South Asian Mental Health: A conversation with my parents

Here in Canada, mental health is just a form of taking care of ourselves - something that is normal, even expected. We learn about healthy coping techniques like talking to friends, going on walks, and writing down our feelings. We hear about it every day on social media, in the news, or from our friends. This openness that we have here is so normal to us that we don’t realize how fortunate we are.

My parents are from Pakistan, a country in South Asia bordering India, Iran, Afghanistan, and China. It is a beautiful country with amazing food and a hard history. It is also the fifth-most populated country with around 241 million people living there. While I am proud of my heritage, there are many issues that persist in that nation - that discord being the reason my parents immigrated.

The reality of growing up with immigrant parents is that there is a lot of disconnect. The cultures in which we grew up are so different that it is difficult to see the other perspective. For this piece, I wanted to understand what my parents were taught back home about mental health.

This is edited for clarity and length and some segments will have been translated from Urdu. This piece contains discussion of suicide. If this is a sensitive topic, please be aware.

I start by asking the main question right off the bat.

Me: Abu (dad), what is mental health in our culture?

Dad: We call it ‘nafsiyati mareez’ in Urdu.

Me: Is that the direct translation to English?

Dad: Oh I'm not sure what it directly translates to. Mental…mental patient?

Mom: It would be just calling someone a psycho in English.

Me: So it's a negative connotation?

Mom: Yes, we only really used that word as an insult.

I had guessed that there wouldn’t be a word for it, and so the next question I wanted to ask was:

‘Is there a specific word for depression in Urdu?’

Dad: No I can’t think of any word for that. I think there isn’t a direct translation.

I want to mention something important here. I went and searched online if we had a word for it and learned that yes- in fact, many Urdu words can be used. However, this doesn’t mean that my parents are wrong or uneducated. This shows us that even if there is a word for it, it isn’t known by the average Pakistani because of the attitudes about mental health present there.

My dad continued.

Dad: I remember once my dad was asking one of my cousins what the word depression meant. He said something like “I keep hearing this word but I don't know what it means. We didn’t know much about it. Actually, there was a man in our town who died of suicide. Nobody expected it from him. He had young kids and a wife and one day someone found him on the train tracks.”

This surprised me for some reason. I didn’t expect to hear about suicide in this discussion, let alone hear about someone my dad knew personally-. I asked my mom if she knew anyone and she did.

Mom: You actually met him once as a baby when we visited Pakistan. He lived across the street from us and we called him Bhai (Brother). He was very close to our family and whenever we wanted to go out he would drive us because our dad didn’t trust anyone else. He told us he wished he could put his kids in school. We knew him forever and I was here in Canada when I got the news. It was so shocking I couldn’t even believe it. I think the main reason was financial issues and that there were some disagreements with his wife. I knew that it was very hard for the family and it is such a sad situation.

I had never heard these stories before; maybe my parents and I don’t talk about mental health enough. But hearing them now made me wonder. Both my parents knew someone who committed suicide, so I looked into the statistics on suicide in Pakistan and learned that 8.9 suicides happen per 100,000 people (Mahesar et al., 2023). The issue exists just below the surface, but it still isn’t acknowledged. My parents, whose taboo around mental health surely must have lightened after 23 years in Canada, still didn’t speak about these stories until I asked.

Moving forward, I wanted to talk to my mom specifically about her college education in Pakistan. She studied Psychology which would indicate that she learned a lot about the human mind and behavior.

Mom: No. No, we didn’t learn anything. Most of the time, the professor wasn’t even there. We had to memorize textbooks by ourselves and even those didn’t teach us about this stuff.

I can’t say I was surprised by the lack of education surrounding mental health but it was still shocking to hear. I looked up statistics about Pakistani mental health, and found that there are less than 500 psychiatrists per million Pakistanis (Sehat Kahani, 2022). Even if there wasn’t a stigma around mental health, there aren't adequate resources to deal with it. From my own experience and those of my friends’, I know that immigrant parents don’t talk about mental health a lot, but the reality is that a lot of it isn’t their fault. They grew up in a place and in a system that keeps mental health hidden and ignored.

From this conversation I have developed a new outlook on coping strategies, and ways to decolonize mental health. The techniques taught to us from external sources may not be applicable in our households, which means second-generation youth must find a compromise. For example, a common issue within immigrant households tends to be communication - something that is essential to building healthy relationships. A second-gen kid in this situation may opt to communicate in non-verbal ways, or to repackage ‘therapy speak’ so their parents may understand. By understanding the views second-gen youth grew up with, it allows us to reach this demographic better, as well as develop tools that would be more helpful to them.

Mahesar, Rameez Ali, Dastar Ali Chandio, Muhammad Latif, Salbia Abbas, and Taha Shabbir. “Demography and Risk Factors of Suicide Deaths in Pakistan: A Twelve-Month Content Analysis Study.” Asian Journal of Psychiatry 80 (February 1, 2023): 103364.

https://doi.org/10.1016/j.ajp.2022.103364.

Sehat kahani | Make Mental Health a Priority in Pakistan. (Oct 2022.).

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