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Filipino Americans reported higher Covid mental health toll than Asian Americans collectively

The group has a disproportionate number of nurses, health care workers and families living in multigenerational homes.

In the early months of the pandemic, Gennie Samala was afraid of contracting the disease and bringing it home to her 67-year-old mom and 96-year-old grandma.

When much was still unknown about the virus then, Samala, 29, an associate clinical social worker in Los Angeles, was diligent about bagging her clothes before putting them in the laundry room whenever she returned home from work. Then she would immediately take a shower before coming into physical contact with her family at home.

The exact impact of Covid-19 on Filipino Americans is impossible to know because death data on Asian American subgroups is lumped into a single category. But exclusive data from a recent survey shows that Covid-19 has had a significant impact on Filipino American mental health: More than half of respondents reported anxiety, depression and worrying, among a number of symptoms. Of those respondents, 85 percent attributed them to the pandemic.

The Filipinx Count Survey, conducted by the UC Davis Bulosan Center for Filipino Studies during the first half of 2020, had about 1,000 respondents and was intended to reflect the experiences of the people who participated, not generalized to reflect the Filipino American population.

It was fortunate that nobody in Samala’s household got Covid-19, she said. But the heightened concern she felt about elderly family members with underlying health conditions potentially becoming infected has been a source of worry for Filipino Americans — 34 percent of whom live in multigenerational households, according to Pew Research Center — throughout the pandemic. What made it even more worrying for Filipino Americans is that many live in multigenerational households, said Christine Catipon, a licensed clinical psychologist in Los Angeles.

Gennie Samala.
Gennie Samala.Gennie Samala

Those figures are higher than the 46 percent of Asian Americans who reported anxiety during the pandemic, 15 percent of whom had depressive symptoms, according to a report from the coalition Stop AAPI Hate. Researchers also found a stronger link between those symptoms and experiences and anti-Asian racism, compared to the effects of other general Covid-related stressors, Charles Liu, assistant professor of psychology at Wheaton College and researcher for the report, said in an email.

Mental health professionals serving Filipino American clients who spoke with NBC Asian America affirmed survey findings. They said reasons for the reported symptoms ranged from loss of employment to finances. But for a community that places high value on socialization, the loss of social support due to physical distancing guidelines was a significant stressor.

Jeannie Celestial, a licensed psychologist in the San Francisco Bay Area, said Filipino Americans typically seek mental health services when symptoms are severe, often when there's suicidality or a change in functioning -- such as performing poorly at school or at work. But as a result of the rise in mental health symptoms in community members during Covid-19, an increasing number of community members have sought those services.

Loss of social support

Catipon, who works with college students, said the pandemic compounded the depression and anxiety her Filipino American clients already face, which are typically linked to a familial or cultural aspect, such as a disparity in values between different generations.

Having had to shelter at home where there may be intergenerational conflicts with immigrant parents and being unable to process or socialize with their peers has exacerbated existing problems for Filipino adolescents, Celestial said.

Jenn Galinato, a 20-year-old student at Sacramento City College, said she had lived at home before the pandemic. But having to stay at home more often for the last year and counting brought some new challenges. Among them was a lack of daily interaction with her friends.

“I had no outlet to freely express what was going on and it was really hard,” she said.

Another was that she and her parents were forced to have difficult conversations where there were stark differences in opinion due to a generational gap, including things like the Black Lives Matter movement and anti-Asian hate.

“When we're at the dinner table having these discussions, sometimes there might be some not so great outcomes,” Galinato said. “Sometimes someone's going to be in tears. But these are really discussions that needed to be had.”

The loss of social support also hit Filipino American seniors, mental health professionals said during a focus group. The closing of areas of socialization, such as senior centers and churches, affected their social support and rituals.

Samala, who works with Filipino American seniors at SSG Silver, a community-based health organization in Los Angeles, said she saw a rise in feelings of depression, hopelessness and helplessness, as well as broken sleep patterns and stress in her clients. Some lost friends to Covid-19 and struggled with being unable to grieve normally because there were no funerals.

