In-depth Q&A with Zoey Ka, multicultural mental health advocate (Part 2)

Trigger warning:

Discussions of mental illness, suicidal ideation, and self-harm.

In this comprehensive interview, Zoey Ka and Monique Moate discuss a wide range of mental health–related topics. They cover, for example, mental health advocacy, lived experience, intersectional identity, the challenges of people of colour, cultural influences, stigma, how to be a great ally and support person, workplace improvements, and hopes for systemic and societal advancements.

First published by The United Project.

Q: Why do you think there continues to be so much stigma, prejudice, and discrimination against those with mental illness, even in 2023?

Zoey: I had this conversation with my daughter recently. We were talking about how a lot of things were so advanced now, but there are so many things that are going back, medieval times, kind of. And one of the things that I talked with her about is that, yes, the awareness is there now. Not everywhere. But the awareness is a lot higher.

But we’re trying to change and make changes to a system that was built that way. A lot of people say the system is broken. I don’t agree with that. I would say that the system was built intentionally this way to support white Australians. The laws and everything that was put in place were intentionally to do that. To cast us out, you know.

Whether it is the First Nations, whether it is anti-Chinese policies, all those things. Those are gone now. But the residues of it are still in the system. So, even though there is awareness, I don’t think there’s necessarily the desire.

And when we talk about change, we talk about the current state and the future state, and there is a transition. Whatever wide or little change we need comes through individuals.

And each of us has to go through the process of having the awareness, and then having the desire, and then having the knowledge, and then actually taking action. And actually repeating it ‘til it sticks. So, each of us individuals, at different stages of our lives, are going through that change process at different times. There are many people who are aware, but don’t have the desire to change.

Monique: Exactly. That was beautifully said. It’s just so true. A lot of people are aware, but they don’t care.

Zoey: And you can’t stop them. Until our system forces that desire to change, those people are not going to change.

Monique: It’s so true.

Zoey: So, we need to focus on the system, the people within, the politicians, the people within the governments, to enforce these changes so that it can cascade down to society.

Monique: Mmm, exactly. So that kind of leads onto the next question.

Q: What kinds of systemic and societal changes would you like to see that would benefit those with mental illnesses (such as changes in healthcare systems, education, policies, attitudes, etc.)?

Zoey: Well, I think, first of all, there is a lack of knowledge of what supports there are out there. If you consider, from my personal experience and those around us, when we are mentally unwell, what do we do? We normally don’t seek help.

And when we do seek help, it usually ends up being an emergency number, or the first point of contact tends to be a GP. What does the GP do? They give you a K10 [a psychometric test], and they send you to a psychologist or psychiatrist.

But there’s actually so much more out there that is really helpful for those who are not doing well. There’s lived experience peer workers, there’s community services, there’s so many other alternatives. Because — psychologists are awesome by the way. There are so many other types of support.

Especially, I would say, the multicultural community, many of us would not like to go see a psychologist because of how stigmatising it is. But we would go to a chess game. And that will also help. Because what you’re really lacking is—. [You have] social isolation.

Or you can use art therapy. So, you don’t actually have to talk about it. You’re not at that time of your life where you’re able to. Or maybe you don’t want to. So, art therapy might be a really good approach for you to get something.

There’s actually more help out there than we are aware of. But, first of all, it’s costly; second of all, it’s unknown. How can the government educate people so they know how to get these supports. And how do pharmaceutical companies get to GPs? Maybe do the same thing.

Get people to actually go out and talk to GPs, ‘cause GPs are the frontline. If they have more information about what’s out there, maybe there can be more alternatives for people, instead of just psychologists and psychiatrists. And I’m not saying that people don’t need psychologists and psychiatrists — I think they absolutely do, and they have their place. But there’s so much more options out there. People should have the opportunity to try different things.

Monique: I think just being with other people with lived experience helps a lot. ‘Cause obviously, when you’re talking with a psychiatrist or psychologist, or doctor, there’s the power imbalance. And they don’t necessarily know what it’s like.

