what’s in the vaccine:
Think about that scar on the upper arm of everyone born in the subcontinent- that’s from the tuberculosis vaccine. Asking elders about what they know about tuberculosis (it has a very negative reputation!) and why they or their parents were willing to get that vaccine can be a step in the direction of helping them recognize the utility and importance of vaccines. It’s also worth noting that many of the vaccines that we have already received (in addition to tuberculosis one) have the same ingredients that the COVID-19 vaccines have.
Finally, we would like to share a few key points that may be worth considering when speaking with community members about the vaccine. For one thing, South Asians typically have many risk factors that make the likelihood of getting severely ill from COVID-19 higher, such as high blood pressure and diabetes. We, as a community, must recognize that we are at higher risk than several other demographic groups. Secondly, because viruses and vaccines are complex topics, it may be worth organizing community leadership (whether that involves religious leaders such as Pundits, Imams, or doctors within our communities who can communicate with our elders in their native languages) to speak about the importance of vaccines. Organizing a panel discussion via Zoom with such individuals can be helpful in addressing misinformation, as well as religion-based concerns individuals may have about the contents of the vaccine.
In July 2022, Sania Khan’s life was ruthlessly taken from her by her ex-husband. Sania was a young, vibrant South Asian woman – a creator and photographer who had the courage to step out of an abusive marriage, even in the face of community norms that discourage women from speaking out. While this tragedy seemed to stir a consciousness in the South Asian diaspora that we can no longer justify the status quo, it is far from the only such incident. Just months later in December of 2022, Harpreet Kaur Gill was stabbed to death by her husband in Vancouver. While the most extreme cases like those of Sania Khan and Harpreet Kaur Gill are highlighted by mainstream media, a small body of research provides evidence that intimate partner violence experiences are equally, if not more, prevalent in South Asian communities than the general population in the US or Canada. That’s why we need to do more as a community and throw light South Asians and intimate partner violence.
Despite the identification and investigation of these norms in South Asia, there’s so much we still don’t know about diaspora communities, especially in relation to South Asians and intimate partner violence. In the US, South Asians have become one of the fastest-growing populations, but we remain unaware of how the stresses of raising a family in a different culture, and the weight of growing up between two worlds, affect these norms, expectations, and experiences among South Asian immigrants, the second generation and beyond.
In this article, we’ll take a deeper look at how these norms are enacted to influence intimate relationship dynamics, discuss the recent rise in intimate partner violence, and explore the work that researchers, policymakers, and program implementers can do to address violence in South Asian diaspora communities.
Social Norms and Violence in South Asian Diaspora Communities
Why does it take catastrophic events to serve as a call to action? For one, the “model minority myth” continues to portray South Asians in America (who originate from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) as a healthy and wealthy group. As a child of Indian immigrants, I always thought this was just a frustrating trope that lived rent-free in my head next to the eternal question, “Log kya kahenge?” (What will people say?) However, I have realized that this constant worry is not just an innocent preoccupation. It’s the result of a dangerous spiral beginning with the portrayal of South Asians as a model minority and the need to maintain that well-to-do image. This only reinforces the traditional gender norms that overlook men’s perpetration of violence and encourage women’s silence, crippling any efforts to understand the scope of the problem and draw attention and resources to address it.
The Impacts of COVID-19 on Intimate Partner Violence
Prior to the start of the COVID-19 pandemic, the frequently-uttered phrase among researchers, practitioners, and advocates alike was “one in three” — one in three women ages 15-49 experiences physical and/or sexual violence inflicted by an intimate partner in their lifetime. Under the cover of the COVID-19 pandemic however, rates of violence against women rose dramatically, prompting UN Women to call for recognition of this “Shadow Pandemic.” During the height of the pandemic, the social isolation that came with lockdowns and quarantine procedures to curb the spread of disease made home a more dangerous place for an increasing number of women. As communities seek to rebuild, the inequities in access to and use of potentially lifesaving services have deepened. Now more than ever, it is critical that we shine a light on the many intersections of our society to prevent South Asian women’s experiences of intimate partner violence from being pushed even further into the shadows.
First and foremost, to better understand South Asians and intimate partner violence, we need better data disaggregated by racial/ethnic group. Since the 1980 Census, only those of Indian origin have had a fill-in bubble.All other South Asian groups have to write something in, decreasing their participation. South Asian communities in the US are not a monolith and they are certainly not all of Indian origin. This perception, fed by our lack of data, likely privileges the Indian community in America and limits the visibility of other South Asian communities.
