Dear reader,
The places, the hosts, the students have all started to blur together, I have to admit. I want to remember, but that has become increasingly difficult, especially during the pandemic when talks all went virtual. All the Zooms look the same. Sometimes, I’m not even staring at an array of black boxes and unmoving profile pics; sometimes I’m just staring at myself as I talk while interacting with participants through the chat. I’ve wondered what is lost, who is lost, during this particular juncture of crisis. I tour unwellness and pain, you see, and when that tour moved to the virtual, I worried those screens would obscure the evolving shapes of that unwellness. I should have trusted in what I had already learned in the beforetimes: when you make it safe, people will tell you what hurts.
I’ve been on a national speaking tour for the last six years, launched into an entirely new kind of orbit with the publication of Open in Emergency in late 2016. Some of my speaking invitations come from professional and community organizations, but most come from universities, from academic units, student services, and student orgs. I’ve now met with thousands of students, teachers, scholars, writers, artists, mental health professionals, community organizers, and university administrators, all wanting to figure out together why and how life feels unlivable, especially for BIPOC students, particularly Asian American ones. I urge them all to think about what the responsibility of our institutions might be—in contributing to our unwellness and being accountable to our health. University faculty, counseling staff, and administrators have been relatively enthusiastic, recognizing the desperate need for resources but not knowing how (or not being willing or able) to do things differently. But students, students have been electrified by these conversations, by the sudden insistence that they matter, that they are allowed to name and address their suffering.
Vanderbilt, Colgate, University of Minnesota, UC Santa Barbara, UC San Diego, UC Berkeley, UC Irvine, UCLA, Ohio State University, Princeton, Yale, University of Pennsylvania, Georgetown, Harvard, University of Michigan, CSU Fullerton, United States Naval Academy, Gustavus Adolphus College, Tufts, Amherst College, University of Kansas, Williams College, University of Virginia, Smith College, University of Illinois Chicago, University of Chicago, University of Connecticut, Garrett Theological Seminary, Washington University at St. Louis, Pomona, Connecticut College, Northwestern, NYU, Brooklyn College, Barnard, Hiram, University of Southern California, Yonsei University, Colorado College, St. Olaf, University of Toronto. The hunger for conversations on mental health, and disability, and on Asian American experiences in particular, has been overwhelming—but not surprising.
Students in my own courses at the University of Maryland, where I taught from 2009 until 2017, had expressed this deep hunger. When I opened my courses with Eliza Noh’s “A Letter to My Sister,” which I mentioned in chapter 1—her haunting, gut-wrenching indictment of processes of model minoritization in American society for their part in causing her sister’s suicide, her recounting of what it looks like for Asian immigrant families to be both victim and accomplice to the death trap of racialization in the United States—students said yes, this, more, please. On suicide, immigrant family dynamics, and gendered racialization. On Asian American studies through mental health and mental health through Asian American studies. Students wanted a language to bridge Asian American studies and Asian American everyday experience, their academic and home lives, their immigrant parents’ version of the American Dream and their own. Day one, this discussion cracked something open for them. The stakes were laid bare, the needed language began to form. Together we began the work of grappling with why their—our—lives have felt unlivable. And they wanted to know: How do we live?
Fast forward to my speaking tour, where I took these questions on the road. I’ve met students at every university I’ve visited, some organizing my visit themselves. And while there are historical and geographical and structural specifics for each place, student experience has been eerily, horrifically, similar across my visits.
One through line is that students are ubiquitously encouraged to “seek help at the counseling center,” especially after large-scale trauma. A mass shooting, a peer’s death, a pandemic—certain kinds of crises are legible, and when those occur, universities remind students that counseling centers exist and that they exist to help. Students are told, “You are not alone.”
They feel incredibly, irrevocably alone.
Even surrounded by thousands upon thousands of other students who feel the same.
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I’d like you to answer this question for me: What does unwellness look and feel like for you? Indulge me, and write it down below: a list, some phrases, some descriptions.
