Story of Lai and Mark Hang Shines Spotlight on Mental Health Care Disparities in API Communities

Los Angeles, CA—On May 23, the Los Angeles Times featured a tragic story about a mother named Lai Hang who killed her schizophrenic son, George, out of desperation and uncertainty. Even though Ms. Hang had tried to seek treatment for George, the article indicates that the strong cultural stigma against mental illnesses may have contributed to this tragedy.

 “The story of Lai Hang and her son is devastating,” said Supervisor Hahn. “It shines a light on a problem that is all-too common within the Asian and Pacific Islander communities here in Los Angeles County.  Language barriers and cultural stigma against mental illnesses prevent many individuals from accessing the mental health care they desperately need.”

Asian-Pacific Islanders, or APIs, are the fastest growing immigrant group in California and now make up over fifteen percent of Los Angeles County’s population. Language barriers and culturally specific stigmas surrounding mental health prevent many, however, from receiving the mental healthcare they deserve. As a result, many APIs don’t receive the care they need. In fact, API patients make up just four percent of the total patients who receive care from the Department of Mental Health.

On February 21, 2017, the Board of Supervisors passed a motion authored by Supervisor Hahn that focused on increasing outreach to the API community with the ultimate goal of connecting API residents who need mental health treatment with highly trained clinicians who speak their language and understand their culture.

“Back in February I instructed the Department of Mental Health to review and overhaul their strategies to reach out to and treat members of the API community,” said Supervisor Hahn. “While it is too late for Ms. Hang and her son, I am hopeful that as we implement these new programs we can increase access to culturally appropriate services and begin to combat stigma within the Asian Pacific Islander community.”

According to Dr. Sherin of the County Department of Mental Health, “The events surrounding the deaths of Ms. Hang and her son, George, are tragic.  Unfortunately, stigma and lack of knowledge about mental illness and treatment alternatives continue to create barriers to timely and effective care.  The Department of Mental Health is working with our clients, families and communities, including various cultural groups, to overcome these barriers.  We want anyone affected by mental illness to know that options exist, treatment works, support is available and we are here to help. “

The Supervisor’s motion required Dr. Sherin and the Department of Mental Health to report back with recommendations on outreach strategies to address the needs of the API community for mental health services commensurate with the mental health services. The report is close to being published, and the Department is working with API underserved Cultural Communities workgroup, A3PCON, and other API stakeholders to review, refine, and implement the following recommendations:

  •  Review and scale up the successful culturally relevant outreach, engagement, and service strategies to address the uniqueness and diversity of the API sub-groups.
  •  Use culturally specific non-traditional activities. For example, aligning well-being activities to the needs and interests of the API population and utilizing holistic service approaches involving the mind and body.
  • Framing mental health services in ways that minimize feelings of shame, such as using the word “healing” and “emotional well-being” over “mental illness.”
  •  Embedding services within cultural values and activities, such as blessing ceremonies.
  •  Using education as a way to connect.
  •  Providing assistance with basic needs as a way to engage individuals.
  •  Plan and implement stigma and discrimination reduction strategies relevant to the API population. A multi-media campaign for API has begun.
  • Engage, include and educate family members to break down historic and cultural resistance to seeking mental health care within households.
  • Involve API cultural brokers, such as a clergy, in efforts to raise awareness of the signs and symptoms of mental illness and where to seek help.
  • Increase presence at schools and colleges through the provision of school-based and school-linked mental health services.
  • Utilize health promoters, peers, parent partners, and family members in all aspects of care.
  • Collaborate with A3PCON and SHARE!, the Department’s advocacy contractor, to foster a culture of care seeking, peer inclusion and development of peer support and self-help services for the API communities.
  • Collaborate with API agencies and National Alliance on Mental Illness (NAMI) to expand family groups to the API communities.