The Mental Health Costs Of ‘Everyday’ Racism

IRA FLATOW: This is Science Friday. I’m Ira Flatow.

Before a 21-year-old white man killed eight people, six of them Asian women in horrifying shootings near Atlanta last week, Asians and Asian Americans in the US had already been experiencing a rise in racist attacks. Since the early days of the pandemic, the Stop AAPI Hate Reporting Center has logged more than 3,700 incidents of racist violence ranging from verbal attacks to physical violence. And the Center for the Study of Hate and Extremism at California State University has reported a 150% rise in documented hate crimes.

Psychologists attribute much of this to those in power last year who blamed China for the COVID-19 pandemic, but anti-Asian racism in the US has a longer history. And the research says trauma inflicted by racism happens well before people are injured or murdered. Even microaggressions– we’ll talk about them– which are considered less overt, less harmful, are increasingly being linked to symptoms of trauma. My next guests are actively studying the links between racist discrimination and mental health as well as where people who have been exposed to racism can find strength and healing.

Let me introduce them. Dr. Charissa Cheah, a professor of psychology at the University of Maryland, Baltimore County, and Dr. Kevin Nadal, a professor of psychology at John Jay College of Criminal Justice in New York. Welcome both of you.

KEVIN NADAL: Thanks for having us.

CHARISSA CHEAH: Thanks so much for having us.

IRA FLATOW: You’re quite welcome. Dr. Cheah, let me begin with you. Let’s start with the research you’ve been doing this last year. I understand you’ve been studying discrimination and violence against a Chinese-American family since last March. Why did you think it would be important to go looking for this data even a year ago?

CHARISSA CHEAH: We know that the racialization of disease is not a new phenomenon, and this is seen particularly when the first case of a virus or a disease is reported in either non-Western geographical region or a minoritized group. So we saw this more recently with SARS and Ebola, for example. And with regard to Asian populations in North America, being targeted for such racialization, SARS would be the closest example where Asian-American communities and businesses were targeted although to a much lesser extent than what we’re seeing now.

And so we know that these racial tropes that are being evoked so easily, for COVID-19 racial discrimination go as far back as the first wave of Chinese Asian immigrants to the United States. And so while we design new items for racial discrimination and racism including xenophobia to capture these experiences around the COVID-19 outbreak and pandemic because no such measures existed at that time, it was not particularly difficult to do so as these stereotypes are woven very much into the very fabrics of the formation of our society.

IRA FLATOW: And so you found that the– data that you found shows some really high numbers about adults and children who experienced acts of discrimination.

CHARISSA CHEAH: We found that during just the period of January to May of 2020, over 76% of Chinese-American parents and children separately reported witnessing at least one incident of COVID-19 racism online, and over 88% of parents and youths reported experiencing one incident of COVID-19 racial discrimination in person. The other number that’s, I think, important to also keep in mind is that approximately one fourth of parents and youth experience online or in person racial discrimination nearly every day. It’s not just the frequency in terms of the numbers overall but the chronicity of these experiences was quite shocking to us.

IRA FLATOW: I know you’re a developmental psychologist, so you’re also asking children about their experiences and mental health. And what did you find there?

CHARISSA CHEAH: For both parents and children, every type of discrimination experience and collective racism perceptions were associated with poorer mental health, specifically higher rates of depressive symptoms high rates of anxiety. We also found that for children, their parents’ own experiences of discrimination were also associated with children’s report of internalizing problems.

We talk about this as a spillover effect from parents to children, so parents’ direct victimization was associated with children’s anxiety and internalizing problems in the way that parents might be indirectly or directly transmitting some of the stress that they’re experiencing and might create more tension and hostility within the family environment. So we should really pay attention to the needs of these children both as individuals but also within the family system.

IRA FLATOW: And Kevin Nadal, it’s not an exaggeration to say that an event like the shootings in Atlanta was traumatic.

KEVIN NADAL: Right. And so this is another form of trauma. In psychological research, we might refer to this as either collective trauma or historical trauma or even racial trauma. And what the research has found is that people who belong to historically marginalized groups may start to develop trauma symptoms and reaction to seeing, hearing, witnessing any of these violent acts that may happen to people in their group.