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I’ve made it a practice to ask students this question in my workshops. Exhaustion, they say. Not enough time. Feeling like a failure. An impostor. Feeling overwhelmed. Isolation. No support. Pretending to be well. Pressure to maintain “normal.” Hopelessness. Not doing enough, not being enough. Guilt. Feeling like a burden. Feeling lost. Feeling ashamed. Something is wrong with me.
Did any of your answers resemble these?
Helplessness. So many students talked about feeling like they had no control, no choices, no agency in anything in their lives—their families, their classes, their futures, the pandemic, the increasing anti-Asian violence. In the context of college life, they reported about pressures to succeed, to not fail, from their families, from their professors, from their jobs, even from the very spaces that are supposedly created to provide support: counseling centers. All the different responsibilities they’ve faced, all the choices they didn’t feel they had, the tunneling of their future that felt like suffocation, like drowning. Be well, do well, at all costs. No wonder “seek help at the counseling center” rings hollow.
Just asking them this question of what unwellness looks and feels like is stunningly transformative. I’m not sure they’ve ever been asked before. Asking them, and affirming their answers as real, opens a door they didn’t even know existed. Students respond powerfully when they are given permission to hurt. They want to know that their pain is real, that it matters—and that it is shared. They want to know they are not alone, that others who look like them feel like them. There is something incredibly powerful about being in a space with dozens, hundreds, of other Asian Americans and discovering that others feel the same fears and longings as you. That others also want something different than what they’ve been given.
Students want to know that shame belongs to people and structures inflicting the pain, not to those trying to survive its crushing weight. They want to know that failure is not what they’ve been told it is. They want their humanity, their complex personhood, seen. Something changes for them when their suffering is no longer an individual pathology to be measured and then cured but a collective trauma that is both normal and completely unjust—and deserving of care.
And then I do something even more unfamiliar to them: I ask them what they need.
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What does wellness look and feel like to you? What does “mental health” mean to you? Hazard a list yourself. Ask a friend to do it with you. Really take a moment to do this before you go on reading. It’ll be worth it, I swear.
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I ask students what mental health means to them, and I write their collective answers on a whiteboard. Across my dozens of workshops, there’s some of what we might expect: the ability to cope and bounce back from setbacks, not being depressed, not being “mentally ill”—whatever the fuck that means. But also, some richer, perhaps unexpected, answers. Feeling safe. Belonging. Having community that you trust. Liking yourself. Experiencing a full range of feelings, not numbness. Feeling fulfilled. Having a purpose. Healthy boundaries. A supportive community. Feeling valued. Feeling understood. The ability to “be yourself.” Hope. Feeling like you have a future. Being happy. Laughing. Being able to be vulnerable with others. Holding loved ones. Agency—feeling like you have control and can make choices. (As I list these here, I find myself once again in wonderment. Students know what’s up. They have a vision for themselves so rich, so full of deep longing, my heart aches and is healed all at once. Their yearning, and hope, is fucking breathtaking.)
Then, inspired by Kai Cheng Thom’s essay “The Myth of Mental Health,” I show them the World Health Organization’s definition of mental health:
Mental health is defined as the state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Students stare in horror at this definition. Their eyes flit back and forth between the two lists. The WHO definition feels both familiar and foreign: its focus on productivity, individual coping and functionality, and the ability to “contribute” to society is what they’ve been implicitly told their whole lives; simultaneously it looks absurd now sitting next to the definition we just collectively generated. The dissonance hums in the air.
Then I give them humanities tools to examine this dissonance. We close-read the WHO definition together, identify its assumptions and assertions, reflect on its consequences. What is “potential” and who gets to tell you it’s been “realized”? What are “normal stresses”? (Is racism a “normal stress”? I ask them. Is student life “normal stress”?) What counts as “productive” work and valuable “contributions” to society? Then we compare the two definitions, side by side. Students easily point out the differences. They easily see the limitations of the WHO definition even as they recognize its dominance in their lives. They recognize they have already been dreaming much bigger than the WHO definition, even if not consciously or intentionally before. They feel affirmed—and affirm each other—in their collective desire for something more than what WHO promises.
