Toward Mental Wellness: Building the Crimson Community

“My dad said I didn’t have mental health, because I was smart.”

I listened as Bai continued to explain how her father had forbade her from seeking healthcare for mental illness. Bai was one of my interviewees for my thesis, which focused on Hmong-American young adults’ health views and healthcare decisions. As a pre-medical student, I was stunned to read about past conflicts between American clinicians and first-generation Hmong-American patients. My best friend in high school was Hmong-American, and I was concerned that she and others in the second generation might still face barriers to accessing healthcare. Considering Bai’s experience, I sought to disentangle what was specific to Hmong Americans from what might have much broader significance.

In the Hmong language, there is no medical word or phrase that means “mental illness.” Indeed, there is a general dearth of medical terminology. Before arriving in the U.S. as refugees from the Vietnam War, the Hmong lived agrarian lifestyles in the mountains of Laos. The Hmong understood health, illness, and healing in the context of a world inhabited and animated by spirits and believed that most illnesses and diseases were caused by the departure of a soul from one’s body. In these cases, a soul-calling ceremony would remedy the problem.

For Hmong-American young adults, “mental illness” is a new concept that can be alternately devastating and empowering. Without a direct translation in the Hmong language, “mental illness” is often explained in terms synonymous with “stupid.” Sometimes it’s described as “broken brain.”

Clearly, a diagnosis of mental illness can damage one’s self-concept. But as a label, “mental illness” also bears positive potential. A diagnosis can create hope for relief from symptoms and suffering, for the diagnosis constructs a disease that can be intellectually understood and medically treated. Bai sought care that helped her to recover, care that was not accessible or available in societies where “mental illness” was not recognized as a legitimate condition.

Yet, during my research I was troubled to recognize that most of my interviewees used “mental health” as synonymous with “mental illness.” Viewing these as synonyms prevents us from recognizing a central part of our health and wellbeing. With this view, we refrain from thinking of our own mental health unless we perceive a mental “problem.” We neglect to consider how declines in mental health lead to mental illness, which means that any one of us could be potentially affected.

The tragic suicides in 2012 forced me to confront these thoughts. I believed that increasing access to mental healthcare services on campus could help to alleviate suffering and prevent suicide.

I considered what it would take for me to access existing services. I would need to go to a room or building with peer supporters or healthcare providers, which would require that I first acknowledge or self-diagnose a problem; then research where to go, for what, when; and then make my way to a place I had never been before, where my very entrance would mark me as someone seeking help. I compared this to my typical “therapy”—text messaging a parent or a friend. I then considered the positive impact that simple pump-up text messages have on my own mental health, and I envisioned a new project: Crimson Community.

During the fall and winter, I met with Dr. Paul Barreira of University Health Services and past and present student leaders of the UC, Room 13, and Student Mental Health Liaisons in order to ensure that this app would serve students effectively and integrate with existing services. Over the J-term, I sent a proposal for the app to developer email lists at Harvard. My request outlined how Crimson Community would work, and what it aimed to do: strengthen the campus community and reduce barriers to accessing mental healthcare services. I wholly expected that I would get close to zero responses, since requests for developers are frequent and typically offer compensation. Still, within a day, seven developers had written back.

Since January 2013, I have been working with developers Ruth Fong ’15, Victoria Gu ’15, Stella Pantela ’15, and J. N. Fang ’16 to create the Crimson Community app. The web app will send a pump-up text message or email to each person enrolled in the Crimson Community once per week. Students enroll by texting or emailing the app. A different student group on campus writes the message each week, helping to build a unified and supportive community on campus.

Then, when a student seeks to access mental healthcare services, he or she can text back the app—the number is already stored on his or her phone—to get information about available services. A text with the words “eating disorder” will receive a text with information about how to access Eating Concerns Hotline and Outreach (ECHO), for instance. Other keywords are similarly matched to information about available services, often with a reference to a webpage on which to find information about additional resources.

With the app in its final stage of development, our team today remains small, but we hope that the app will soon help to build a Crimson Community on campus that crosses all barriers—including an often-imagined distinct line between general wellness and mental illness. We all have mental health. We are stronger when we listen to ourselves enough to recognize it. Together with our peers, let’s build a supportive campus community for all.

Annie E. Ryu ’13, an anthropology concentrator, lives in Quincy House.This is part of a semester-long series organized by SMHL (Student Mental Health Liaisons) to encourage conversation around mental health.