More accurate information will help us better understand where the need is greatest. We can make a stronger case for more equitable resource allocation, improve South Asian language materials for survivors, and enhance provider training programs, accounting for the specific cultural implications of disclosing and seeking treatment for violence in South Asian communities. Public health researchers should increase efforts to understand the prevalence of experiences of violence, the environmental factors that make South Asian women in America vulnerable to experiences of intimate partner violence, and how it impacts their health.
While outstanding organizations such as Narika in California and Sakhi in New York are leading the charge in raising awareness, running active helplines, and providing support, they cannot be the sole safe space for survivors. While the system’s failure to protect Sania is not an isolated incident, it has served as a wake-up call.
All South Asian women in America should be able to be healthy and safe and lead lives free from violence, coercion, or abandonment. To achieve this, we need better data, more research, culturally-tailored resources, and appropriate legislative action that will allow for prevention, screening, and treatment efforts to finally take root.
I’m at the gym. I’m on my grind. I keep telling myself that if I keep doing ‘X, Y, and Z,’ I’ll get results. Which is true — all the fitness gurus say so. The personal trainer I once had said as much. Yet, I forget to take a breather. I’m hoping for instant gratification, when I know the results I want — better energy, endurance, and metabolism — take time. I have to be patient with myself. So why do I feel pressured?
When I sit down to take a breath, I notice this idea of instant gratification weaves a common thread. I put pressure on myself to complete projects, quicker and faster. As a licensed therapist, my clients also talk about how they feel the pressure to do more work in a shorter amount of time, leading to longer work days and burnout. Some new clients ask, “How long does therapy take? Will I feel better after three sessions?” It’s like those junk tabloids with headlines like, “how to lose 10 lbs in 10 days!” In an ever-changing, fast-paced world, there are expectations to do things faster and better. On top of that, a relationship with our body, our career, our mind, and yes, our therapist, takes time too. To wait for results can create an uneasy feeling. We can’t trust the process if we don’t see results right away. We’re focused on the destination rather than the journey.
I believe the same idea is being applied to dating and relationships too. I cringe and roll my eyes when I hear, “Dating is a numbers game.” While it’s true that you might have to meet many people before finding your person, this has caused some of my clients to ‘gamify’ dating: swiping right on every dating profile and trying too hard on the first date in the hopes of landing “the one.” This prevents them from slowing down, truly seeing the person in front of them for who they are, and being vulnerable. My South Asian American clients feel the cultural pressure to settle down quickly and think they need to “catch up” with their friends who are getting married. They’re working very hard in the South Asian dating market, hitting up all the singles they meet, and finding instant chemistry with “the one.”
Here’s how South Asian American singles should stop shaming themselves for being single, this Valentine’s Day season, and try dating with intention. At the same time, this therapist has some thoughts on how we South Asian singles could be dating better. If you’re single this Valentine’s season and wondering, “when am I going to find my person?” you’re going to have to challenge some long-held, societal beliefs about dating, marriage, and relationships, both within and outside of our culture. It means:
Being okay with not going on a ton of dates
Dating is not a game to win! Forget about the “numbers” game. You are also not trying to “trick” anyone into being with you. That shit is not cute. Show up authentically and don’t be afraid to be “caught off guard.” After changing their perspective, some of my clients tell me, “I haven’t found a decent quality person!” Yeah, that’s kind of the whole point. You could go on a ton of mindless dates and have your time wasted, or you can have one or two quality dates and feel fulfilled. Pick one.
Because some South Asian cultures have a much faster timeline with marriage, you might find yourself trying way too hard to impress your first date in the hopes that it will rush the chemistry high. Dating scenarios that start this way burn out once things get serious. Looking for chemistry too soon is like chasing a temporary high. Be patient and take your time getting to know someone because chemistry takes a long time to build.
Paying attention to what your date says and how they say it
We’re all putting our best foot forward on a first date. What do they talk about? How do they talk about other people? Does the conversation feel superficial? Does it feel like a performance? Do they take an interest in you? Are they sharing anything about themselves?
Remembering what you want from a long-term partner
Superficial qualities aren’t an indicator of how good of a partner they’ll be in the future. Having a high income doesn’t mean they’ll contribute to your relationship or the family you both build. However, their financial decision-making can indicate what they prioritize and what they value. And while physical attraction is important, there is no fountain of youth. Will you still want to share your life with this person when they are 60? Or will they annoy the shit out of you?
