Mental Health In Asian Society: the Paradigm Shift?

Amidst a strangulating culture of perfection, where lies the room for mental health?

Therein lies the problem, although progress has been made, socio-cultural barriers continue to foreground the progress of mental health. Indeed, a “paradigmatic shift” takes time, especially given that such cultural elements are inextricable with tradition; tradition entrenched within the collective consciousness. We have been accustomed to quick and obvious results, looking at quantifiable data on a macro-scale. Unfortunately as such, mental health continued to be trivialised and stigmatised despite increased social awareness, even with ever-increasing suicide rates: a study by City University found that a third of pupils aged between 10 and 14 in Hong Kong exhibit potential suicide risk. Mental health is an issue in which its exigency cannot continue to be ignored.

89% of respondents from a recent MindHK study agree that there is a need to adopt a far more tolerant attitude toward people with mental illness. Yet, the same study reveals that 40% of respondents believe that one of the main causes of mental health illnesses arise from a “lack of self-discipline and willpower”.

This leaves much to be desired.

Ranging from an overburdened education system obsessed with grades and metrics, to unending, toilsome work hours creating a culture in which overtime is expected, breathing room is seemingly non-existent; this veritably affects the livelihood of individuals. A local study found that one in seven (approximately 1 million) people in Hong Kong suffers from some form of mental health issue. Amongst the many variables underpinning such circumstances, an irrefutable driving force would be the inherent cultural expectations and inhibitions ingrained within society; these are driven - centrally - by the pursuit of excellence, cultural elements characterize a society that orients itself towards “results”.

Cultural Expectations

Societal expectations perpetuates a need for excellence: a positive feedback cycle of achievement that is result-oriented and a negative, depressionary spiral for those they fail. As evidenced by reports by the Hong Kong Paediatric Society and the Hong Kong Paediatric Foundation, academic performance, parental expectations and societal pressures remain an irrefutable source of mental health problems.

Moreover, traditional elements of Chinese culture emphasises transcendence through determination and as aforementioned, “willpower” - indeed, beliefs vastly intertwined with normative ideals of masculinity, an equally problematic conception. In China, with the persistence of traditional ideations, mental health remains heavily stigmatised, if not entirely a taboo.

Hong Kong, with comparatively “liberal” tendencies (the bustling city of multiculturalism!) has given rise to increased accessibility to mental health provisions - albeit slowly and not without public stigma. From the same research conducted by MindHK, it is revealed that nearly three quarters stated that their workplace did not provide mental health provisions for staff, with calls for this remaining on the fringes. More often than not, psychological wellbeing is seen as a luxury left to the eccentric and the wealthy.

Normative Conceptualisations of Success

As evident in countries such as Hong Kong, Singapore, Malaysia, Taiwan, South Korea and Japan, success is defined within comparatively narrow parameters, exemplified by the ever-growing - patently lucrative - tutoring industry, in which academic attainment remains a core value. It is estimated that market sales of private tuition will generate around $4.7 billion this year. This largely unregulated market, befitting Hong Kong’s non-interventionist system, is here to stay. Many founders of tuition companies are now fabulously wealthy and famous, with posters on advertisements portraying them as a cross between James Bond and Steve Jobs.

Increasingly, however, academics are but one facet in the pursuit of “excellence”, especially for students. With ‘merely’ academics no longer sufficient to remain competitive in a society known for continually increasing grade averages, extracurriculars are equally pursued and have been equally metricized. These compounding commitments exacerbate - if not preclude - the pursuit of wellbeing and mental health - all by virtue of success as viewed through the lens of traditional thought. Indeed, the “goal” of both academic attainment and the pursuit of extracurriculars invariably tends towards getting into “big name” universities and, by extension, “pride” and “prosperity". All in all, certainly a system of honour and dignity.

Revaluation of All Values - Success Redefined?

While academic attainment is an important variable in the determination of living standards, the pursuit thereof should be tempered with appropriate regard to mental wellbeing. “Mental health” should be integrated and introduced in the education system in such a manner that is taken seriously and remains engaging. Indeed, for many, mental health remains a topic seldom discussed, as a result, stigmatisation persists. Discussion is undoubtedly one way forward.

Moreover, success should be viewed as a multifaceted construct, with mental and social health as necessary constituents. In fact, increasing amounts of research suggest a positive correlation between mental wellbeing and academic attainment. Certainly, even traditional, narrow minded definitions of success and mental health are not contradictory: students who experience mild to moderate depression or anxiety demonstrate more academic difficulties and a lower GPA when compared to non-depressed students. (Locke, 2009; Deroma, Leach,and Leverett, 2009).

Cultural Inhibitions

In the same vein, the aforementioned cultural expectations lead to inhibitions in help-seeking, seeing it as a weakness and source of shame. Ironically, the supposed “collectivism” of Asian cultures fails to accomodate for a “collective” mental health support system. In Chinese culture, mental health is often associated with shame, weakness and guilt. Superstitious beliefs (such as mental illness being a punishment for ancestor’s sins) - are all characterized under “deviancy”. This could in part be due to lexical gaps arising from variances in medical systems. The general uncomfortability and lack of understanding gives rise to dismissiveness and thus individuals are reluctant to seek help - for fear of damage to family honour or personal reputation.

As demonstrated, the dual notions of shame and honour are interwoven into the Asian cultural fabric.

The Paradigm Shift

Public discourse surrounding mental health must continue, which by extension, improves public knowledge and mental health literacy. As noted, a paradigm shift takes time to occur, yet, Hong Kong and other Asian countries must “get in with the times” - all to keep up with great strides in the global climate of mental health, increasingly valuing success as a multifaceted construct. Although the government has indeed introduced mental health initiatives in the form of public education programmes. Moreover, allocating HK$135 million in 2010 to set up an integrative community network for people with mental illness, the entrenchment of misguided notions will require concerted efforts from both the public and private sector to resolve. A holistic approach will be needed in the pursuit of the paradigm shift.

References cited.

Huffington Post, Ling, C. (2017, December 07). Societal Views on Mental Health in Asia Need to Change. Retrieved June 28, 2019, from http://tiny.cc/se5x8y

https://www.asccc.org/sites/default/files/SMH%20-%20An%20Important%20Element%20of%20Student%20Success%20rev%20103114.pdf

SCMP, Asian parents' idea of success just adds to mental health stresses. (2018, March 14). Retrieved from, http://tiny.cc/a75x8y