Then I ask the question that usually feels like a gut punch: Which definition does your university align with?
At my visit to Amherst College, a counseling center therapist sat among the participants. The therapist slowly raised their hand, still looking at the two lists side by side in horror: “I want to do this,” they said, pointing to the side that we collectively generated. “But I’m pretty sure I do this,” pointing to the WHO side. They then admitted to not knowing how to do the first within the constraints of the university counseling center. Everything put in place is to help students go back to being productive students—no more, no less.
Every single student at every single place I’ve visited over the last six years has said that their university aligns much more closely with the WHO definition.
There is something simultaneously banal and awful about the way mental health is done on college campuses. Mental health “happens” almost exclusively at the counseling center—mental health is the strict purview of the counseling center and a few other units or spaces. There might be a wellness center to complement the counseling center (Does this mean the counseling center is the illness center?) that offers a variety of classes on stress management, alcohol consumption, nutrition, sleep, time management. Or wellness programming that includes public talks on “tolerating distress” or “regulating emotion” by counseling center psychiatrists. But by and large, universities imbue counseling centers with the sole authority to “do” mental health, and they turn to their counseling centers as the solution to all crises deemed mental health related. No one seems to question this authority, this strict delineation.
Let’s back up for a second: even if we don’t question this authority, we don’t seem to even notice the very simple contradiction of capacity. Universities keep saying they want more students to go to the counseling center; counseling centers try to invent new ways of doing outreach, including promotional videos meant to demystify counseling center processes. But it is already nearly impossible for counseling centers to see the students that do come—students from nearly every place I’ve visited report long waits, limits on number of sessions, rotating clinicians, and inevitable referrals to private off-campus services, not to mention an array of clinicians with little to no training in working with Asian Americans and other students of color (or queer, trans, nonbinary, and/or disabled students). And it is definitely impossible for counseling centers to see every single student on their campus—because, let’s be real, every single student, every person, needs and deserves mental health care. Counseling centers as they are do not have the capacity to serve all their students—numerically or intersectionally.
But beyond the capacity issue, why is it that counseling centers are the official “center” of mental health on college campuses? And why do they get carte blanche decision-making power to determine what that mental health care looks like? No one (in authority) questions what kind of care is being given at counseling centers, the purpose of it, the shape of it, the implications of it.
Remember that all the students I’ve met have said that their universities align with the WHO definition of mental health.
An example: in 2017, I was invited to an elite liberal arts college in the northeastern United States to do mental health workshops for students—and, surprisingly, counseling center staff and academic deans as well. One therapist, a queer Latina intimately familiar with ethnic studies and community organizing and one of the only people of color (maybe the only) on staff at the counseling center, saw a need for more—and different—mental health resources for students of color at this predominantly white school. She also saw a need for more and different mental health resources for her fellow colleagues so that they could better meet the needs of students. “They need help,” she said to me when I got there. I think she might have meant the counseling center staff even more than the students.
So I asked the counselors and the deans what they thought mental health is. Some similar answers to students: having a range and balance of feelings, the ability to be present and to self-soothe. Some wildly different:
• “self awareness of baseline” especially “cognitive”
• “ability to learn, think, problem-solve, self-direct”
• “free of debilitating symptoms” especially “psychosis”
• “awareness and engagement of social rules”
These professionals were defining mental health in terms of students’ ability to meet their responsibilities. Students need to understand their cognitive baseline, need to be able to learn, need to not be debilitated by psychosis, need to follow social rules. The focus here was very individual, very psychological, with a heavy emphasis on coping skills and behaviors. Disturbingly, psychosis, or a debilitating state of being unable to reality test, was the bar of mental illness—and mental health was simply to be free of this. This was so unimaginative in terms of both highs and lows—that being out of touch with reality is the only way to imagine deep suffering and that being free of that debilitation is the only way to imagine wellness. But also disturbing was how these answers reflected institutional expectations. These answers were deeply colored by the counselors’ and deans’ sense of responsibility to the institution, the need to direct students to meet the expectations of the university. Wellness is being able to follow the rules. To be a good student.