Taking your parents’ opinion with a grain of salt
Marriage is not just a blending of two families; it’s a ‘business contract’ between you and your spouse. Would you go into business with this person? Would you want to share physical space with them? Share a bed with them? Your parents are not the ones who are going to bump uglies with them, and at some point, your parents will no longer be around. Whose decision do you want to be stuck with?
Remembering no one is perfect
There is no such thing as “Mr/Mrs. Right.” Let go of the idea that there is someone better out there. Dealbreakers are important because they indicate what you have tolerance and patience for, and this can affect intimacy, but don’t write someone off for something workable. Think about the things that give you the “ick” versus things that don’t give you the “ick.” If someone’s qualities are only mildly imperfect but overall don’t give you the “ick,” then it shouldn’t be a dealbreaker. If it’s something that can be changed, then maybe it’s worth being flexible. If it’s something that can’t be changed and you can’t get over it, then you’re wasting your time and their time too.
As a South Asian American who is also single, I am pressured by my family to get married quickly too. I know that many people in my situation would either give in to their demands or take matters into their own hands. They might date to appease their parents that they’re “working on it.” But I refuse to give in to the pressure. When I date, I date to enjoy the person in front of me. I see the person for who they are, not some idea I cooked up in my head for the outcome I’m trying to achieve. I put my most authentic self forward. If this doesn’t result in a relationship quickly, I’m okay with that.
If this therapist can be patient with her process, then why can’t you? Like exercise, relationships take time, and you could be doing everything right and still not getting exactly what you want. You won’t be a good fit for everyone, and likewise, not everyone will be a good fit for you. But don’t close yourself off from the world. This Valentine’s season, learn to trust the process. Tune out the noise; the idea of “instant gratification,” Be patient, be honest, and be yourself. And don’t forget to take that breather.
The Covid-19 pandemic and feelings of uncertainty, which have been prevalent across the globe, had lasting effects on all of us. One of the more positive impacts has been on the mental health industry, particularly the normalization of mental health challenges and a more open dialogue about mental health. There have been discussions in the workplace, in schools, and even on Hinge profiles, but what about in South Asian communities? Though some progress has been made, mental health stigma is still widely prevalent among South Asians, impacting individuals’ desire and comfort in seeking help. As a result, the South Asian community reports lower rates of seeking mental health services. And of the individuals who do seek out mental health services, many face challenges in finding therapists who are equipped with a multiculturally competent skill set to understand the South Asian client’s concerns. This is why it’s important to recognize and become aware of the intersections of mental health and South Asian communities.
Although there is an overlap between the mental health concerns of South Asians and other communities of color, there are also unique intersections between culture and mental healththat I want to bring to the forefront of this conversation. As a South Asian psychologist, who is both a researcher and clinician, I have firsthand experience examining how our individual cultural context impacts our emotional experience. If we can understand, or at least consider, how the cultural context impacts us, we can better understand ourselves and feel seen by others too. We, South Asians, are a diverse group in terms of ethnicity, language, food, religion, traditions, and so much more. So, while learning about the “state of mental health in South Asian communities” is much more complex and nuanced than what I can cover in just one editorial, I believe starting the conversation about issues that don’t get talked about nearly enough is an important first step towards destigmatization.
What is the state of mental health in the South Asian community?
Here are some numbers to set the stage, based on research done on South Asian communities. One in 5 South Asians currently reports experiencing mood or anxiety disorders. South Asian youth and young women, in particular, are at greater risk of having suicidal thoughts and behaviors compared to other groups. Only 24 percent of South Asians diagnosed with a substance abuse problem sought treatment. And South Asian Americans express greater stigma toward mental illness than other ethnic groups. How often are facts like these discussed? Not often. Since South Asians are often mixed in with the larger Asian American population, these issues and their nuances are rarely discussed within mental health communities. This underrepresentation can make the reality of our emotional experiences easily misunderstood and make our needs feel invisible. Relatedly, concepts like “model minority” lead outsiders to often assume that South Asians are well-adjusted. And even within the South Asian community, stigma and beliefs about the causes of mental health issues (e.g., mental illness indicates problems within the family, a sign of weakness, etc.) lead all these facts to continue being ignored.
How do mental health concerns intersect with South Asian culture?
While mental health concerns are prevalent among my clients from all backgrounds, these common concerns intersect with culture to create an individualized version of the issue that requires specialized attention and care.