When I was in hospital, two different people said to me that one of the good things about being in there is that everybody knows what it’s like. And it’s true. You don’t feel like people are judging you, or expecting you to be a certain way.

Zoey: I love that. And I probably say that I have—. What I was saying at the beginning of my journey using my lived experience, in my profession, was that I’ve been in active therapy and just in therapy in general for a very, very long time. And I felt like my life was quite good. I was living a good life; I felt mentally healthy.

I felt that therapy has really supported me. I’ve developed a big toolkit for me to manage my mental health in various ways, and in different situations. Whether it is my rejection sensitivity, dysmorphia. Whether it is my doubt, whether it is my anxiety getting the better of me. Whether it is I’m going down to a low because of something. I have a lot of tools to get me back up. That has really supported the way I live.

However, it really wasn’t until I met many people with lived experience that I went, I didn’t realise that this was what I needed. To just be accepted. And I wouldn’t say that my psychologist didn’t accept me. I’m not saying that the general society wasn’t accepting of who I am. There are some incidents that were quite discriminatory.

A great example I love to use now — and I’m stealing this from one of my good peers, named Phoebe Kingston — the difference between lived experience support workers and peer workers, versus a psychologist. You’ve dropped down to a hole, and the psychologist is at the top. They will hold a big speaker and put down a ladder, and they will call out instructions. And you will climb up that ladder, slowly, at your own pace. At whatever time.

Whereas, someone with lived experience will jump into that hole with you. And you will ask that question, “What if this impacts you as well?” That person simply says, “I know how to do this; I can do it well. Let’s walk together, walk up this ladder and see if it works for you.” That’s the biggest difference. At different points in our lives, we need some of that.

Monique: Definitely. 

Q: How could workplaces improve to better support those with psychosocial disabilities and mental health conditions?

Zoey: I think flexibility really helps. Having a really good flexibility policy. At MIFA, yes, my working days are Monday to Friday; I do have meetings at different times. If we have to move those, they’re already completely okay – they don’t ask questions. They support my life in general. I get all my work done, and if I don’t, I have conversations.

So, not just support EAP [employee assistance programs], but actually, really cultivate a healthy culture where people are talking. My CEO Tony Stevenson always says, “We are humans first before we are employees and CEOs.” And I think that has made the biggest difference, during some of the days where I’m not doing too well.

And not added stress, but minus the stress. When I’m not mentally well, I know I don’t really have to tell them. And I can say, “I just need to leave for the day,” and they’re okay with it. There’s not too many questions asked.

They also trust me a lot. So, they will trust me when I feel like I need to say something — that it’s impacting my work. But a few hours or half a day of me going through, you know, maybe just some bad days. That I can’t get up, for example, starting work later. These things, no one’s ever questioned it. And no one ever judges me for it, that’s the thing. And that changes everything.

And I think it’s really important that I want to tell people, it’s that, we’re not dangerous. We’re not incompetent. And that stigma, that just because you have a mental illness — I hate that word, by the way. That we’re incompetent. Or we need other people’s help.

But I’d like to ask, who in this human world, as a human being, doesn’t need someone else’s help? Like, don’t you get on the bus? You pay someone, but they’re helping you get to work. Everything we do in our life, humans are born to be with people. And each other supporting each other. It’s just, for some reason, when it comes to mental health, it’s just harder.

Monique: I believe I lost my job because of my mental health, and that’s one reason I joined The United Project. They’re doing a lot of good work. Because Matine from there, he co-founded The United Project because he lost his job—. But it was because of his mental health. I think this is really needed.

It’s really just something that, like, a lot of people, they don’t feel comfortable. I know ‘cause you work in the mental health field, I guess it’s more expected that people—. Especially, if you’re a lived experience support worker, maybe it’s a bit more expected that you would be more comfortable talking about these things.

Zoey: But, you know, Monique, I’ve never talked about my mental illness to anybody, especially in a public place, until that particular article for Asian Australian.

Monique: Oh, really?

