Racial Justice and Lived Experience in Mental Health Advocacy: An Interview with Pata Suyemoto

Pata Suyemoto is a feminist scholar, educator, curriculum developer, activist, and artist. Her work promotes racial equity in mental health and suicide prevention through teaching and advocacy. She advocates for equity and inclusion at all levels of mental health care, from grassroots organizations to state-level policy institutions. Dr. Suyemoto has spoken and written about being a suicide attempt survivor and her struggles with chronic depression and PTSD.

Dr. Suyemoto earned her PhD in Education from the University of Pennsylvania, where she researched multicultural and anti-racist education. She currently serves as the Training Director for the National Asian American Pacific Islander Mental Health Association and leads the National Asian American Pacific Islander Empowerment Network.

She is also a leader in suicide prevention at the local and national levels, serving as the Equity Coordinator for the Massachusetts Coalition for Suicide Prevention and co-chair of the Greater Boston Regional Suicide Prevention Coalition. Dr. Suyemoto co-wrote an educational resource called “Widening the Lens: Exploring the Role of Social Justice in Suicide Prevention – A Racial Equity Toolkit.”

In this interview, Dr. Suyemoto discusses how her identities as a Japanese American woman and lifelong educator have influenced her work promoting racial equity in mental health and suicide prevention. She shares her efforts to build a national network of Asian Americans with lived experiences of mental health challenges. She emphasizes the importance of equitable partnerships with those with lived experience in research, advocacy, and therapeutic contexts.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Julia Lejeune: In one of our previous conversations, you shared with me that cutting across all of these roles and the hats that you wear, you really see yourself as a health educator and activist, primarily. I’d love to hear more about that from your perspective and to hear about what led you to health and mental health education and activism as a practice. How has your role as an educator morphed over time?

Pata Suyemoto: I feel like I have been chosen to be an educator by the Universe or whatever. I have been blessed. I’ve taught everything I’ve ever loved to do, which includes art and writing and biology and sign language and Reiki and bicycle riding and joy-making. I really feel like I’ve taught everything I’ve ever loved to do, and I’ve taught preschool to graduate students. So, I feel like that was what I was meant to do in the world.

I feel very lucky that I feel like I’ve made lemonade out of lemons. I struggle with my own mental health challenges. I have major depression and complex PTSD and really was down for the count for a few years, like really on disability and very compromised in what I could do, and went through that darkness, really, and came out, sort of peeked out the other side, and thought, if I’m going to have these conditions and I can help someone by sharing my story, being a support, then I was going to do that. So, it went from I was teaching at the university and I was teaching in a teacher education program at a university and doing multicultural education, anti-racist education, that kind of thing, and then I couldn’t do it anymore. So, I had to leave the university. And then it was sort of like, what am I doing now? For a while, just healing was the answer.

And then, the second thing was, what can I do with this person, this person with lived experience, and how can I use that lived experience to help someone else? So, that’s sort of where that ended up moving into. Also, I connected with the Asian American community in Boston and realized there was a huge need in our community to talk about mental health because it’s so stigmatized in our community.

As I started sharing my story in the community, I’d have young Asian American women line up to talk to me afterward, and I thought, this is something that’s important because these young people were struggling in terms of being able to manage their own mental health concerns and not having anybody in the community they can talk to, because it’s so stigmatized, they can’t talk to the parents, no one is going to go into a clinic. So, it’s really gotten into using my education and my experience and combining it all together.

I have a PhD in education, and I studied anti-racist education and multicultural education, and how to teach teachers and that kind of thing, but I used all of that teaching experience in the work I do as a mental health activist and educator.

 

Lejeune: You have been responding to the same calling and using the same skills across all of these contexts.

Suyemoto: And I think using a lot of my identity too. I mean, as an Asian-American person, I talk about that, and I talk about what it means to be a child of a father who was interned in World War II and the legacy of trauma that causes. Historical trauma, the generational trauma, particularly in our current world: a very racist United States. So, I think that that has allowed me to really think deeply in certain areas about what it means to be Asian American with a mental health concern. What does that mean to me and what does it mean to the world, and how is that received or not received?

 

Lejeune: One of the ways in which you have infused your identity within your activism has been the development of this tool kit for suicide prevention. You developed this tool kit for organizations to use to center racial equity in that work. It’s called Widening the Lens, Exploring the Role of Social Justice in Suicide Prevention: A Racial Equity Tool Kit. I’m curious to hear more about what your motivations were for creating this resource. What was the process like of choosing what to put into it? If you could also speak broadly to why it is so essential that we center racial justice and equity in suicide prevention.