And so last week with the shootings in Atlanta, many Asian-American people, particularly Asian-American women or Korean people or immigrant Asian Americans may have felt a deep connection to that. There’s the fear that this could have been me or this could have been someone very close to me. And it’s not just that they feel sad, but they actually develop symptoms such as inability to concentrate, inability to function, the inability to just even get out of bed and continue with their days.

IRA FLATOW: But your work is on microaggressions that seem small but have a larger impact. So tell us more about that, please.

KEVIN NADAL: Sure. Microaggressions are the subtle forms of discrimination that people may experience in their everyday life, particularly when they belong to marginalized groups. And so what we’re thinking about with Asian Americans are some of the experiences like being asked where they’re from, and then the Asian American says I’m from New York. And then the person says where you really from, and then the Asian person says I’m not going to give you my address.

It’s a very common experience for Asian Americans to hear comments like these that aren’t necessarily intended to be malicious, but the accumulation of these subtler forms of bias actually add up and actually can lead into a lot of different negative health outcomes including depression, anxiety, and even trauma symptoms. So when we talk about microaggressions, we’re actually also talking about trauma because of the accumulation of those things. What research as found is that the more microaggressions that people experience, the more likely they are to report some of these negative symptoms. Research has found this even to affect things like sleep, substance use, eating disorders, body image issues, and even physical health.

IRA FLATOW: And this to me sounds something like we’ve heard about PTSD. Are people– is this that kind of a form of PTSD? Over so many years, it just adds up?

KEVIN NADAL: Yeah, for sure. I think one thing that we have to recognize is that trauma can exist on a spectrum, that there are people who may experience very severe trauma. This is typically what we think about when we talk about PTSD or post-traumatic stress disorder, that survivors of war, sexual assault survivors, and so forth, they may be unable to function because of these intrusive memories, anything that may trigger them to think about whatever that traumatic event is. And so people with PTSD, they might express some of those very severe symptoms.

The people who experienced racial trauma that is more vicarious, more secondary, meaning that they didn’t witness it directly, they can also experience symptoms of PTSD, but maybe they won’t be as strong or vivid as those who were the direct survivors of the PTSD. And just one last thing that I always want to advocate for is that when are trauma survivors who seek treatment, one of the things that they are told is that they are experiencing what is considered normal and expected reactions to trauma. They’re told this by the therapist. They’re validated in this way.

Though when people experience racial trauma, oftentimes they’re met with messages like are you sure it’s really that bad or you weren’t even there. Why are you making such a big deal out of it? This is why it’s so important for us to label racial trauma as trauma just so that even the patients who experience these things won’t be invalidated by their therapist or their practitioners because that person will have been trained in knowing that racial trauma is actually real and actually scientifically proven to be a legitimate experience for people.

IRA FLATOW: Is this kind of trauma worse and longer lasting, Charissa, in kids than in adults?

CHARISSA CHEAH: We did find that some of these experiences were more strongly related to children’s mental health outcomes for several reasons. First, their identity formation is being developed, so they might not have a clear sense of their belonging or affirmation and the positive benefits that they could be deriving from their racial ethnic identity, which we to be a protective factor. They are also more likely to be questioning their place in the American society or the American. How do they belong? Where do they fit?

And also– they also are less likely to have coping skills and strategies than adults. The other issue is that for many of these youths, particularly in our sample, they might have been born in the United States in the sense that their parents, if they’re first generation immigrants, might have clearer senses of why they came to the United States where second generation or third generation children might not have that same sense. And so their identity and sense of belonging is being questioned in a different way that could have additional negative impacts on their mental health.

IRA FLATOW: Let’s talk about then some of the help that our Asian and Asian-American listeners or anyone who is dealing with microaggressions or more overt discrimination or traumatized in the wake of last week’s killings. Charissa, what other advice do you have for them?

