There is a lifeline for seniors in Canada facing language barriers and stigma around mental health. Just don’t call it therapy

Life can be lonely if you’re old. Life can be challenging if you’re an immigrant who can’t speak English or French. And life can feel particularly difficult if you’re an elderly immigrant.

Several phone hotlines in Canada are trying to make life a bit easier, but they often have to begin by helping immigrants get past a culturally ingrained stigma of seeking help in the first place.

“It’s no secret that among a lot of immigrant cultures, particularly Asian cultures, the older generation is not generally open to things like therapy,” said Angie Chuang, a professor of journalism at the University of Colorado Boulder and a former journalist specializing in issues of race and ethnicity. “The idea of acknowledging that you might be depressed and might have a mental health condition … there’s a lot of cultural baggage and taboo associated with that.”

“Their generation (has a) resistance to looking at mental health as a real issue.”

This might be even worse for the immigrant population, said Chuang, “because if you’re an immigrant, you’re supposed to be successful. You got to live the (North) American dream … You’re perceived as somebody who got to benefit from the prosperity of the (North) American experience, so you should be doing great, but that’s so often not the case.”

“The Asian population, in general, is slow to recognize (that) talking and therapy (can be useful) for emotional and psychological well-being, because they feel like it is a sign of weakness,” said Jenny Zhan, a professor of gerontology at Georgia State University. “You should be able to handle your own problems. They don’t recognize the professional need to address their problems as much.”

Therapy has gained some ground in China, but only as a luxury for the upper-middle class. The lack of therapists who understand Chinese culture, even in China, mean that fewer are available in North America to help Chinese immigrants here, Zhan said.

Hence the need for the Chinese Emotional Support Hotline, a Calgary-based support service where anyone can call in to talk in Mandarin. Co-founder Ailian Liu, a social worker with Alberta Health Services, came up with the idea for the hotline more than a decade ago. She had noticed that many of those from minority groups who turned up at women’s shelters wouldn’t feel comfortable there, and that volunteers on most distress hotlines couldn’t build up a strong rapport with callers who didn’t speak English well.

The hotline (587-997-5977) came to life during the COVID pandemic. Volunteers are available 24/7 and it serves roughly three to five callers each day. Although most callers and volunteers come from Alberta, they get calls from all across Canada, the United States, and even China and have volunteers working remotely from as far away as Europe.

Because of the stigma around such issues, there are no references to suicide or child abuse in their Chinese-language brochures, said Lei Ma, the hotline’s director of fundraising and marketing. Instead, they say that people can call them if they need to talk to someone or need non-judgmental emotional support. They also mention that they can provide free food, or free or low-cost career training.

A similar help line run by an immigrant-focused social services agency, S.U.C.C.E.S.S., operates out of Vancouver, running for 12 hours a day, seven days a week. In keeping with demographic trends, the agency has expanded beyond the Chinese community, serving callers in not just Cantonese (604-270-8233) and Mandarin (604-270-8222), but also Korean (1-888-721-0596 / Ext. 3) and Farsi (1-888-721-0596 / Ext. 4) with roughly 75 volunteers across all four languages. They are considering adding a Ukrainian-language line.

The volunteers must pass a screening process and a criminal record check before going through 30 hours of training, said Queenie Choo, CEO of S.U.C.C.E.S.S. The training discusses how to talk to and actively listen to callers, de-escalate certain situations, respond to those who are emotionally devastated, and when to pass callers (such as those contemplating suicide) on to professional help.

And in Toronto, the Distress Centres of Greater Toronto offers a multilingual distress line service, where volunteers take calls in Cantonese, Mandarin, Portuguese, Spanish, Hindi, Punjabi and Urdu on weekdays between 10 a.m. and 10 p.m. (905-459-7777 from Caledon; 877-298-5444 from Brampton and Mississauga; and 905-278-4890 for TTY services).

Of the roughly 300 volunteers, 26 volunteers can take calls in Cantonese or Mandarin; 18 in Spanish or Portuguese; and 10 in Hindi, Punjabi or Urdu. In 2021, the Distress Centres took more than 18,000 calls (or 73 per day) in Spanish or Portuguese; roughly 9,500 calls (or 38 per day) in Cantonese or Mandarin; and roughly 5,700 calls (or 23 per day) in South Asian languages.

“More funding always helps,” said Robert Ridge, the executive director of the Distress Centres of Greater Toronto. “Not just to operate the lines directly, but to … communicate both to prospective volunteers and prospective callers the existence of the service and the need for people to volunteer for it. More volunteers equates to our increased ability to take calls and serve more people.”

Sometimes, those calling these hotlines don’t need emotional or material support but simply help in navigating a foreign country: Where can they get vaccinated? How can they pay their taxes?

Many, though, call for help with their personal relationships: How can they raise and understand their children, who are growing up in a culture different to their own?

And many of the seniors who call simply feel lonely, said Ma, with no one to talk to because of a generational (and sometimes language) gap with their children and grandchildren or because their family is out all day. S.U.C.C.E.S.S. also observed a rise in the number of calls from seniors during the COVID pandemic, said Choo, when they were left feeling particularly isolated.

This is particularly ironic because many of the most recent immigrants from China came to Canada for the express purpose of taking care of their grandchildren while their own children are working outside the home, said Yidan Zhu, a professor of adult education at Texas Tech University who completed her graduate studies in Toronto.

But these seniors can experience difficulties in establishing a social network outside the home, especially if they cannot drive (car ownership in China is roughly one-fourth what it is in Canada).

Female callers outnumber males at the Calgary hotline by four to one, said Ma, and domestic violence is a concern. In Chinese culture, “the man is the breadwinner in the family,” she said. “I feel that females are more vulnerable than males – financially, emotionally, physically.”

To this end, Ma and her colleagues have also translated locally-produced, English-language domestic violence resources into Mandarin, even hiring Chinese actors to re-enact short videoclips.

Roughly 150,000 seniors living in Canada today were born in mainland China, and 30,000 of these arrived within the last 10 years. In addition, more than 65,000 seniors were born in Hong Kong (although fewer than 500 arrived within the last 10 years). These help lines could provide a much-needed resource to this community so traditionally loathe to acknowledge its usefulness.

“Mental illness is a taboo,” said Choo. “But we’re talking about mental wellness here.”

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