In Palo Alto, where Asian Americans make up nearly 40 percent of the student population, they also make up roughly 40 percent of youth suicides over the last decade. And in just the last two years, four out of five teen suicides in Palo Alto have been East Asian kids.
But many parents are first-generation immigrants, leery of acknowledging and addressing mental health problems. So psychiatrists at Stanford University are turning to an unlikely art form to start the conversation: theater.
"A lot of parents are reluctant to talk about their own feelings," says Dr. Rona Hu, a second-generation Chinese American Stanford psychiatrist and the main force behind a volunteer theater troupe whose job it is to model good parenting techniques informed by American psychiatry. "Immigrant parents often aren’t aware of or prepared for the way that their teenagers behave in this culture, because it’s so different from the way that they were raised."
Hu, who has no performing arts training beyond one drama class in 9th grade, came up with the idea of theatrical, therapeutic vignettes in 2015 while making the rounds as a speaker on mental health at local schools. Parents would come up to her after lectures and panel discussions and ask for more practical help. "You can tell us to communicate better with our teenagers," Hu says of her interactions with parents. "But show us. How do we do it?"
She was also inspired by her days as a resident at the University of California, San Francisco (UCSF), where faculty members used theatrical vignettes to help young doctors learn how to interact with difficult patients. During these sessions, teachers would act out a negative exchange, talk in character about what went wrong, and then reenact the scene to demonstrate a better outcome.
Hu's theater troupe is comprised mostly of medical professionals who write and perform skits inspired by their first and second-generation immigrant experience. They've been performing since March of 2016.
On a recent evening, the troupe performed at Jordan Middle School in Palo Alto for an audience of roughly 100 parents.
With the barest of sets and costumes, the cast – most of them medical professionals - played out six uncomfortable conversations, covering topics like bad language, poor test scores, and depression.
In the staged scenes, the parents all love their children, but their tendency to respond with shock, anger or denial drives an emotional wedge between the generations.
Though the scenes are often played broadly for laughs, they also reflect real-life experience. Hu says, "I’ve had any number of parents coming up to me with tears rolling down their cheeks, saying, 'That vignette was my life.'”
As with the skits at UCSF, a moderator "interviews" the actors after their scene, so they can explain the psychological underpinnings of the argument. The audience also has an opportunity to weigh in with questions.
Then, the actor-psychiatrists model on stage what good parenting looks like. The father who first berated his son for failing another math test offers sympathy and practical solutions instead. The mother who first laughed off her daughter's depression now agrees to help her consult a medical professional.
The overall idea of the theater project is to get parents talking about applying emotional intelligence to their daily interactions with their children. “'What’s wrong, sweetie?' versus 'What’s wrong with you?' which sounds accusatory," Hu says. "Especially if they’ve been raised in a culture where it was taboo to talk about feelings, these are skills that will take some work to acquire."
Federal researchers who delved into the data found many teen suicides in Palo Alto in recent years had underlying mental health issues. Each case is unique, but Hu says a child that feels his or her parent is an ally is less likely to hide problems that could develop into something serious, or even life-threatening.
"If the parent knows about the issue, then they can do something about it," Hu says. "But if they don’t know, then there’s really nothing they can do."
Gloria Zhang, a Palo Alto parent present at the Jordan Middle School event, says she doesn’t want to wait till there’s a crisis to develop a better relationship with her middle schooler. She says she feels like she could use more training to talk to her son without losing her temper. "I want to improve; communicate with him better, to let him to understand I love him," Zhang says. "I want him healthy."
That feeling isn’t limited to East Asian parents. By popular demand, the troupe has expanded its audience base to include Latino and South Asian families.
The Stanford psychiatrists are currently applying for grants to study whether the skits work in a scientific sense -- as well as a theatrical one.
The Stanford psychiatrists perform next for the American Psychiatric Association Saturday, May 20, in San Diego. More info here.