Editor’s Note: This story contains references to suicide. If you or someone close to you needs immediate assistance, assistance is available 24/7 at National Suicide Prevention Lifeline: 1-800-273-8255.

As a Bhutanese refugee who came of age in Pittsburgh in the 2010s, I often heard about the death. The death that happened to people, self-inflicted. I found myself on the periphery of the mental health crisis that seemed to have engulfed our community, though it was rarely talked about. Murmurs of death everywhere.

I remember hearing stories from my parents about the man who hanged himself in his three-bedroom apartment or the funeral my mother attended for her co-worker’s spouse who had committed suicide. And it was often his the life. It seemed to me that they were almost always men. More importantly, it seemed like it was, a matter of fact.

It also seemed like a distant problem. I wasn’t particularly close to any of the victims. I was a teenager. The funerals were for people between the ages of 30 and 40. To me, 40 seemed like centuries. I paid no attention to it; my job was to be a student.

Until one day, it hits a little too close to home.

On what appeared to be a normal autumn day, near our apartment complex in Baldwin Borough, a body was found hanging from a tree. My father told us early in the morning. First he told me, then he told my older brother who had been friends with the young man since we became neighbors about five years before. They went to school together, they ate together, they walked around town together. My experience was fleeting. I knew him through my brother. But I still knew him. And now he was dead.

To a large extent, this was my first experience with the permanence of death. A few months earlier, I had gone to the gas station where the young man had worked. My brother forced me, at the height of my introvert, to make small talk as he got a free pack of cigarettes. I listened as they talked about their plans. The young man talked about buying a house so that his parents would finally move out of the apartment complex and put his sisters through college. And now he’s gone.

His death was part of a wave of tragedies in Bhutanese refugee communities that cut across class and age, particularly affecting men.

The story of the Bhutanese refugees

As a child, I was often told about the history of “our people”. Through oral history, the story goes that in the 16th century, the Kingdom of Bhutan sought immigrants from Nepal to work as farmers. Being settled in remote but isolated rural villages, my grandparents talked about always celebrating Dashin and Tihar, two Nepalese festivals. In fact, my grandparents never learned Dzongkha, the language of Bhutan. Instead, they spoke the same Nepali language the community had had for centuries.

After hearing about individual stories for years, I wondered if the source of the suicides was rooted in our collective history as refugees. Now, at 21, I wanted to understand the context of my childhood.

However, this separate identity has caused them to be referred to as “lhotshampa” by the Bhutanese government, a term considered derogatory by some members of the community. In the 1980s, as the “lhotshampa” demanded more political power, the government responded with brutal repression. According to the stories of my parents and their relatives, people disappeared from their homes at night. Bodies reappeared the next day in streams and creeks. Torture has become endemic.

I read stories contextualizing this oral history like an adult. Growing up, I remember hearing about distant uncles who had been tortured, resulting in lifelong mental health issues. By the 1990s, almost the entire population had fled to Nepal. Makeshift houses were built and seven refugee camps were erected in the southeast of Nepal. Both sides of my family ended up settling in the same refugee camp, the camp where I was born.

Nepal itself was going through a political crisis, which led to an active civil war between Maoists and monarchists. At times the war became so violent that I remember my mother telling me not to hit anything on the roads, lest it be a makeshift bomb. In this environment, when the opportunity to relocate becomes a realitymany families like mine have tried their luck and resettled in America.

In Pittsburgh, the largest group of refugees by far are Bhutanese refugees of Nepalese origin. In a similar pattern to older immigrant groups, my family first found refuge in affordable South Pittsburgh, then moved to the outer boroughs along the Highway 51 corridor. , you don’t have to go too far to find a grocery store, restaurant or community center that welcomes Bhutanese refugees.

depth of the problem

After hearing about individual stories for years, I wondered if the source of the suicides was rooted in our collective history as refugees. Now, at 21, I wanted to understand the context of my childhood. I learned that there was actually a higher suicide rate among Bhutanese refugees, compared to the general US population.

