He has straight A’s, a full schedule of Advanced Placement classes, a chair within the youth orchestra and a bedroom wallpapered with college acceptance letters. He hadn’t slept through the night in months. She wakes up at 2am, convinced she’s a burden on her family – and has no idea the best way to tell anyone.
I do know such students. My niece—a young woman who was quiet, hardworking, and by all outward measures well-to-do—was one in every of them.
During the primary yr of the COVID-19 pandemic, he died by suicide. Her family didn’t know she was depressed, nobody at her school raised concerns, and she or he never sought mental health help.
After his death, I began asking different questions – not only as a member of the family, but in addition as an educational and researcher. Between 2023 and 2025, I interviewed 11 Chinese immigrant parents living within the U.S. about how they perceive their kid’s mental health and why many families avoid mental health services, even when Their children are struggling.
The parents I interviewed for my doctoral dissertation at Cleveland State University weren’t indifferent to their kid’s suffering or overall well-being. They were navigating mental health through a distinct framework—one shaped by deeply held traditional Chinese beliefs about family honor and self-control. Often, they lacked the language and understanding to openly discuss mental health.
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When suffering has no name.
While many immigrant youths are victims of this. Mental health challengesChinese and Chinese-American youth with immigrant parents experience higher rates of tension and depression than those with immigrant parents. Many of his colleagues.
Suicide rates amongst Asian American girls ages 10 to 19, meanwhile, It has more than doubled in the last two decades..
Despite this growing crisis, a big treatment gap amongst youth persists: Only 10 percent of Asian American college students and youth are experiencing emotional distress. Get professional help. This leaves nearly all of these students to struggle with stigma, academic pressure and silence. They fear their parents’ response if they ask for help..
Many Chinese immigrant families I spoke with didn’t use labels that Westerners might use to explain emotional distress, resembling depression or anxiety.
Chinese and Chinese American children and adolescents may struggle with mental health challenges that they’re uninterested in, for instance. Chinese immigrant parents often notice only physical symptoms of their children, resembling headaches or lack of appetite. Neither the youngsters nor the parents have the words to associate what they’re seeing with depression or anxiety – and the college sends home an English-language brochure that nobody reads.
In tight-knit immigrant communities where fame matters and word travels fast, admitting that a baby is struggling can feel like broadcasting the family’s failure. Everyone who knows them. One parent in my study told me in 2024:
“Chinese parents care loads about ‘face’. If something is positive, they need the entire world to know. But if it’s negative, they’d prefer to cover or hide it. Even in the event that they have an issue, they’re unlikely to hunt help publicly.
Another Chinese parent described how the words “mental illness” are heard in her community:
“If someone has even the slightest mental problem, others think they are not normal and may discriminate or gossip about it. ‘Mental illness’ is often used as an insult.”
My research, within the strategy of publication, also found that many parents completely missed the warning signs of a baby’s deteriorating mental health – not because they weren’t looking, but because they didn’t know what to search for. Many described a “wait and see” approach, assuming that teenage stress was temporary and that the kid would grow out of it.
A Chinese father, an elementary school teacher with a 21-year-old son, described what he observed in his community:
“Most parents want to protect their child and believe that their child is normal. Most parents just hope the day goes by – they think that if the child acts up, nothing, it will pass. Too many days go by, and these problems are ignored.”
A mother in my study shared a story that stayed with me. A teenage boy in his community jumped off a constructing on the primary day of faculty because he couldn’t turn in a homework task. He survived. Later, her mother realizes that she has missed the warning signs through the years, unsuitable to retreat because of her exhaustion and laziness. As my partner explained:
The boy’s mother “thought he was just lazy or unmotivated. But in reality, he had no energy — a severe lack of motivation. Her philosophy was that ‘hard work can make up for lack of talent,'” this other parent explained.
What goes unsuitable in schools?
Schools are a spot to discover and support students with mental health needs.
Some parents in my study described supportive teachers who reached out with real empathy once they saw a student withdrawing or struggling. More often than not, she encountered counselors who didn’t understand the family’s cultural context, sent household materials only in English, or treated them with behavior that was completely normal in a Chinese family, resembling a baby avoiding eye contact or expressing disagreement through silence reasonably than words. As a cause for concern.
When a faculty’s entire approach to student mental health is built across the expectation that students will name their feelings directly and that families will welcome clinical referrals, it might probably feel foreign – and subsequently unsafe – to many Chinese American families.
I imagine that a number of things are needed to make real progress in supporting the mental health of Chinese American youth:
First, states with growing Chinese immigrant and Chinese American populations could fund bilingual, bicultural mental health services. Screening tools utilized in schools can recognize what could also be a cultural way of expressing anxiety in Chinese culture, not only through the self-reporting language of Western psychology.
Second, I believe schools could spend money on a bilingual family liaison role inside counseling teams – not only an interpreter for paperwork, but a real bridge between two worlds. Mental health systems can establish formal partnerships with community institutions that families already trust: Chinese-language churches, cultural organizations, and community centers.
My niece was celebrated for her grades, her discipline and her quiet reliability. What she needed was someone to look past all of it and see how she was really doing.
With my niece Joe I am unable to change that. But his death continues to shape my work – and my belief that schools, families and communities must learn to see young people more fully – not only for what they achieve, but for what they silently carry.