“[There’s] this worry of impending doom, not knowing if they're going to make it through the pandemic, if they will see their friends,” she said.

Michelle Madore, a mental health provider in the San Francisco Bay Area, lost vital social support for her special needs child. When establishments closed down, she was thrust into the role of being her daughter's preschool teacher, and occupational, physical and speech therapist. She formerly relied on family to help care for her child as well. But because her daughter had an underlying respiratory condition, that support disappeared.

Multigenerational households and living at home

The high share of Filipino Americans living in multigenerational households can be a source of strain, as there is the expectation that members of multigenerational households pull a significant share of responsibilities in the home, Catipon said.

It’s something Samala has had to navigate. Although she lived at home prior to the pandemic and helped with tasks such as cleaning and moving her grandma around the house, she had to set boundaries with her mom when she began working at home.

“It took some time for her to understand that and to become more conscious of the fact that I'm literally working from home,” she said. “So it's been interesting to balance what it's like to be at home and that can be pretty stressful.”

Catipon said her Filipino American clients struggled with sheltering in place and restrictions on going out. Part of this was because they had just begun experiencing independence as college students who had more freedom to go out prior to the pandemic, she noted.

“They experienced even more overprotectiveness. And parents probably did it because they didn't want to expose the family. But that doesn't help when both parents are in health care or essential workers. And so it was just a very stressful, tense time for a lot of my students,” she said.

Anti-Asian hate and vaccine hesitancy

Filipino Americans are also worried about the rise in anti-Asian hate incidents. Madore said she has worried about her mom, who lives in a part of California with more conservative political leanings. Prominent anti-Asian hate attacks on Filipino Americans include Noel Quintana who was slashed across the face in a New York City subway, and Vilma Kari, who was attacked on her way to church in March in New York.

Another stressor for community members is vaccine hesitancy, particularly among seniors.

It’s something Catipon has dealt with in her own family, including those who work in health care. She noted that those who are hesitant often rely on information from social media platforms like Facebook and aren’t able to discern whether a source is reliable.

“There's just such a strong resistance to it, and it's frustrating because it affects family relationships; it pits people against each other,” she said. “We're supposed to respect our elders. But when it comes to this kind of stuff, how do you get the message across? They're not wanting to know.”

Impact on mental health professionals and what’s ahead for Filipino Americans

The increasing number of people who have sought mental health services has affected mental health professionals who have had to carry their clients’ experiences with the pandemic while navigating the crisis themselves.

Madore said that while Filipino American therapists encourage clients to take care of themselves, they’re just as susceptible to sacrificing their needs to care for others.

“I think a lot of providers in our community are very quick to ignore our needs to help someone else,” she said.

Although putting others’ needs first took a toll on some community members who spoke with NBC Asian America, they credit the Filipino American bayanihan spirit of collective responsibility and caring for one another as a reason that outlook has survived the pandemic despite all the lives lost.

“Our culture is very resilient,” Catipon said. “We’ve been through colonization, we've been through lots of corrupt governments, and we're still a happy smiling people. Or at least we try to be.”

While the community has emerged from the crisis with that resilience, the tangible mental health impact of job losses, deaths and other events throughout the last year needs to be acknowledged, Catipon said. Andrea Cabrera Jakucs, a licensed clinical social worker in the Los Angeles area, said she’s concerned about the possible aftermath for nurses who may not have processed the trauma they experienced on the front line.

Mental health providers said it’s crucial that efforts to normalize mental health among Filipino Americans continue moving forward from Covid-19.

“With our community, when we think somebody has a mental health condition, we think of somebody who maybe has schizophrenia or depression. But it doesn't have to exactly be those situations,” Samala said.

“Maybe you lost a relationship with somebody because of Covid and you're having a hard time coping with that, and that’s OK,” she added. “We need to encourage people to seek counseling, to talk to somebody. It’s OK.”

This is the second story in a three-part NBC Asian America series, “The impact of COVID-19 on Filipino Americans,” supported by the USC Annenberg Center for Health Journalism 2020 Data Fellowship. Read the first story here.

The Center’s engagement editor, Danielle Fox, contributed to this story.

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