I also learned that suicide epidemic has followed the refugee camp community to newly resettled households in the United States. This led me to a report 2013 from the Centers for Disease Control and Prevention, which helped me realize the depth of the problem and possible causes, research which has been corroborated by a more recent study 2019 study published by Cambridge University Press.

The report details what I previously described: Bhutanese refugees express post-traumatic stress but do not receive mental health diagnoses from medical professionals.

All the stories I had heard made sense in the context of an alarming statistic. The suicide rate among Bhutanese refugees was nearly double the rate of the country as a whole, according to the 2013 CDC report.

As with other aspects of life, the pandemic has laid bare the importance of talking about mental health. In the years leading up to the pandemic, the crisis slowed, but the pandemic presented new challenges…

After confirming that the stories I heard growing up seemed to match the stats, I wanted to figure out why the problem persisted. I looked at the inequality that I had seen among Asian Americans as a block and how income gap persistence is for Nepali Americans (due to differences in migration demographic patterns) or the language barrier and the challenges it presents. Or an intersection of the two, combined with other factors.

All of this I understood implicitly, but what was made more explicit by a doctoral thesis I had recently stumbled upon were links between economic success and the ability to speak proficient English. I was lucky since the research was conducted here in Pittsburgh during the height of the crisis in late 2016 to early 2017.

The thesis also made it possible to answer another alarming question: why are there disproportionately men?

Raising families, working and acclimatizing to a new culture create barriers to accessing English lessons. These stressors would themselves make life difficult, but add to that the expectation of masculinity, and I knew that was a powerful mix. Having been raised as a man, I am aware of how American and Nepali cultures value men as “the provider,” a task that is exponentially more difficult to accomplish as a refugee. The burden of overcoming a language barrier as well as notions of masculinity are a daunting challenge.

After thinking about the research and my own experiences, I looked for the solutions to the problem. I remembered my time volunteering with the Bhutanese Community Association of Pittsburgh [BCAP] as an interpreter from the age of 16 until the start of the pandemic.

Bridging the Public Health Gap

In an effort to combat the problem, community organizations have begun to invest in mental health. BCAP, for example, recently worked to connect Bhutanese refugees to a mental health helpline and a direct line to a BCAP staff member who can help in Nepali, bypassing the barrier of language.

Seeing the need for conversation, BCAP started a mental and behavioral health program. I spoke to Madhavi Timsina, who was hired as the program coordinator in 2020, about her experiences with home visits and phone conversations with community members. She shared how valuable just providing a space to speak in Nepali was for community members.

“Most of the time they are unwilling to share their thoughts,” she said. But after a while, “they start reacting; they won’t stop because sharing their feelings will bring comfort to the spirit. She talked about taking the time to just talk to community members and discuss their needs with them, especially with the barriers put in place by the pandemic.

Just seeing organizations like BCAP engage with the community on once taboo topics has given me hope for the future.

Even before having Madhavi at the helm, executive director Kara Timsina had stressed the need for mental well-being. It shed light on the timeline of deaths and provided some much-needed optimism. He notes that there were “numerous cases” of suicide between 2010 and 2016, but that “we haven’t seen such cases in Pittsburgh for a few years now.” As a leader in the community, Timsina provided me with the context of what I had been through during what appears to be the worst of the mental health crisis.

A few months ago, the grant funding Madhavi’s work with BCAP as a full-time dedicated mental wellness staff member ended. Since no one is focusing specifically on mental health, the work will fall to BCAP’s already small staff. As with other aspects of life, the pandemic has laid bare the importance of talking about mental health. In the years leading up to the pandemic, the crisis slowed, but the pandemic presented new challenges, making the need for mental health resources more important than ever.

Avishek Acharya is a senior at Duquesne University, majoring in political science and history. He is a Bhutanese refugee and has worked as a long-term volunteer for the Bhutanese Community Association of Pittsburgh. He can be reached on Twitter @avishekwastaken and by email: [email protected].

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