Zoey: Never shared it with work [in the past]. Some of my friends know, but that’s it. I’ve hid it my entire life and managed it that way. Like you said, it’s really, really needed. And not everybody will want to — it doesn’t matter. They don’t need to be that kind of lived experience advocate; they don’t need to be verbose about it. And that’s okay.

There’s this notion that I really, really don’t like that you should share your story with other people to empower people. I think that’s bull*. Not everyone has to do that. There shouldn’t be any expectations to do that. If you have the capacity—. No, that’s even the wrong word; if you say you have the capacity, you’re saying that person doesn’t have the capacity. No, that’s not right.

If you have fire within you, and you feel it helps you become a better person, if you want to share, then share. But there should be no pressure or expectation that you should.

If you don’t want to share, you should not feel — well, I can’t tell anyone not to feel ashamed — but there really shouldn’t be that pressure.

Monique: Personally, I feel very comfortable sharing. ‘Cause, yeah, as long as it helps someone. I think it would help someone out there, hopefully. Feel a little bit less alone.

Zoey: But don’t you think that we do that sometimes for ourselves, as well as for other people? And that’s okay. I feel like when I do that, and when I share my story with you, Monique, I feel happier. I feel lighter. I feel like, like you said, if it gets to anybody, and it helps someone make the day even just one minute happier, or a sense of relief, I think then what I did was worth it.

But it doesn’t mean that other people need to. I’m not always comfortable sharing either. I have days. [both laugh]

Q: How can we better support people we know with mental health conditions, especially severe and/or ongoing ones?

Zoey: I’d probably say educate yourself. Like racism, don’t expect—. You know, it’s okay to be curious and have conversations. But don’t expect the other person to be the one teaching you what it means to have depression, or what it means to have schizophrenia or bipolar. They might be really happy to educate you. But don’t expect—. The onus is on them [the other person] to learn.

If you want to better support people around you, educate yourself.

That’s probably my biggest advice. Educate yourself, but don’t absorb the information like those are 100% correct, if that makes sense.

Because the information that we get on the internet, specifically, from a medical, a biomedical model, there’s a lot of things that might not be what that particular person resonates with. But it’s good to understand various points of view.

Q: What kind words would you share with someone experiencing depression or other mental illnesses?

Zoey: I’d probably say, I’ve been there too. And I’m happy to walk alongside you if you will allow me. And that you are an awesome person, whether you feel like it right now or not. That’s probably it.

Monique: And you’ve survived 100% of your worst days.

Zoey: Absolutely. And I see you. I see you and I hear you.

Monique: That’s good.

Q: Is there anything else you would like to add?

Zoey: I think our conversation has been really multifaceted, whether it is the work, whether it is my personal view. But I think one of the things people really should consider understanding is what stigma really is and the levels of it. Because most of our own self-stigma is unconscious. And unless you’ve actually learned to be self-aware of it, like, if you’ve gone to therapy, like me, for many years, I know when I’m self-stigmatising.

So, it’s understanding the three layers of stigma. The first one is systemic, so the policies, the system that is really stigmatising for us, and hard for us to access what we need, or the way we are treated is unethical or not right in general.

And then there’s the public stigma, which is the discrimination and the devaluation by other people because we have a mental illness. That we’re dangerous; that we’re incompetent, etc.

Then there’s the self-stigma. Really, the internalisation of negative stereotypes. It’s really understanding, what is it about me, that I’m saying about myself that it’s true. For example, I spent a lot of my years thinking that I’d never get better and that depression will be the death of me. And I truly believed that. That was me stigmatising myself — and saying that I will always be someone that is unwell.

Until I shook that belief, and I really thought to myself, I can make changes to my life. I don’t think I ever consciously thought, oh, I’m not mentally ill anymore! But I do know that I am living the life that I’ve always wanted. Even though I thought that I never had that opportunity because I have been so unwell.

Monique: Thank you for mentioning that. I do think it’s important for people to be aware of self-stigma. I wasn’t even aware of that concept until recently. And I think, in some ways, maybe self-stigma is the worst kind of stigma, ‘cause you’re basically internalising—. It’s sort of like internalised racism.