Suyemoto: First, I want to say that I didn’t develop the tool kit alone. Jennifer Kelliher, the managing director of the Mass Coalition for Suicide Prevention, we worked together to develop the tool kit with the MCSP’s Alliance for Equity, which is our equity committee at the Mass Coalition. It was definitely a collaborative process.

I think what motivated me to do the tool kit was when I came to the Mass Coalition for Suicide Prevention. I was a representative on the executive committee from a regional coalition, and when I got to the executive committee, I asked Jen how many people of color were on it. She said, “you are replacing the only one.’ I looked at her, and I said we needed to do something about this. We started the Alliance for Equity, which has a People of Color Caucus and White Ally Caucus, intentionally. There are times when people of color need to talk amongst themselves, and then there is a time when white allies need to talk amongst themselves. It struck me that there was nothing in suicide prevention or mental health that dealt with racial equity intersection. There wasn’t another tool kit, and there wasn’t anything that was out there that could help guide us in this process.

So, coming from a curriculum development background, coming from a DEI background, I thought we have to do something about this. So let’s start thinking about how we would go about changing the culture, the kind of work we do, the lens we use, et cetera. So, we started developing it really for ourselves because we were looking at our coalition as a place that needed to be moved along that dial, that equity dial, if you will, moved toward more equity.

It’s a living document. So, we have a version that now is our second edition, and we added some things. We added content on white supremacy culture, for instance. So, this tool kit centers on racial equity because it’s so problematic in our country. It’s not to say that there are other inequities that are not as horrible, particularly in suicide. We see LGBTQ+ folks struggling with suicide and mental health concerns at a higher rate, but we decided to start with racial equity because we knew that everyone was uncomfortable with it and that starting there allowed us to then move toward other intersectional identities. We are not just one person; we are not just one identity. We are one person with many identities.

So, how does that function, and how do we pay attention to other inequities, still centering on racial equity but not ignoring the fact that this is compounded intersectionally if you are a person of color with a disability or a person of color differently abled or a person of color and transgender. These things are compounded, and we are moving into that space now, where we are not going to ignore all the other inequities.  But we are going to teach centering on racial equity because it’s not going away. People are uncomfortable with that to some degree because people want to move off racial equity. They want to go into something else because it is uncomfortable.

So, our next tool kit we are working on, and it’s not coming out any time soon, is it takes a long time to develop them, but it’s on gender and looking intersectionally at race and gender, and how that plays out.

 

Lejeune: I’m curious if you could give an example of one of the workshops or activities that you might do with an organization that’s using this tool kit.

Suyemoto: The tool kit has a lot of different things in it. It has some activities in it. It has some of what we call foundational concepts, which are basically informational sheets on different concepts, like intersectionality, and white supremacy culture, things that people need to know about when they start the work. What do you need to know?

People always ask us: why do this work in suicide prevention when most of the people who die are white men? There are many answers to that. Not the least of which is any suicide is important, and we see it varying in different cultural and racial groups. In African-American and black boys, for example, right now, there has been an uptick in suicide. It’s really critical that we think about how these issues come out, and the tool kit does other things like it has inventories like a series of questions to ask yourself or your organization, how much do you talk about these things, how are you doing your work, whose culture is being valued. Communication style is another thing.

So, there are all these concepts in the tool kit. There are inventories in the tool kit. There are activities in the tool kit. It’s not a progressive thing. You don’t start at page one and go to page whatever it is and just go marching through it. It’s like you need to do the inventories and figure out where you need to go.

At the Coalition, I feel very fortunate because the Coalition has the support of the Department of Public Health, and they are doing equity work at the Department of Public Health Suicide Prevention Program. So, they do work at that level. We get funded by them. So, we are doing it at our level, and we’ve tried it all, from our executive committee to our general membership. So, it’s throughout the organization. Equity work is everywhere, and they just hired me as a part-time staff in equity. So, they’ve made the commitment, and they’re actually putting their money where their mouth is, saying we know this is going to continue. We need someone leading the way.

So, I feel very fortunate, and we’ve had the opportunity to take this work and do some webinars too. We did presentations all over the country and at an international conference in Ireland a few years ago. People have really embraced it, which has been very exciting.

It is really fundamental that this work has to be done at all levels of an organization. It can’t just be siloed, it can’t just be a committee, and it can’t just be the board. It has to be everywhere. And the other thing is that it needs to happen at all levels of our lives. So, it has to happen at the personal level too.

