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In-Depth Q&A with Zoey Ka, Multicultural Mental Health Advocate (Part 1)

In this comprehensive interview, Zoey Ka and Monique Moate discuss a wide range of mental health–related topics. They cover, for example, mental health advocacy, lived experience, intersectional identity, the challenges of people of colour, cultural influences, stigma, how to be a great ally and support person, workplace improvements, and hopes for systemic and societal advancements.

Trigger warning: discussions of mental illness, suicidal ideation, self-harm, etc.

Part 2 is here.

Q. First, could you share with us a bit about yourself, your story, and your lived experience with mental health conditions?

Zoey: Myself, I probably say I’m a highly sensitive person, an empath, an introvert, an Asian Australian, specifically, Chinese Australian. And I was born in Australia but raised in Hong Kong until I was seven. I came back and have spent my entire teenage years jumping from place to place.

So, obviously, that has really impacted on my mental health, especially with childhood emotional neglect. I have never been formally diagnosed for many of my [conditions]. However, my formal diagnoses are depression and anxiety.

Q. How did you start out in mental health advocacy, and what advice would you give to those interested in doing so?

Zoey: I’d probably say “mental health advocacy” is such a loaded term. When you first hear it, you think it’s, you know, you have to be advocating on a national level with the commissioner, or talking about policies. That is definitely a part of it.

But I think mental health advocacy is as simple as talking to your partner or talking to your friend or your peer about mental wellbeing. I think that’s really the beginnings of it.

And if anyone wants to consider mental health advocacy, I’d probably say, look into yourself and ask what does advocacy actually mean to you? Because advocating on a professional level means you’re in an advocacy role; at the same time, you can be in formal roles. Or you can be doing that as a citizen of your country, and just talking to people about mental health awareness. That is a form of advocacy too.

Monique: That’s interesting to think about.

Zoey: Probably lots of people won’t agree with what I say. But that’s how I see it, to be honest.

Monique: I think I see it the same way. ‘Cause it is a loaded term, and we do think about it more in a professional context. But there are lots of ways to be an advocate, even if you’re just an advocate for yourself.

Zoey: You’re right.

Q. Could you tell us more about your current work with MIFA and Finding North?

Zoey: Absolutely. So, the organisation that I work for is the Mental Illness Fellowship of Australia. It is an advocacy and policy organisation, with a focus on severe and complex mental health.

Now, we know that during COVID, the government has provided a lot of funding because mental health and mental health conditions have really, really come out of hiding when many people have been impacted by it.

However, a lot of the major funding has been put into, I guess, the lower end of the spectrum. Hate using that term, but you know, anxiety/depression is on the lower end. Whereas there’s still not a lot of funding for those who are severely impacted by mental health, such as psychosis, schizophrenia. They’re still quite stigmatised.

Even though we say that mental illness is a lot more out in the open now, there are still things that people are not talking about. And we really need to talk about it.

Essentially, I work on the Finding North team. So, Finding North was actually developed by a co-design team when we went through a branding process, to develop a website and also an exclusive network for lived experience. When we went through that branding process, our co-design team really, really wanted something that would be hopeful. Something that transcends through culture and time.

In the end, we landed on Finding North. Because wherever we are, whatever journey we are on, there is a north. And your north and my north may look different. And my north may look different at different times.

I always like to use this example of my personal experience. My north, probably, 10, 15 years ago, was to get up and get out of bed. That was a success. And another north of mine, many years ago, was to wake up and not wanting — please use a trigger warning in this — not having any suicidal ideation. Or any self-harm, for example. Or drinking. Or any sort of drug use, for example.

But now, my north right now is to really use my personal experience and to advocate. Also, share with others, and hopefully support others in their journey in various ways. And also make sure that the lived experience sector, which is a growing sector now to be heard—.

The lived experience workforce is growing; however, what I’ve found is the lack of diversity, especially in terms of people of colour. And that’s kind of where my north is right now. To first, work on and see why is it that there is a lack of people of colour in that particular sector. I have a lot of thoughts about that. But I guess that’s where it is.