Zoey: It is.

Monique: Internalising anything negative that people say about you. In some ways, I think it’s the worst kind.

Zoey: I would say so too. And the most harmful to yourself. Because there’s boundaries you can put to avoid people’s stigmatisation or whatever. But the boundaries you can put within your own mind is a complete different thing. I feel like I’ve built this little alarm in my brain. When I have these thoughts, ‘cause I used to pick them up and journal a lot. Because one thing I used to really struggle with is self-love.

One of my therapists told me for me to learn to love myself, the first thing I need to learn is how to trust myself. For someone who had made many, many mistakes in life, and, you know, bad decisions in my life, I do not trust myself.

That’s why I handed the power to other people. Learning to trust myself over many years is making the right decisions at the right time. Not really spiralling because I made one wrong decision, and just keep going.

I think, over the years, I have this alarm now. Whenever I have these little stigmatising thoughts about myself, it’s like, ding, ding, ding, ding! And then I’ll pause. I really have to take the time to pause and go, is this thought true? Or is this a story that I’m trying to spin?

One of the most fascinating things, and probably the most useful thing I’ve learned, through my years of therapy — not just talking about all these techniques — is actually realising that my thoughts might not be true!

My thoughts are not truth. Because I used to tell myself, I’m useless, or I should be dead, or I should die, or all these things. But they’re just stories from my experiences; they’re not necessarily truth or facts. And once I’ve learned that, and now I have. I feel like I’m an expert.

And I still fall down. When I have these negative thoughts and self-stigma types of thoughts, that are really harmful to myself, I pick them up really quickly and I kind of break them.

I’m not saying that I don’t feel the toughness or the negative emotions that come with these thoughts. Because thoughts and feelings are different. But by really crushing those thoughts a lot quicker than I used to, I am able to manage my feelings and emotions a lot better.

Monique: What you said made me think of this concept of the observing ego. Where you just observe rather than get—. I think there’s the observing ego and the experiencing ego or something like that. It’s kind of like thinking to yourself: right now, I’m having this thought. Right now, I’m experiencing this. Right now, I have this feeling.

It’s not something that’s necessarily true or something that’s going to last forever.

Zoey: Impermanence. The impermanence of things. Because I think it’s the hardest when a feeling or a situation has arisen and you’re overwhelmed. Or you’re feeling a lot of extreme or heightened emotion. And having the clarity in your brain to realise that it’s not a permanent thing can be very, very hard. That can be such a circuit breaker.

Monique: Mmm. I guess mindfulness is pretty much developing your observing ego. Just watching what happens rather than experiencing it, I guess.

Zoey: When you talk about mindfulness, it makes me laugh ‘cause I can’t do meditation for shit. But I realise as someone with ADHD, silent meditation is just not something I can handle. But guided meditation I can handle. Walking meditation, I can handle. So, when people are like, oh, mindfulness is such a fluffy word, blah blah blah blah, I get it.

But at the same time, try different types of mindfulness. Whether it is colouring in, whether it is painting, whether it is walks; there’s so many different types. One thing I’ve learned that mindfulness has helped me with, is it really helps me ground myself. And it allows me to be present.

And for someone who is an expert at living in the past, or having anxiety about the future, living in present is probably the hardest thing that I can ever do. That I’m currently trying to do. [laughs]

Monique: I mean, it’s so simple, like, when we look at our pets or other animals, they’re always living in the present. It’s just so effortless for them.

Zoey: It’s so YOLO! It’s so YOLO.

Monique: [laughs] But it’s so amazing how hard it can be for people, you know?

Zoey: Of course. But there has to be that balance, right? You can’t spend all your money on chocolate when you still have to pay for rent. [both laugh]

Monique: Exactly. Thanks, Zoey. That was all my questions.

If you would like to connect and chat with Zoey more about the lived experience of being an Asian Australian, her lifelong mental health journey or her work at Finding North Network, please contact her at zoey.ka@mifa.org.au or  https://www.linkedin.com/in/zoeyka