A lot of times, when I go and do a workshop, I’ll do an identity exercise or something to get people to talk about these issues for themselves, personally, and to each other. People are so resistant to that. They don’t want to do that. They want to jump in and change the organization, but they don’t want to change themselves. I don’t believe it can be done, and that’s why we’re working our blind spots in terms of equity, and that’s why we’re working on the places where we have growth edges. We can’t do this work for an organization. You just bring all your bias into the organization, and then you have all these blind spots, and you are doing it kind of haphazardly.

 

Lejeune: In the moment, when you are receiving that type of push-back, or you’re sitting with others’ discomfort, how do you respond?

Suyemoto: We like to level-set the fact that discomfort is actually a good thing because if you’re not uncomfortable, then you are probably not doing the work. The other thing is that discomfort is different than being unsafe, and that’s the thing, I think, that people kind of get – they feel uncomfortable, and then they feel unsafe, but it’s not the same thing. You can be uncomfortable and be safe. You’re not going to get hurt or shot at or something like that. Sometimes, for people of color, it’s a matter of discomfort, but it’s also a matter of being unsafe. So, I think it’s really important to make that distinction and to know that discomfort is part of the process.

 

Lejeune: I’d like to shift gears a little bit to hear about some of your current work as the Training Director for the National Asian-American and Pacific-Islander Mental Health Association. Specifically, I’d be curious to learn more about your role there in centering the voices of Asian Americans, both young people and adults, with lived experience.

Suyemoto: Sure. So, I actually have two positions at NAAHPIMHA, which is the Training Director, and I’m also the director of a network of Asian-American, Native Hawaiian, and Pacific Islanders with lived experience. We call that network NAAPIEN, which is the National Asian-American, Pacific-Islander Empowerment Network. At NAAPIMHA, we have a very strong focus on people with lived experience and with youth. We have a program called Friends Do Make a Difference, where youth can start talking about mental health issues together, learn how to talk about them, learn how to talk with their friends, that kind of thing, and know what to do if someone is expressing feelings of suicidality and that kind of thing.

We also have NAAPIEN, which is the Network of People with Lived Experience, and it’s just being developed, but the vision is to have a network that does two things. One is to support people in the network because, as Asian-Americans and as people with lived experience, this is not a highly supported group of folk.

In the lived experience community, there aren’t a whole lot of Asian Americans, and in the Asian-American community, there are not a whole lot of people talking about mental health. So, we land in a particular spot. So, there is this need to support each other. There is also a need to be a voice, a voice of people with lived experience from the Asian-American community, to talk about the specific needs we have around breaking the stigma.

I am hoping to develop a Speakers’ Bureau where people could come, go out and speak about their experiences. I also have this idea of developing what I call a Resource Bureau. What if you’re writing a grant and you need the voice of a person with lived experience who is Asian-American? This would allow a resource that they can hire. I think it’s really important that you hire the person. They wouldn’t volunteer for you, but to provide that input, to review the grant or whatever it’s needed to be.

The other thing we are working on is some special interest groups. So, things like parenting. What does it mean to be a parent? I feel very strongly as a parent who has lived experience as an Asian-American. So, how do you feel about the issues of parenting and LGBTQ+? What are the issues if you add that identity onto the identities you have? So, NAAPIEN is an important network because we are so invisible and silenced a lot.

We are doing a summit in San Francisco on April 14th and 15th, and that summit focuses on youth and people with lived experience, and that was really important to us because it was important to take the most disenfranchised voices and say we need to pay attention to them.

 

Lejeune: As you’ve been building this work, how has your work been received by the Asian-American community?

Suyemoto: Overall, I think it’s been received well. People are interested in what we are doing. I also feel like we are just beginning. So, people don’t necessarily know we are out there, and if people do want to join the network, they can go to NAAPIMHA’s website, which is NAAPIMHA.org. If you want to join and find out what we are doing, go to our website. You can also register for the conference on the website.

 

Lejeune: Being an individual with lived experience, being Japanese-American, and having the wealth of experience you’ve had navigating different leadership positions in academic, research, and legislative spaces, what do you think meaningful inclusion of people with lived experience throughout these processes truly looks like, and what does it take for that to actually happen?

Suyemoto: So often, we are tokenized. On a panel, you have four doctors and then the person with lived experience, and they are often last. So, right before lunch and everyone else has gone over, and everyone wants to go to lunch, and no one wants to listen to you. So, one thing people can do is think about whose voices you are favoring and elevating and whose you are not. What does that look like?

So, if you are going to include the voices of people with lived experience, you’ve got to start from the beginning. Whatever you are doing, you’ve got to include them from the ground up because it doesn’t help in some ways to do the token thing, like we’ll have them look at it and just put a rubber stamp on it. That’s not inclusion. That’s basically using someone to be able to say we’ve run it by a person with lived experience.

