September, also known as Suicide Prevention Month, has come with many awareness posts on social media, regarding the importance of suicide prevention.
Mental health initiatives and influencers alike have come together on their platforms to share personal experiences, resources and acknowledge the prevalence of suicide in society today.
However, while conversations surrounding suicide awareness and mental health are just slowly beginning to become normalized in Western society, those of us who come from South Asian households know how much longer these conversations take among our own families.
The stigma that comes with talking about anything related to mental health bears a heavy weight, and oftentimes, we simply don’t speak about it.
Nivetha Sivaranjan, a registered social worker who works as a community support worker with the Canadian Mental Health Association Peel Dufferin (CMHA), recalls a time she was sitting inside of a Starbucks, trying to get some work done. She went to the bathroom and when she came back she noticed a note left by an unknown person.
It was written in response to the suicide prevention training sticker that was placed on her laptop.
“I sort of looked around to see who put this down and someone made eye contact with me and so I told them to come over. We went outside and had a chat and they said they were struggling, really struggling with suicidal ideation today and they needed to be able talk to someone.”
Sivaranjan alongside co-founders Nivethika Nagularajah and Varshini Nagularajah is a founder of Aadhya Empower Yourself, a mental health initiative that focuses on the Tamil community. She says she thinks back to that day and hopes that she was able to help that person.
“At least for that one moment, they knew somebody cared about them,” she says.
What are the statistics?
In Canada, suicide is the second leading cause of death among Canadians under the age of 25, and this number tends to be greater for ethnic minorites.
According to Statistics Canada, the prevalence of suicide is greater among racialized females than males.
Additionally, for every death by suicide, there are about 20-plus suicidal attempts. These statistics are alarming and deeply saddening.
More importantly, these statistics represent a number of South Asians who are struggling and may not know where to turn to for help.
Unfortunately, few studies have examined the prevalence of mental health disorders and suicide rates in the South Asian communities, resulting in a lack of accessible treatments and resources tailored to South Asian mental health.
Different cultural and interpersonal stressors can prompt suicidal ideation behaviours. Stigma attached to failure, familial pressure, academic pressure, role expectations, intergenerational and cultural conflict are just some examples of potential stressors that lead individuals to attempt to self-harm.
It is important to know that suicide is preventable. Know the warning signs, look out for the people around you and check in with them. About 75% of individuals showcase some type of sign or symptom linked to suicidal behaviours.
Thus, recognizing and becoming familiar with the signs of suicidal ideation is important. Signs include but are not limited to: withdrawal, hopelessness, excessive sadness, depressive symptoms and many others.
Becoming familiar with these can help identify a friend or family member that may be struggling with their health and get them the help they need.
Finding it hard to relate
Sivaranjan says she has had her own struggles with mental health and even suicidal ideation in the past.
She says her experience trying to seek out support and therapy were difficult. Due to the Anglo-centric nature of mental health in Canada, it was hard to relate to her upbringing of coming from a Tamil household.
“I felt like I was trying to prove myself to somebody while I was talking to them, it didn’t reflect my experience,” she says.
From there she decided to start Aadhya in 2017 and works to challenge and reduce mental health stigma from within the Tamil community through peer support groups, educational workshops, creation of educational tools and “trying to be the middle person, connecting everyday folks to everyday resources.”
Sivaranjan says it is a lot more accessible for people to connect with someone like herself, a registered social worker who can help them navigate through the otherwise complicated system.
She spoke about the importance of awareness in the South Asian Tamil community as there has been an increase in suicide related deaths within the community.
“There have been an influx of folks in our community who have died by suicide or died by overdose, and that’s fairly recent as well,” she says.
“I think this is something I’ve identified recently with my team to push for and encourage people to talk about it.”
Sivaranjan says even if it means simply putting out an educational post on social media that can be shared and seen, she wants people to know their feelings are valid.
Understanding the gap between South Asians and Mental Health
This lack of communication surrounding mental health and those in South Asian communities is something that has been a long-running issue.
Komal Bhasin, the senior director of research strategy and operations at the Centre for Addiction and Mental Health (CAMH), says this mindset is common in several immigrant communities within Canada.
“The South Asian community, like many others, I wouldn’t say struggles, but has had less exposure to Western ideas and Western framing around mental health, and there is also as a result, a lot more stigma and hesitation about how to talk about it,” says Bhasin.
She adds that there are barriers to knowing how to talk about mental health, given that in certain cultures there aren’t even words for mental health or a word for depression.
Bhasin outlines two barriers that get in the way of furthering mental health within the South Asian community at large.
The first, she says, has to do with the difference in family dynamic, which can be boiled down to the notion of normative hyper-involvement of the traditional South Asian household. In other words, everyone is concerned with everyone else's business.
“We often need to check with the matriarch or patriarch about if we have permission to speak about things and keep things very much within the family. Much less individualistic, much more collectivist. Those social obligations, social expectations and familial expectations prevent people from seeking help,” says Bhasin.
While the first barrier can be hard to get around, there is always the case that a family member might advance past it.
There is still another point of interruption before a real discussion can be had.
“A second barrier shows up and it’s a barrier to culturally competent support,” says Bhasin.Some research has begun in researching the culturally competent support for South Asians. In August of 2019, CAMH announced it had received just over $1 million in funding to research using cognitive behavioural therapy (CBT), specifically in the South Asian community.
Bhasin says this type of evidence-based research to better understand the scope of mental health in the community will take time and should continue to happen alongside the work of mental health initiatives that are reaching out to the community.
The need to continue the conversation
For Sivaranjan, she hopes that conversations around suicide prevention and awareness continue to happen beyond the one month dedicated to it.
“As someone who has struggled with suicidal ideation in my past, I think it’s important to know there are people out there willing to listen and not judge you; just listen.”
She hopes that the work she does can continue to help some open up about their experiences and allow some to have compassion and empathy around mental health.
“It’s okay to not be okay and you don’t have to do it alone.”
The importance of tackling stigma head on allows those who are struggling to connect with resources and openly communicate with loved ones or reach out for support. Mental health outreach programs are better tailored to address the unique mental health needs of the South Asian population in Canada. Check out the resources linked below.
Suicide Prevention Lines: