Chinese Healthy Mind Project
CDW Simon Newitt writes about his experiences working with Chinese elders
You cannot prevent the birds of sorrow from flying over your head, but you can prevent them from building nests in your hair.
-Chinese Proverb
Simon Newitt (BME Community Development Worker)
Contact: s.newitt@nhs.net
“Sometimes it seems as though there is no way out of things. I don’t know if this is depression or not…it’s like being trapped by four walls.”
“You have brought a Western guy with you?” asks the old lady. She is tiny with lively eyes and an anxious manner. Angela is too kind to say so but I sense her reassuring the old lady and negotiating consent for us to record an interview with her. I am used to being ‘White’ in my work but this time I am ‘Western’ and unsure what this means for her (or to me). I try to counter my ‘Westerness’ by smiling a lot, probably too much. I feel awkwardly overwhelming next to her. The old lady must feel it too as the interview begins and ends inside five minutes.
I am a Community Development Worker for Black and Minority Ethnic Communities (BME) supporting the Chinese Healthy Mind Project. Undertaken by Bristol and Avon Chinese Women’s Group the project is part of the Care Services Improvement Partnership’s (CSIP) Older People’s Mental Health Programme but also forms part of a wider government agenda on Delivering Race Equality in Mental Health Care.
The aim of the work is to develop a resource for the Chinese community of England promoting mental health and wellbeing among the elderly. Having never worked with either group I am not sure what to expect from the project or how much help I can be beyond enthusiastic encouragement. The ethnocentricity lurking in me imagines Chinese elders to be both well cared for and respected within a hard working community both self-contained and self-sufficient. I begin the project on some distant level surprised such work is even necessary within the Chinese community.
“I do not understand the English language and I know nothing. Most of the time I am on my own and I feel as though…(sigh)…I’m helpless.”
Angela (the acting Carers Manager for Bristol and Avon Chinese Women’s Group) shows me the results of a survey she has just completed with Chinese elders from across England as a prelude to this project.
The survey shatters my feeble stereotypes. The results indicate very high levels of social and cultural isolation, material poverty and pervasive language and literacy barriers. I am shocked to see that nearly half of those who took part reported having no emotional or practical support at all from their family.
According to official estimates, the Chinese population of England as of 2005 was roughly 347,000[i]. In 2004, Chinese pupils were the group mostly likely to achieve five or more GCSE grades A* to C, and the group most likely to have a degree (31%). Interestingly 20% had no qualifications at all[ii] and are also least likely to self-report their health as ‘not good’.[iii] I’m unsure what, if anything, can be inferred from these figures but in relation to education it makes me wonder if the quantitative data hints at a qualitative difference between first and second/third generation British Chinese that has real consequences for the community.
It quickly becomes apparent that targeting a resource directly at Chinese elders promoting their mental health and wellbeing is going to be very difficult both in terms of dissemination and finding an appropriate medium. Thankfully, Bristol and Avon Chinese Women’s Group is clear about ‘who’ needs to be targeted and a mixed media resource (podcasts, booklets, photographs and video) containing elders own experiences and health promotion, is identified as the most flexible means of reaching second and third generation Chinese and encouraging a renewed responsibility and ownership for the health and wellbeing of their parents and grandparents.
Two mental health promotion days with local Chinese elders follow. Infused with talks, Tai Chi, massage, consultation and good food the days are both well attended and received. Meanwhile, Angela uses her extensive network of contacts to try and arrange some interviews with individual elders.
“When you are older I think you go a little mad. Even a small problem and I feel…uneasy…(sigh). Such bitterness cannot be explained and I know many people from outside will not understand me.”
Angela and I begin a week of interviews visiting the homes of elders across Bristol and South Gloucestershire. They don’t all go to plan. Whether it is my presence as a ‘Westerner’ or the idea of being recorded, not all the elders seem happy to, well, complain. The project’s survey had shown a strong sense of ‘self-help’ among many Chinese elders and on more than one occasion this is borne out in the tone and content of the interviews.
We don’t have a preconceived list of questions to ask and the interviews are kept informal and free ranging. Angela asks how and when each elder came to the UK and what their experiences, impressions and quality of life were today.
I find myself straining both ears and concentration but the language feels impenetrable. Unable to glean any impression of what is being said I cannot help but let my eyes wander over the homes of each elder. I am struck by the lack of material possessions a lifetime of work has brought these elders. This is clearly a value judgement on my part but the effect a lack of ‘stuff’ has on the atmosphere of the living space is an emptiness reflected in many of the present lives of the elders we talk to.