Within the South Asian community, there are cultural differences in alcohol and drug use and the discussion of these topics. Alcohol is prohibited in Muslim and Jain faiths which makes open dialogue about substance abuse and its prevalence even more of a challenge within these communities. Admitting you have a problem can be hard and adding the cultural taboo can make it more difficult.
There is a tendency in the South Asian community to highlight that only linear careers in financially stable or ‘reputable’ fields — such as medicine, engineering or finance — will lead to success. This expectation not only impacts career decisions but also mental health, self-esteem, and self-confidence. Even if we think we are not influenced by outside factors in our career choices, how do we know that subconscious messaging is not impacting our decisions? I personally was pre-med for as long as I can remember and was apprehensive if my parents were going to accept my desire to go into psychology and mental health instead of medicine.
Caring for loved ones, who are aging or ill, is emotionally challenging for most people. What makes this stress unique for the South Asian community? South Asian communities are collectivistic and therefore rely strongly on interdependence well into adulthood. Therefore, caretaking and providing for elders is an integrated part of our lifestyles. Pursuing personal goals can sometimes be seen as selfish and therefore South Asians feel the need to sacrifice personal desires. This can make setting boundaries in relationships or making decisions focused on one’s own needs especially difficult and not as straightforward as may be suggested by Western psychotherapy interventions.
Romantic relationships can be especially stressful for South Asians because of the need to navigate between one’s own desires and family expectations. Older generations pass down messages that people should focus on their careers instead of dating, which can lead to not dating or secret dating and youth navigating romantic relationships on their own. Then, suddenly, the conversation shifts to the need to get married by a certain age, which seems especially difficult when you have not been allowed to date or when it is not something you want in your 20s. South Asians may also experience family expectations about their partner being from the same ethnic/religious background, working in a specific industry, or having a specific family background. These family or cultural expectations and issues also impact the LGBTQI+ South Asian community and South Asians often feel the need to sacrifice personal desires for the expectations that their families or deep-rooted social norms have set for them.
Being able to communicate the complexity of our emotional experience is especially challenging when being emotional is considered a weakness. This cultural sentiment further perpetuates emotional suppression and increases the barrier to seeking support. Also, South Asian languages have limited vocabulary to describe mental health and the emotions involved. It is not only challenging to identify our emotions, but it is difficult to communicate the complexity due to the lack of words in South Asian languages to describe those emotions. Let’s take the word, “gussa,” which means “angry” in Hindi. The only way to explain the level of anger you are feeling is to describe the full situation. While in English, you can use variations of the word “anger,” such as “annoyed” or “furious” to describe the emotions with more nuance.
Culture is integrated in small and big ways into how South Asians experience their body. It can be common for family members, especially older women or “aunties,” to comment on one’s body weight in direct ways like telling someone they have gotten fat or thin. There are also unspoken rules about food that impact one’s relationship with food and potentially overeating, including “it is rude to not finish all the food on your plate,” or if you don’t go up for seconds that means you didn’t like the food. Research has also found South Asian women in particular often struggle with the pressure to conform to Western beauty norms (e.g. removing dark hair, and lightening skin color).
We all are constantly evolving and understanding who we are and what we value. What makes this unique for South Asians? Culture intersects with other parts of our identity, including generational status (1st, 2nd, or 3+ generation), religious beliefs, gender identity, and age which impact the way we make sense of who we are. Being born in the US makes one American, but are you still American if you primarily connect with your South Asian ethnic identity or maybe your religious identity? Or what messages does culture pass down about what it means to be female? Are you supposed to do all the cooking and cleaning? Do you have to have children? Culture intersects with identity development in complex ways.
How can you get support with what you may be feeling and experiencing?
I believe the first step in breaking the barriers, is shifting your mindset about seeking mental health support from something that means you have a “character flaw” to something that you do for your overall well-being. Taking care of your emotions and processing your emotional experiences is as important as your weekly workouts, annual physicals, or that apple a day. One way to start this process on your own is to spend 10 minutes a day engaging in mental hygiene practices (meditation, gratitude journal, positive experience journaling, writing a thought log, prayer, or deliberate time in nature).
If any of the concerns I discussed earlier resonated with you, consider signing up for Anise Health by filling out this short intake form; you’ll get matched to a culturally-responsive clinician within two business days. I’ve also listed a few additional resources below that aim to address mental health needs in South Asian communities.
I hope we can continue to bring the ways our South Asian culture impacts our well-being into the forefront of the conversation around mental health. By highlighting the South Asian community’s experiences,we can feel more seen and create a more accepting environment that allows us to get the help that we all deserve.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.