Also, really think about compensating people with expertise. This is a subject matter expert, and if you were to invite a professor to be a subject matter expert, you wouldn’t say, “could you do this for free, please?” What you are saying to the person with lived experience is your experience is not as important as these other experiences. I think that that’s basically the exploitation of a person.

The voices of people with lived experience have been marginalized for so long, and to center them or to move them toward the center is going to take some effort. First, you have to identify people with lived experience who are willing to talk about it and willing to be part of that process, and there are certainly a lot of us out there.

NAAPIMHA put on a conference in New York a few years ago, and I was on the panel of people with lived experience at this conference, and we started the panel.  We started the conference, and it was a whole panel of us. It wasn’t five doctors and a person with lived experience last. I’ve been on the program of different panels and things where the organizers left off my Ph.D. because I was a person with lived experience, but they knew it. I gave them my bio. There was a doctor, doctor, doctor, and Pata. I’m like, I wrote them back, and I said, I don’t care, but if you are going to call everyone else doctor, you need to call me doctor too. That type of micro-aggression really goes to show what people’s stereotypes are about people with lived experience.

 

Lejeune: Given all of these barriers to this meaningful inclusion, what was the experience like for you to choose to hold that identity and be open about your own experiences?

Suyemoto: At first, it was scary, personally. I was teaching at a university, and I was teaching a course on equity in education. I was struggling, and I knew if I had any physical illness, like if I had kidney disease or if I had breast cancer, I would have shared that with my class pretty much right away. I am dealing with this, and I am going to work through it, whatever, but it was really hard to share that I had a mental health challenge, that I was struggling with depression, and that it was getting in the way of my work, which it was.

I finally did, and then I had students come to my office and thank me and say that they struggle too, which was a powerful message to me that sharing. Yes, it was scary, and it could have backfired, depending on the administration and all that kind of stuff, but I also felt like it created an opportunity to talk about these things that people need. We need that. We definitely need that.

We have such a top-down system. Doctors are telling people this is what they should do for their treatment plan. It’s like, wait a minute, what about me? Where is my voice in that? When I do speak about my own personal life, I talk about my treatment plan, but I use that term intentionally to reclaim it. Like, “my treatment plan” includes bicycle riding. My treatment plan includes art. My treatment plan includes writing in addition to psychotherapy, and I do take medications and other self-care things like acupuncture, but my treatment plan is the whole thing, and none of it is negotiable. So, I think we need to really re-think that, think about what it means and what it means to be in treatment.

I always say I really hate all the words that describe people in my position. “Patient” is a medical model. “Client,” business model. What are the other ones? “Consumer.” It’s like, let’s go to the capitalist situation. Let’s use that language. Cool, I’m a “consumer.” Well, yeah, I don’t really like being called a “consumer.” I haven’t found a word that I like better, like one word, but I kind of joke and say I want to be a collaborative recovery partner with my practitioners. Because that’s what I am. They are not doing it for me. I am doing it, but I am in collaboration with their guidance.

 

Lejeune: I know you are an avid biker. You also mentioned art and creating art as part of your treatment plan. How has art shaped all of this for you? How has your identity as an artist influenced your role as an educator and activist, or vice-versa?

Suyemoto: It took me a really long time to be able to claim the identity of an artist, and I think that’s because we have this idea that unless you are trained or went to art school or something, you are not an actual artist. So, that was something that I had to get over, but the thing that’s so ironic, of course, is that as a teacher, I’m always like, of course, you are an artist, of course, you are a writer, but for myself, I was like, well, can I really claim that?

When I went on disability and people would ask me, what do you do? That’s the lede at the party, so what do you do? You really can’t say, I am in bed trying to recover. It doesn’t fly. It’s kind of a conversation-stopper. So, I started saying things like I am a writer and I am an artist, and I am working on these things, which was true because that’s the only thing I could really do, was art and writing at the time.

Yes, definitely, art has been a way that I can express how I am feeling. I like being able to do things with my hands. I like being able to create things. I try to use that lens in the work I do as an educator as well. I often try to include spoken word, sometimes, or different kinds of ways of accessing information even. I mean, healing through the arts is huge, but also just using various ways of engaging with materials. As an educator, part of it is using that creative mind. Drawing or something, as opposed to just using the words.

 

Lejeune: Before we move into hearing you share one of your pieces, is there anything else that you would want to add or speak to?