CHARISSA CHEAH: I’ll start off by focusing on what parents can do to support their children. The most important thing is for parents to really provide a safe and secure emotional context during this and any other stressful event. This includes making children feel heard and supported and that their experiences feelings and thoughts are valid no matter what they might be thinking or feeling at that particular moment. Listen, validate, and then try to guide them if they need additional support and advice and to remember that this will go on for a while.

In doing that, parents then also need to engage in self-care. To be able to take care of others, parents also need to remember that they are also going through this very stressful period and to obtain the kinds of help and support that they themselves need. I would also advise parents to engage proactively in racial ethnic socialization strategies, which include passing on messages and cultural strengths and identity to their children. Be advocates for the children if they feel that they’re experiencing instances of bullying or hate in the school environment.

These days there are lots of wonderful resources available on the internet from different organizations including mental health organizations such as the Asian-American Psychological Association. Developmental scientific organizations have put out different webinars and resources including the Society for Research in Child Development. And also there are advocacy or social justice based organizations such as EmbraceRace.org, which has a ton of wonderful resources for parents how to talk about race and how to take care of yourself and your children during this period.

You can also find information on how to access mental health practitioners via helplines or local providers in your community and information to talk to your children more proactively to prepare them or reactively in terms of processing some of the tragic events that we’re witnessing and that they might be experiencing or reading about.

IRA FLATOW: Just a quick note, this is Science Friday from WNYC Studios.

Kevin, one last question for you because we just heard Charissa talk about a whole bunch of resources, but I would think that asking people who are dealing with the after effects of trauma to seek help and be resilient especially when they’re hurting is a lot of work for victims. In a system that always is easy to navigate, is there any other kind of systemic change or solution that your research leads you to advocate for?

KEVIN NADAL: That’s a great question, Ira. I definitely agree that people do need resources, but we note that there are so many different systemic issues that may prevent them from seeking those resources. To find a therapist in most parts of the United States, to navigate these systems is sometimes even a challenge for me. So if you think about people who are English as a second language speakers, immigrants, people who are searching for providers who may match their cultural identities in some ways, and so systems really need to do a better job of making it easier for people to seek treatment and therapy whether it be providing more resources in different communities of color, whether it means having language accessible resources available to people of different groups, or even just making things free and less of a hassle for folks who might not have the financial means.

The systems also need to do whatever they can to assist people of Asian-American descent and really all marginalized groups during this time that might mean in workplace settings recognizing that this anti-Asian hate may occur and to check in with your Asian-American employees on ways that you could better support them. That might mean in school systems, creating curricula that focuses around Asian-American history so that people are aware of the ways that Asian Americans have been treated and oppressed throughout the history of the United States.

It can also mean that parents and family members can talk to their kids and to others in their family about the issues that are going on so that they can be allies and accomplices. Many times people are witnessing these Asian-American hate crimes and aren’t doing anything in response, aren’t intervening, aren’t calling for help, and that’s something that can easily be changed if people just are aware of how serious this problem is.

CHARISSA CHEAH: Part of the racial trauma for Asian Americans is this invisibility of Asian Americans throughout history. And so this idea that Kevin brought up of nobody seeing it as traumatic or people don’t share our experiences or that these experiences are not validated is very much part of the racial trauma. And so something families have been doing that have been helpful is just really storytelling for victims to share their experiences to really speak out and for non-victims to stand up and to validate these experiences.

And I completely agree with Kevin about Asian-American studies and ethnic studies also more generally being included in the curriculum. That’s an important part of addressing the marginalization and invisibility of Asian Americans but also other marginalized groups.

IRA FLATOW: Some very good information. Thank you both for taking time to be with us this hour. Charissa Cheah, professor of psychology at the University of Maryland, Baltimore County, Kevin Nadal, professor of psychology, John Jay College of Criminal Justice in New York City, thank you again for taking time to be with us today.

KEVIN NADAL: Thank you, Ira.

CHARISSA CHEAH: Thanks so much for having us.

IRA FLATOW: And for more resources on mental health, healing trauma, or just being a better bystander for your neighbors, visit our website ScienceFriday.com/mentalhealth.

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