“There is not much meaning to my life…what is the point in living a few years more?”
An exception to this is an old man who lives alone and who has covered his walls in photographs of his children and family, a large-scale map of China with crosses marking (I imagine) places he has visited or has some connection to, and a larger banner that Angela later tells me says ‘to strive for life’. Tomato plants fill the windows and his many shelves appear crammed with books and papers. He makes us a pot of green tea and refills my cup at least three times during the hour. Sitting there next to him I have no idea he is bearing his soul to Angela.
“Some years ago…I built a rack and noose to hang myself as I thought it would be simple and end my pain, but my son found it and removed it. Then one day a friend sold me some charcoal after a barbeque in exchange for my bicycle. I thought I could gas myself but when I thought about it I thought my actions would have a negative effect on my children and so I decided not to think in this way.”
Children and family life is a recurring theme in every interview. Many seem to have moved away and/or are working long hours in professional occupations. Some have families of their own now. Most elders one senses, long for more contact with their children and grandchildren but would never say as much. Sadly I am able to recognise the forces at play here. They are the same forces that have reshaped, (maybe misshaped) family structures in the West. They are the social and economic forces that mean we have come to view old age as a period of physical, psychological (and economic) decline and the elderly as burdensome and out of step with the modern world.
“If I could change one thing about my life I would want someone to come and see me now and then, and when I need help for someone to be there.”
In reality it is only later, once Angela has translated the interviews, that I get a real sense of the experiences I was able to sit so dispassionately through. For me the stories are moving not simply because of the loneliness and loss they describe in the present, nor because of the openness, stoicism and dignity with which they are shared. I find them most moving because in their depth of experience and their sense of history it is hard not to reflect on one’s own life and the passage of time. Ageing brings the human experience into sharp relief and sentimentality, if unwelcome, is hard to suppress.
More than this, in the particular experiences of these Chinese elders we are confronted with some difficult questions and truths relating to migration, equality, identity and mental health in the early part of the 21st century. China’s star is rising in today’s world and will no doubt come to define much of our shared futures, but the elders, generous enough to share their experiences with us, represent a generation that has contributed economically, socially, culturally and (very often) for longer than I have been alive, to our shared present.
For many, their courage and toil seems to have come at a heavy personal cost in old age. To have lived in a country and community for so long and still be unable to speak a word of the common language, to feel so culturally alienated from the landscape you have lived in for so many years and to be so dislocated in time, space, culture and even language from one’s own children and grandchildren, it is difficult to imagine what this must feel like at a time in ones life when reflection must feel as natural as breathing.
“I do have family but they live far away and my daughter works six days a week so doesn’t have time to look after me…I can’t live with my children as they do not have space in their house. I have to live alone which makes me empty and lonely.”
It should not be in the nature of a Community Development Worker to judge any individual, family, community or culture. I have learnt such work to be about life’s shades of grey, where individual choices and behaviours meet larger macro-socioeconomic forces and inequalities. Nonetheless, it is occasionally important to challenge what is happening in our communities and to not simply defer to modernity and ‘progress’ as though these processes are all inherently good for us. It is to the credit of the Bristol and Avon Chinese Women’s Group that the resource they ultimately developed does this.
Personally, my own stereotypes about the British Chinese community were so flawed not because they didn’t represent something of the actual virtues and strengths within Chinese culture - but because they assumed that cultural identity to be immune from the eroding forces of globalisation, capitalism, racism and all the material and psychological inequalities that flow from these.
The personal and the emotional fallout of these larger social and economic forces is often washed up at the door of mental health services and the experience of the Chinese elders must demonstrate Delivering Race Equality in Mental Health to be about more than the way in which services are delivered. Their stories show us it must also be about equality in life and our recognising and redressing the variety of complex expressions and experiences of inequality and oppression within race, identity, migration, capitalism, and power in 21st century Britain.
Anyone interested in the Chinese Healthy Mind Project resources should visit the NIMHE Older People’s Mental Health website (link below) or for more information contact Rosa Hui at the Bristol & Avon Chinese Women’s Group.
Useful Contacts
Bristol & Avon Chinese Women’s Group
Contact Rosa Hui (admin.bacwg@btconnect.com)
Bristol & South Glos BME CDW Mental Health Programme
Contact Marvin Rees (marvin.rees@bristolpct.nhs.uk)
Delivering Race Equality in Mental Healthcare
National Institute for Mental Health in England (NIMHE)
www.olderpeoplesmentalhealth.csip.org.uk
