Fear, despair, and exhaustion are emotions collectively expressed by health care workers during the COVID-19 pandemic. Years of health care experience has not equipped us with ways to maintain our mental wellbeing in the face of current pandemic, as evidenced by painful stories of fellow colleagues who have lost their lives. An especially vulnerable group among health care providers are Asians, who account for 18 percent of physicians, 9 percent of registered nurses, and 7 percent of physician assistants in the United States. In addition to the overwhelming number of sick and dying patients, Asian health care providers have been subjugated to a new wave of racial discrimination. This, accompanied by our cultural expectations to dismiss mental health concerns, poses a new challenge in the Asian American health care community.
In the hospital, health care workers are mentally and physically exhausted on a daily basis. The emotional toll of witnessing patients’ last goodbyes to their loved ones via video chat, along with a surge in negative patient outcomes has become difficult to handle. Julie Ji, a certified registered nurse anesthetist at MacNeal Hospital outside of Chicago, comments on how she and her coworkers are overwhelmed with “a large sense of helplessness and hopelessness, as [they] continue to care for a huge surge of COVID patients.” Beyond the COVID-specific population, health care providers are also faced with patients with treatable conditions who hesitate to seek care due to fear of contracting this virus. This delay in proper treatment inevitably increases morbidity and mortality. The current pandemic has pushed providers to their limits, with many lacking the proper and necessary coping strategies.
For Asian health care workers, the stress does not stop once we leave the hospital. Since the start of the pandemic, the Asian community has been scrutinized, harassed, and assaulted in a country that is our home. Monica Allen, a Filipino registered nurse working in the ICU of White Memorial Medical Center in Los Angeles, recalls being “afraid to even get gas on the way home for fear of being harassed for being Asian and a nurse.” The unprecedented spike in racism needs to be addressed as studies have found a significantly stronger association between racism and negative mental health outcomes among Asian when compared to other races. Given the combination of discriminatory remarks spreading through our community and the rise in work-related stress, we are in a frightening new environment that needs mental health support more than ever before.
Sadly, Asian American health care providers often find themselves unable to reach out for help due to a multitude of barriers. The most notable is our community’s tendency to undervalue mental illness and overemphasize silent resilience. This tendency can be traced back to decades of cultural belief in diligence and hard work with the promise of upward mobility regardless of ethnic background. In a society where silence is revered as strength, discussions about mental health is unsurprisingly associated with weakness. This cultural belief has cornered us into believing mental health is an issue with discipline and is a sector that does not need to addressed. This phenomenon is evident in the recent National Latino and Asian American Study (NLAAS), where Asian Americans were found to be three times less likely to seek mental health services than Whites. To make matters worse, reaching out to a mental health professional brings up an unexpected challenge of finding one who is trained in cultural competency to relate the challenges of being both Asian and a health care provider.
Even though it feels like our job, community, and culture are fighting against us, it is imperative Asian American health care workers are aware that we are not alone during this pandemic. At an individual level, we must recognize the complexity of mental health concerns to demystify the stigma surrounding mental health. We want to start building platforms to encourage our own circles to champion and advocate for mental health. At a system-level, we need to let our health care leader know that our community is a priority and is not to be overlooked. This includes funding evidence-based measures such as proactive mental health screening and providing culturally competent mental health professionals. The unfortunate truth is that health care burnouts and racial bias are old problems that are still present today. These issues are reignited in light of the COVID-19 pandemic with Asian American health care providers suffering in silence. As such, we have to advocate and participate in a movement to go beyond the pandemic and put to rest our negative beliefs about mental health.
Oscar Chen, Dong Gue Oh, Zhang Huang are medical students. Sarah Y. Song is a neurologist.
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