Q. What have been some highlights of your advocacy work so far?

Zoey: I think the acceptance of me as an individual. And also, the comradery of people within this sector. Everyone goes on their own journey of advocacy — what they feel strongly about, what resonates with them, what doesn’t. A simple one is the term “recovery.” You know, Chinese Australian, I’ve been quite indoctrinated into the system.

Also, the power thing, where I listened to what the doctor said. The doctor says I’ve got this and I’ve got this; the doctor tells me to take medicine. Like, I’ve never had the opportunity or even the awareness to question these things.

Whereas, when I first came into this role, and I posted something about recovery, I had a very, very nice peer who shared with me. They said that they don’t align with the term recovery. There was no judgement there, the fact that I used that terminology. Because some people definitely like that term. There are some who don’t.

But it was the fact that someone wrote that comment that had given me an awareness that, oh, I didn’t know that I could like a word or align with a word. Or not align with a word. So, I think that my biggest highlight of advocacy is the ability to have a choice and awareness on what I feel comfortable with, or not comfortable with. What I should be involved in.

Monique: That’s really interesting. ‘Cause words have a lot of power and connotations surrounding them. I mean, I have thought about that myself. When will I ever kind of “recover?” Will I ever recover? Or is it just gonna be something that’s kind of always there, waiting to be triggered, you know?

Zoey: Mmhmm. And that’s why some people are like, “I don’t think I’ll ever—. I don’t align with the word ‘recovery.’ Because I’ll never recover.” Recovery has this connotation that you were “a full piece,” at one time, and now you’re broken. And in the future, you’re able to piece all those pieces back together.

But really, when your life changes so drastically because of mental ill health — whatever terminology. That’s another term: “mental illness,” “mental health conditions,” “psychosocial disability.” So, we’ve got to speak different languages to different people. Some people don’t think they’ll ever recover. And some people think they will, and they accept that, and they prefer that. And that’s okay.

But knowing that there’s the option, and choosing what word resonates with you, that’s the power I was never given. The only reason I used the word “recovery,” in that particular sense, was when I first started this journey, that was the only word I knew. There were no other words that my support network, my clinicians, have used.

Monique: What word would you prefer to use instead?

Zoey: Oh, god, I haven’t really thought of that. But I probably say just—.

Monique: Remission? Or?

Zoey: Probably just my journey. I know that J-word is so used. But I think I’ll always be on a lifelong journey. And I don’t think I’ll ever “recover,” because I don’t necessarily think I was in a good place before. At any time, if that makes sense. I’ve never been fully well. [laughs] Or what people might think is fully well.

But when I look back, I was never in a very good place. So, if I have to talk about recovery, I don’t think—. I think I’ve healed. That’s probably a better word of my journey; healing from a lot of the trauma. But I don’t think it’s recovery.

Monique: Mmm.

Zoey: Very complicated!

Monique: Yeah, it is. Especially if you have childhood trauma. Were you ever really safe? And how it affects your personality development and attachments with other people. It’s interesting to think about. A lot of these terms, they mean a lot of different things to different people.

Zoey: Mmhmm.

Monique: You have to unpack them for your own self.

Zoey: Who has the time to do that, though? Unless you’re forced to. [laughs]

Monique: Language is like—. It’s so easy to be misinterpreted by people. Another word that’s used a lot lately: intersectionality.

Q. How does an intersectional approach inform your work?

Zoey: Looking back, I wouldn’t have said that I have a particular approach. But I did a lot of things intuitively. And I’d probably say that I’d always look at it from a racial point of view. You know, as a woman of colour, in particular, what are the points that actually really restrain me from doing the things that I want. What are the typical assumptions people make for a Chinese woman, for example.

And that really helps me inform the work that I do by making sure that, okay—. I think the biggest thing for us is that we’re in a Eurocentric world. And so, I can’t say that I understand other cultures aside from my own as a Chinese Australian.

But I think that sensitivity, in terms of the discrimination and racism and sexism that I’ve experienced, and many of my peers have experienced, that it’s always in the back of my mind to be sensitive, to be aware, and to be respectful as much as possible.

Monique: Me too, actually. It’s one thing if you’re white, and you’re not really aware of—. You don’t have that lived experience, and you don’t know how much it hurts. But it’s completely different if—. And for people to start talking about racism, it means they’ve experienced a lot of it, you know. Not just one or two incidences.

