An Interview with Center Director Dr. Chen on Emotional Well-being

CCCSEW Executive Director Dr. Justin Chen was invited to speak at a Mental Health and Well-being Workshop on October 8 hosted by the Council of International Schools, a non-profit membership organization based in the Netherland that provides high-quality education services to schools and higher education institutions. Dr. Chen’s talk, “Bridging the gap: Supporting the emotional well-being of diverse student communities,” addressed common factors that impact students’ wellbeing within a cross-cultural context, the role of culture and ethnicity in students’ experiences of mental health, and specific strategies that educators can utilize to better support students, especially during COVID-19.

Seventy school leaders and counselors from institutions based throughout the world attended the workshop, and the feedback provided was very positive regarding the “exceptional” expertise of the presenter and session content.

In this interview, we asked Dr. Chen some questions about topics covered in the talk.

Justin Chen M.D., M.P.H.

Justin A. Chen, MD, MPH, is the Medical Director of Outpatient Psychiatry at Massachusetts General Hospital and Co-Director of Medical Student Education in Psychiatry at Harvard Medical School. As the Executive Director and Co-founder of our Center, he delivers talks and training for families, clinicians, and educators throughout the United States on promoting the mental health of diverse student populations.

During your work as a psychiatrist, what are the most prevalent factors that impact a student’s wellbeing?

Both high school and college can be very stressful times filled with change and uncertainty, both academically and personally. As competition for colleges, internships, and jobs heats up, students may feel a lot of pressure to excel in multiple domains. At the same time, these are crucial years for exploring personal identity, preferences, and relationships. Conflicts between different priorities unfolding during a compressed time period often contribute to increased stress. This is all very normal. On top of that, minority students, including Asian Americans, may face additional pressures, such as conflict with parents about personal and career decisions, and other discrepancies between the “mainstream” culture of their peers and their own family backgrounds. Often parents are dedicated to their children’s success, but lack the skills or tools to communicate in the most effective and supportive manner possible. Many of the students I work with struggle to navigate these differences with their parents, and the result is that communication can break down entirely. This removes an important source of support that can help moderate some of the stresses the students face.

What changes have you seen in students’ wellbeing due to COVID-19?

COVID-19 has upended every aspect of life for almost everyone, and students are certainly no exception. While it is wonderful that so much education can happen virtually, the shift to online classes threatens the personal connections and relationships that are so important to learning. Connection is a key part of emotional wellness, and many people have observed how hard it can be to promote connection and engaging discussion online. Of course, the pandemic also naturally raises everyone’s stress levels, since there is a lot of fear involved (of catching the virus ourselves, of transmitting it to others, or of family and friends getting infected), and almost every decision involves a risk calculation, which can contribute to decision fatigue. For international students, these stresses are compounded by uncertainties about visa statuses, travel plans, time zones, and sleep.

How can organizations, schools and universities, support students, particularly during COVID-19?

One of the biggest ways I think educational institutions can be supportive is to remain flexible and understanding of the enormous challenges students are facing. We all need a certain level of safety in order to learn, and students are very aware of whether a learning environment is supportive or not. On top of that, educational institutions should be proactive about identifying student populations that may be more vulnerable/higher risk, including low-income and international students. Members of our Center recently published an article in the Journal of American College Health titled “Priorities for addressing the impact of the COVID-19 pandemic on college student mental health,” which may be useful for those seeking additional information on this topic.

What is the role of culture and ethnicity in students’ experiences of mental health? How can we better support culturally diverse student bodies?

In my talks I usually share my favorite quote on this subject, by the anthropologist Margaret Mead (quoting her mentor William Fielding Ogburn): “Never look for a psychological explanation unless every effort to find a cultural one has been exhausted.” It is critically important that educators and clinicians understand and respect the foundational influence of culture on the way we as human beings experience, interpret, communicate about, and seek treatment for our symptoms - perhaps nowhere more so than in the realm of mental health. Which symptoms are emphasized, and what they meant to a given individual, will determine the importance that person places on those symptoms and how they choose to go about addressing them. As a psychiatrist, it does me little good if I think I know exactly what is happening for my patient, if I cannot bridge their own understanding of it and speak to them in a way that makes my perspective acceptable or useful to them. With growing diversity on campus and the importance of international students at both the high school and university levels, educational institutions must continue to support faculty development regarding this type of cross-cultural humility in both learning and mental health.