Palo Alto, California is a Bay Area community with a population of 66,853 located in the northwest corner of Santa Clara County. Since 2009, the community has experienced two separate suicide clusters—defined as a group of three or more suicides in close time or geographic proximity. In a community that is demographically 64% white and 27% Asian according to the 2010 US census, Asian-American male adolescents have been disproportionately represented in these suicides.
Following the second suicide cluster of four Chinese-American males in 2014-2015, the Stanford Center for Youth Mental Health and Wellbeing conducted a set of focus groups to better understand the community’s perception of current mental health needs and possible solutions. Participants included parents and adolescents of both Asian and non-Asian descent, and adolescents discussed the intense pressure from schools, parents, and peers to achieve personal and academic success as a large factor in mental health. Participants also identified stigma against mental health as a significant barrier to open communication between family members, as well as to accessing mental health services, and they voiced a need for more community education, resources, and support.
Parents also identified difficulty in discussing emotional topics with their adolescents and specifically requested a more “hands-on” way of learning skills to better communicate with their adolescents. In response to this request, Rona Hu, MD, a Stanford Psychiatry faculty and Chinese- American, developed several vignettes as a tool for educating parents on effective communication (click HERE to read Dr. Hu's welcome letter). The vignettes simulate difficult, real-life scenarios that parents face, with specific emphasis on challenges that may arise in Asian-American households. Members of the Stanford Psychiatry department have employed these vignettes, beginning in the 2015-2016 academic year, to help engage and educate guardians in the topics of adolescent mental health and improving family communication.
Communication Health Interactive for Parents and Others
As CHIPAO was founded in response to the disproportionate representation of Asian-Americans in the most recent suicide cluster, the vignettes featured in our workshops are tailored to Asian-American families. However, there are many cross-cultural components and learning points in the vignettes that can be applied to all families, and the three workshops that have been open to the community thus far have been attended by non-Asians as well.
Workshops begin with background information regarding the suicide clusters in Palo Alto, as well as the history of CHIPAO. Members of the Stanford Psychiatry department then role-play 7 vignettes while periodically fielding questions from the audience.
Each vignette depicts a different topic including dating, school pressure and bad grades, teens feeling embarrassed by un-acculturated parents, excessive video game playing, and depression and self-harm behavior. For each vignette, the actors initially demonstrate problematic communication between the parent figure and the adolescent, and after a time of moderation and comments from the actors and the audience, the actors repeat the scenario with improved communication style. Then, there is again a time for the audience to interact with the crew and ask questions or give final thoughts.
This project has generated lively and rich discussions thus far among parents, school administrators, and mental health professionals, and we look forward to what lies ahead.
Seeing as how the requests for workshops are coming in more quickly than we are able to man as a small team, we aim to film our existing vignettes and develop a curriculum. We would like to increase reach and scalability by providing schools and other community partners across the nation with materials they can use within their own infrastructure.
As of now, the vignettes target parents and guardians and reflect on ways in which they can modify their approach to communicating with their adolescents. We will be working to create vignettes for teenaged audiences. We have also received several requests to develop vignettes that are more specific to the Latino and South Asian communities.