Zoey: I think what hurts are not the people that have experienced racism, or even the allies not being able to fully understand. I think what hurts are the people of colour who have never experienced racism — or at least, in their own perspective — and say that out loud, and being quite disrespectful. I get that it is their truth.

But at the same time when they make these assumptions, oh, you know, this area, I’ve never once experienced it. It does harm other people. So, I think that the way that we talk about these things really have to be appropriate. And many of us are not equipped with the language to do it. And sometimes it does more harm than good.

Monique: Mmm. I guess this kind of leads into the next question.

Q. What do you think are the unique challenges facing people of colour with mental illnesses? And women of colour with them?

Zoey: I can only say this from my own experience, but people of colour’s experiences of mental illnesses can be somewhat similar to, let’s just say, white Australians, just using that as an example.

For example, men versus women. Men tend to not have the appropriate language. And bottled up because they’re the breadwinner, and they’ve never been taught to do these things. They have to just swallow a spoon of cement. Those type of similarities across men and women, there are similarities.

However, one of the layers I feel hasn’t been talked about is the notion, especially for those who are first-generation or second-generation Australians, is they come over from another country, and a lot of them feel very, very grateful. And so, when they have issues or have challenges, they feel like they should not be a burden on the system because they’ve been treated so well. I’m talking about some; I’m not talking about everyone.

Also, add on top of that, the traditional things like, “mental health is not real.” That really cascades — on that. Different cultures have different approaches to mental health. So, it can be really hard for people of colour to actually seek help.

And if you think about the help that is out there, it’s so focused on Western medicine. It definitely works for many people, but it doesn’t work for everyone. Just the process of going through a GP, doing a test, and then going to a psychologist, a psychiatrist, that in itself is very stigmatising, traumatising, and very challenging.

So, it’s not accessible. And if it’s not accessible for white Australians, which is what the system is built for, why would it be comfortable or accessible for people of colour who are basically seen as second-class citizens?

Monique: Mmm. Another thing I’ve been thinking about recently is how the vast majority of therapists, like psychiatrists, psychologists, are not people of colour.

Zoey: I think mental health in Australia has usually been dominated by people from white backgrounds.

Monique: It’s another aspect to it.

Zoey: And you look at Asian Australian—. The one in Melbourne, what’s it called? Shapes and Sounds. Look at their list of Asian Australian psychologists; there’s not many. If you think about how many registered psychologists are in Australia.

I’m not saying that list is complete, but that’s a very good sign of how many there are, just in terms of Asian Australians, and think about how many Asian Australians are in Australia.

Monique: And also, there’s the shame aspect, I guess, as well. In some cultures.

Zoey: I think that some of us are willing to go get help, and willing to face our challenges head on. It doesn’t mean those around us don’t have those. It’s just they hide it very well because they don’t want other people to know.

Monique: I do respect that. But I also believe there is a lot of value in talking about what you’ve been through. Even if other people don’t want to talk about what they’ve been through. I think it does help them.

Zoey: I couldn’t agree with you more. Sometimes people ask me, “How are you so comfortable with being vulnerable?” Because I share my story. And I say to them, “No, it’s not easy for me.” It might seem easy because I talk about it a lot. But the only reason that I do it is because I feel like I’ve broken the hardest walls.

Because randomly talking about just my mental health — “Not feeling that good.” Just by saying, “I’m not feeling this great today,” sometimes I see that it’s given others permission to just say, “Oh, it’s a shit day.” And you can see the shoulders go— [exhales]. I don’t have to pretend that everything is good.

Monique: Yeah, I know.

Zoey: Just as simple as that. I never expect anyone to share, or ask anyone to share, to be honest. But if I have the capacity mentally, and I’m in a mentally well space, and I have the ability to talk about some of my experiences, then I will always do that. Because I think someone always has to take the first step, to be vulnerable. And I’m more practised in it now. So, I’m okay to be that person.

