A Mirror Image?

Men and mental illness in Canadian and Chinese cultures

Cynthia Row
Interviewers: Pat Merrett and Vicki Rogers

Reprinted from "Men's" issue of Visions Journal, 2005, 2(5), p. 21

stock photoTwo men of Chinese heritage were recently interviewed by Pat Merrett and Vicki Rogers of the Mood Disorders Association of BC. Mark and Winston (not their real names) were asked about their experience of being males with mental illness within the Chinese culture.

I expected these interviews to support the commonly held belief that attitudes about men and mental illness are more progressive in North American culture than in Asian cultures. But, as is often the case, casting a critical eye on another culture reveals much about one's own. In fact, these interviews betrayed the conceit that traditional stereotypical expectations of men to be emotionally strong and unflappable have changed in our culture—that we now accept mental illness as part of the male experience without prejudice—while attitudes about men with mental illness in Chinese culture lags far behind.

The reality is more likely that acceptance and support of men with mental illness has progressed in Asian cultures, and that Asian attitudes towards mental illness in men have caught up to our own. But the understanding and acceptance of male mental illness in Canadian culture remains largely intellectual and academic, while the reality is that men still expect themselves, and other men, to be emotionally strong no matter what, and they are fearful of disclosure. Expectations of men and men's expectations of themselves in both cultures are unrealistic — and harmful (reflected by high suicide rates among men). Special attention must be paid to these realities, as evidenced by the articles in this edition of Visions.

Winston pointed out that, in Chinese culture, all illness is stigmatized; mental illness is not singled out as especially shameful. "It is not really just mental illness," he says. "We had a party and there was a little girl who was crippled, in a wheelchair, and my mother pulled me aside and said, 'Are you bringing that person into the house? Are you sure that she's accepted here?' And this person [in the wheelchair] was a well-known person in the community. If that is the way she's accepted, can you imagine what it is like for others?"

The reaction of Mark's family and friends to his depression is a familiar one to anyone experiencing depression: "Why can't you just be happy? If you just cheer up, everything will be better."

Mark also highlighted another frustration for men seeking help for mental illness. "I had to do my own research to find out what was wrong. Doctors didn't help at the beginning," he says. While it is appropriate for physicians to rule out physical causes of mental distress, there is much anecdotal evidence suggesting that physicians are quicker to consider a diagnosis of mental illness in women than in men, with the result that treatment for men can be delayed.

When asked if there was a difference between the reactions within Canadian and Asian cultures to men with mental illness, Mark responded, "Maybe I'm biased, but I don't see any difference between the Asian or Canadian population. We suffer from the same problem. It is not just Asian groups, but people in general don't want to seek help. Why? Denial."

The April 1, 2004, suicide death of a Hong Kong superstar, actor and singer, Leslie Cheung Kwok-Wing, is a wake-up call for the Chinese population, says Mark. "People realize that depression can be a fatal illness. No more 'just cheer up—it won't kill you.'" A society's understanding of mental illness is always advanced when the illness affects a person of prominence, but it is a lamentable fact that it takes such an event—whether in Asia or in Canada—to draw attention to an illness that affects so many.

Being among non-Asian Canadians doesn't seem to make Winston any more comfortable about disclosing his illness. "In society it is difficult to be Asian," he says. "At work, with six executives, I'm the only Chinese. I don't say anything about it, especially at work. Only my family is aware."

Awareness, acceptance and the treatment of mental illness in men has come a considerable distance in both Canadian and Chinese cultures, but they both have a long, long way to go.

About the authors

Cynthia is Editorial Assistant for Visions

Pat is Newsletter Editor for the Mood Disorders Association of BC (MDABC)

Vicki is Education Director with MDABC