Suyemoto: Actually, I do have something. I am very concerned about issues of parenting because I feel like we don’t talk about it enough. And I’ve been thinking – this may or may not be relevant – but I’ve been thinking about the importance of talking to our kids about psychosis because my mother was psychotic, but no one ever told us what was going on. That’s very dysregulating. It’s like someone saying, “the sky is green,” and then as a kid, you are saying, “mom is saying the sky is green. I think it’s blue. What’s real?” It’s very disturbing.

I think that there are ways – if someone had sat me down and said, “sometimes your mom doesn’t see the world clearly,” it would have helped. You can say it in words that don’t have to be “psychosis.” You can talk about it like, “sometimes she hears things that you might not hear,” and what does that mean for that kid? So, I just feel like we need to really think about what it means to be a parent, how we talk to our kids, and in general, how we talk about all this stuff in general, but specifically to children.

So, I just feel like one of my responsibilities as a parent is to think about how to communicate my condition and my situation to my daughter, so it has the least impact on her mental health and that she has the most understanding and compassion she can have for people with lived experience.

 

Lejeune: I think it really speaks to the importance too of having a safe space for parents with maybe similar conditions or experiences to come together and support one another in that process of parenting. I know you mentioned that the NAAPIMHA was going to have a parenting special interest group. We do absolutely have listeners and readers who are parents and maybe tuning in; I am curious what would be the best way for them to get connected or involved if they are interested.

Suyemoto: The special interest groups aren’t up yet, but they should apply to be part of the NAAPIEN network, and there is a place to put a message and just say that you are interested in the parent special interest group or whatever their interests are, that’s fine.

 

Lejeune: All right. Thank you so much, Pata. To close us out, I would love to hear one of your spoken word pieces.

Suyemoto: So, I am going to read a piece of poetry called My Story is Full of Lies. I actually originally wrote this for a presentation on the social determinants of health, but this is my personal story in relation to the social determinants of health.

 

My Story is Full of Lies

When I was twelve,

my diagnosis was

major depression.

At sixteen, I attempted

suicide.

At thirty-five, my diagnosis included

dissociative disorder,

not otherwise specified.

At forty, I took

nineteen pills to combat

chronic and severe major

depression,

and complex PTSD.

Perhaps, this is not surprising

since my aunt died by suicide,

my uncle faced serious depression, and

my mother had bipolar disorder.

One could say that genetics is

the cause of

my mental illness.

This is a lie.

In 1942, my dad and his family were

imprisoned in a camp

in Topaz, Utah.

There is nothing there now, but

tumbleweeds, hard, dry ground, dust storms,

and a plaque with an American flag on it.

After camp, when my dad was in

high school, a math teacher said he wouldn’t

amount to anything;

My dad earned a Ph.D. in mathematics.

But trauma and racism

silenced him.

He became

reclusive.

I can only wonder,

what impact

this has on me.

And although I grew up solidly

middle-class, I also grew up in

a white community where I was taunted

and called chink and soy sauce.

I was bullied in junior high.

My mom was the

crazy divorced lady.

My sister’s friend was forbidden from

coming to our house.

My mother also told me not to stand

with my legs apart.

“It’s not lady-like,”

she said.

But closing my legs didn’t stop

my cousin from

molesting me at six.

Or at sixteen, a supervisor from

groping me.

Not to mention the onslaught of

catcalls and innuendos.

A “normal” womanhood,

one might say.

This too is a lie.

I grew to hate myself.

What was there to love?

After all, I was ridiculed for

my race and attacked for

my gender.

When I came out as

bisexual, that too

was cause for pain.

In high school, I hid this

from my friends and my family.

I hid this

from the therapists in

the hospital they put me in.

In my twenties, friends died

of AIDS.

They said it was

our own fault.

God’s wrath.

This is too is a lie.

No one ever said,

perhaps your depression and

PTSD are normal

reactions to racism, sexism,

homophobia, and hatred.

Perhaps,

you are not sick.

Perhaps,

your despair is not an illness.

Perhaps,

This is my truth.

 

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To join the NAAPIEN network, go to:

www.naapimha.org

To learn more about the NAAPIMHA arts and healing project:

https://www.asiansinfocus.com/

Massachusetts Coalition for Suicide Prevention (MCSP)

www.mcspnow.com

To access MCSP’s Equity page with webinars: https://www.mcspnow.com/equity

To download the Widening the Lens Toolkit: https://www.mcspnow.com/_files/ugd/6ba405_6e9b04a98de444978b4c502e64a6af6d.pdf

To contact MCSP Alliance for Equity via email:  [email protected]

 

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MIA Reports are supported, in part, by a grant from The Thomas Jobe Fund.