Monique: I think I reached out to you through Asian Australian Alliance, ‘cause I read your post on Being Asian Australian. And I thought it was really brave of you to admit that, you know, your suicidal attempts and stuff. I haven’t spoken about that publicly. But that is really brave to do that. [laughs]

Zoey: Thank you. And I think there is no pressure for anyone to share any parts. There are a lot of parts of my personal story that I never share publicly, to be honest. And I don’t think I ever will. Maybe if, like, we have a coffee or, sometimes it gets to that, then there will be some.

But it’s always learning to understand yourself. What parts can you share, are you comfortable with sharing? And at different times as well. ‘Cause one thing I’ve learned in the last few years is sometimes I share the same story, the same content, and I feel completely okay, and I feel empowered and powerful.

And there are days when I talk about specific bits and pieces, and it will really activate me. So, it’s about learning and being aware of your state of mind really, I think.

Monique: Mmm. I just saw your little cat in the background. [both laugh / cat talk]

Q. This may be a more sensitive question, but how do you think racism impacts the mental health of people of colour?

Monique: I think we might’ve covered some of that.

Zoey: I probably think it’s much harder, the same as before, for people to reach out for help. And especially if you come from more of a collectivist type of culture.

Also, sometimes the notions, the self-stigma, labels that have been given to us. For example, a very, very typical one as a Chinese or as Asian per se, is that you’re good at math. And you might not be good at math, and you have a shame spiral because I’m not good at math, and I’m not becoming an accountant.

The society, your family, and yourself have these expectations that you should be a certain way. And for Asians in particular is being very hard-working. So, you have this expectation to push yourself and be a high achiever. And when you actually need to look after yourself or take a step back, or you’re not going like a gun, then I think those impact your mental health as well.

That’s probably what I have to say about it, but I don’t know how racism impacts the mental health of—. I think it impacts everything.

Monique: That’s right. I guess also a part of it is, like, because the majority of therapists are white, you can’t really talk about those things with them. They don’t get it; you know what I mean?

Zoey: It’s a privilege that, yeah.

This reminds me of a really funny experience with one psychologist a long time ago. I remember telling them something along the lines of my family dinners. And my family dinners were a really, really triggering and activating event for me. Because they were, first of all, noisy, in a big Chinese restaurant. Also, families, when they get together, they talk and say a lot of things that are quite hurtful, but they don’t realise it.

When I went to my psychologist back then and talked about it, her first reply to me was, “Don’t go.” I don’t know if she really understood. I don’t know if it was a race thing, but that was her first response to me. Immediately, I felt like she didn’t understand my family, or the cultural implications of family dinners, like Chinese New Year and Autumn Festival, etc. I think that had its impact. Well, I don’t think you’re trying to understand me.

I’ve also had really good psychologists, and it wasn’t because of—. Just because they’re female and white didn’t mean that they didn’t understand. I think in this interview we also add that there are amazing allies or psychologists who are white, or any other colour, or whatever it is, that they are amazing as well, and very culturally sensitive.

Q. What advice would you give to people, especially those wanting to be better allies, regarding multicultural mental health?

Zoey: I’d probably say, don’t just ask, “Are you okay?” Don’t ask, “Are you okay?” in a working environment for example. Especially when that particular person has a particular kind of persona, per se, at work.

If you really care, maybe do something social — maybe they don’t want to. But, as allies, supporting them, by asking various questions. Not just directly asking about their mental health. Asking about family is a good question, that potentially leads to conversation.

What I’m saying is if you want to be an ally, have better conversations with those around you and those that you care about. And actually take that time, and not just put this expectation: “Are you okay? Yes, or no?” and then a straight response. Some of those people around you may say they’re okay a couple of times before they actually say they’re not.

Be consistent with them. Don’t push them too much. But at the same time, trust your gut feeling. If you know someone is not doing well, then check in on them. It doesn’t even have to be a question.

What I’ve really noticed is that, previously, as an ally of others, or peers or friends, I know that something is not going well, but I also know that they’re quite stubborn, and they’re not comfortable in sharing.

So, instead of saying, “How are you?” I simply message them and say, “Thinking of you.” Just letting them know that someone cares, someone is there, and someone is thinking of them. It’s already quite helpful.

Monique: That’s really good.

Part 2 is here.

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