I wonder: Would they have answered this way if they were thinking about themselves and not students? Maybe, maybe not. I wonder if they would recognize their own human needs in a different context—or if this ability has been trained, institutionalized, out of them completely.
I’ve already shared what students across the country in aggregate have said about their unwellness and wellness. But I’d like to take a moment to look at what students at this college said in particular, to directly compare with their counselors and deans (see fig. 2.1).
Students there want to know themselves, to be safe, to have community, to feel, to heal. They want an environment that is enriching and encouraging, one that supports them, does not judge them, gives them hope. They want a reckoning with their individual and communal histories. They want so much more than what their college is giving them—more than even what their college, in its counselors and academic deans, dreams for them.
Even more striking was the vast difference between how these two groups defined unwellness.
First on the list for the counseling center and deans was “sleep deprivation.” Because of too many “extracurriculars.” Second was “procrastination.” Then “substance abuse.” From there, they were willing to expand to “academic pressures,” “uncertainty about future,” “impostor syndrome,” “social pressures,” “social life/interpersonal conflict,” and “sense of belonging.”
Now let’s look at what their students said (figs. 2.2 and 2.3).
Looking at this list again now, I am first struck by how long it was. Two pages. And this was already condensed, me the notetaker writing in shorthand. Second: holy shit, this list perfectly diagnosed how the institution, their college, makes them sick. Unwellness is feeling like you have to do it all alone, like you have to always be productive, independent, high achieving, positive. Unwellness is martyring yourself, not being able to be vulnerable or admit your limits. Unwellness is denying your own feelings, not having language for your suffering, devaluing your own experiences—to be gaslighted, to gaslight yourself. Unwellness is normalizing and romanticizing stress, glorifying busyness. Unwellness is to be a good student.
The generous framing of the starkly different perspectives between these students and staff could be to see them as two ships passing in the night. The staff’s and students’ ideas about what hurts and how to care for those hurts differ so drastically; no wonder these groups have trouble connecting. But that framing is too simple. It erases power and structure. Counseling centers are institutional creations, beholden to the larger institution. Counselors are trained in fields that are their own institutions—most often psychology and psychiatry—from which we inherit the medical model of mental health, of individual pathology to be cured. And all institutions are in the business of subject formation—of shaping us into beings that function within those institutions. Counselors and students aren’t simply two equal ships unknowingly passing by each other; students are being crushed by a Titanic that tells them (and even thinks) it is helping them. And as they are being crushed, they are told they need to fix themselves—to learn better time management, to drink less, to procrastinate less, to tolerate distress better, to sleep more, and of course, to go to the counseling center—so that they can go back to being good, productive students again.
“Why would you want to place yourself into the hands of an institution that seeks to resocialize you into the environment that made a mess of you in the first place?” Eliza reminds us.
To be fair, the deans and counselors were very open to hearing from me what students have shared across my university visits. And they were open to hearing that their approaches were missing the mark. I want to be clear here that I don’t think their ideas were exceptionally bad. From what I’ve learned from students across my visits, I would expect most university deans and counselors to answer similarly. In fact, their willingness to meet with me and have this challenging conversation demonstrates that they are ahead of other institutions, with real hope of actually engaging student needs. They actually asked what they should do differently.
So I asked them to generate a list of spaces on campus where college life happens—and asked them what it would look like to understand those spaces as also where mental health happens, and where care might happen as well. What would it look like to extend mental health care across campus, to think about building care across spaces, classrooms, units, communities—to see every person and every unit as responsible for a commitment to the well-being of all whom they encounter, to see mental health as the purview, the right, the responsibility of every person and every unit? This is the transformative work I want to see happening at every institution of higher learning, and these academic deans and counselors were willing to listen and begin the work of imagining more, real, care for their students in these ways. Who knows what has happened there in the years since my visit, but I remain hopeful—because there is no way to stop missing the mark without first doing the hard work of examining the ways you’re missing it.
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From Mimi Khúc’s dear elia: Letters from the Asian American Abyss. Copyright 2024, Duke University Press. All rights reserved. Republished by permission of the publisher.
