“一下子，我觉得自己不舒服了，晚上睡不着，白天也吃不好，当时，我一下子瘦了九斤。”

来自中国上海的贾月娟与先生余乐群一起，和自己的女儿、女婿、外孙居住。去年三月初，新冠疫情来袭，她感到异常紧张：“我听了许多关于疫情的消息，觉得很紧张，害怕染病。” 到了四、五月，随着疫情越来越严峻，贾月娟感到更加紧张了，这种担心的感觉，甚至影响到了身体健康、影响到了日常生活：“我晚上睡不着，总觉得自己发烧了，我在枕头边上放了量体温的体温计，时不时就要量一下，但我也不敢告诉家人，怕他们担心。”虽然贾月娟不说，但其实她的变化，家人能够明显地感觉到。她的先生余乐群回忆那段时间，自己的妻子非常紧张：“如果来了个快递、或者是什么人，她就紧张得一塌糊涂。我们安慰她，似乎也没什么用。”

贾月娟的经历，也可能是许多长者在新冠疫情中的共同经历。根据美国疾控中心的相关报告，40%的美国人在疫情中经历了精神健康危机。“在2020年至少有4万新增的焦虑、抑郁病例，而其中70%的病例原因是隔离。”纽约市卫生局公共资讯发言人宋怡帧透露，纽约市卫生局的报告中也显示，2020年5月，44%的纽约市成年人，出现于covid-19相关的焦虑症状，相当多人出现抑郁症的症状，这些因素让很多成年人处于罹患心理疾病的高风险中。

“疫情开始之后，一个明显的感受就是，焦虑、抑郁的病患增加了。”王家廉社区医疗中心的精神科医生陆小春说：“特别是我们亚裔的长者，在疫情前，有许多老人中心，社会的支持，让他们能够出去走走，参加各种活动，但是疫情以来，他们只能待在家里。”加上年长者一旦获患新冠，致死率高于其他年龄层人群，这也更加令年长者感到恐惧，带来精神压力。“以前都是好好的，没有任何问题，现在出现严重的焦虑，睡不着觉。”

姚虹和八十多岁的父母住在一起，疫情前，父母每周有五、六天会去老人中心，从早上七点就有车来接，在中心吃早饭、午饭，和老朋友们谈天，做一些运动，然后下午回家。“去年三月听说有疫情，一开始老人中心还没有关闭，我父母还是坚持去，但我的两个儿女已经在家，就说为什么他们还去啊。”姚虹回忆道：“后来老人中心关闭前一周开始，我父母没有再去了，后来听说确实老人中心的司机和负责人都有染病……”不出门确实降低风险，但是父母却没有了和朋友交流的机会。“一开始老人中心还把电脑课等课程搬上网，但后来有很多问题。”姚虹说很多时候连自己都无法帮助父母解决电脑方面的技术问题：“后来政府也关闭之后，就停了，几乎有一年多没有消息。”姚虹也说，谁也没有料到疫情持续时间如此之久：“时间一长，就有点无聊了。”老人在家运动减少了，原本可以自己行走的距离，现在也不得不依靠助步器，交流减少了，她发现母亲的听力也有严重的下降。身体机能的退化，也给精神健康带来影响。

“确实身体健康，我们有明确的测量指标，但是精神健康，我们没有相同的指标，那我们靠什么来判断呢？就是从功能上判断。”有着多年精神科治疗经验的陆小春医生说：“我们精神科医生是靠了解病患日常生活的各项功能是否能正常发挥，来进行判断的。比如精神是否稳定、作息起居是否有很大的变化：睡不着觉，就是很重要的一个指标；或者是吃不下饭。这些变化都是很明显的，家人如果观察到老人有这样的变化，就应该联系家庭医生，来进行一个初步的诊断。”

SOMOS医疗联盟主席、长期在华人社区行医的家庭医生陈治年说，疫情开始以来，已经接触到大量出现精神健康状况的长者。“我们遇到一种很常见的情况，是一开始就说，我是来体检的，但当我们进一步了解情况时，他们有时候就哭了，然后开始说怎么晚上睡不着。”陈治年医生坦言，在华裔社区，精神科医生很缺乏，特别是能够说中文、广东话、福州话的医生更少了，而精神科本身是需要通过交谈来判断和治疗的，因此许多时候，家庭医生扮演了“半个精神科医生”的角色：“我们首先来了解情况，安慰他们，解决一些问题。如果有轻微症状，我们会开一些比较轻微的镇定、或者是抗抑郁、或者是安眠类的药物，帮助他们度过难关。如果复诊再来，还是不行的话，我们就要转介他们去精神科医生那里。”

“过去，亚裔社区很长时间，都是不太谈起精神健康的话题的，对精神健康的认知也比较低，但最近几年有明显的好转。”纽约市卫生局公共资讯发言人宋怡帧说，2018年开始，纽约市卫生局开始在华裔社区普及精神健康知识。“疫情开始之后，我们特别设计推出了名为‘疫情中的社区对话’ （COVID-19 Community Conversation）的线上讲座，从7月开始第一场讲座至今已经举办了超过50场，提供精神健康相关知识，以普通话、广东话讲解，就是特别考虑到社区的长者群体。”

“对待糖尿病、高血压等身体健康疾病，许多人会去学习相关知识，改变生活习惯，去缓解或者是降低患病风险。”宋怡帧说：“其实精神健康也是一样的，需要去学习、了解相关知识。因为在当今的社会，不谈论精神健康的话，其实健康是不存在的。”

编者按：

五月是亚裔传统月，也是精神健康宣传月。在美国老年学会，代际记者联盟，银发世纪基金会

（The Gerontological Society of America, The Journalists Network on Generations and the Silver Century Foundation）赞助的系列节目中，我们特别关注在过去一年的疫情里，亚裔老人的精神健康经历了怎样的危机，同时，一起寻找如何获得各方的帮助，像保护我们的身体健康一样，守护我的精神健康。

Mental Health of Asian Elderly in the Pandemic: Facing the Mental Health Crisis

"All of suddenly, I felt sick. I couldn't sleep at night and didn't eat well during the day. At that time, I lost almost ten pounds at once."

Yuejuan Jia, originally from Shanghai, China, lives with her husband, her daughter, son-in-law, and grandson. At the beginning of March last year, when the pandemic hit, Yuejuan felt extremely nervous: "I heard a lot about COVID-19. I felt very nervous and afraid of catching the virus." In April and May, as the pandemic was getting worse, Yuejuan felt more nervous. This feeling of worrisome even affects her physical health. "I can’t sleep at night and always feel like I was have a fever. I put a thermometer on the side of my pillow to take temperature from time to time. I didn’t tell my family, I don’t want them to worry about me." Although Yuejuan didn't say it,  her family could clearly seel her changes. Her husband, Lequn Yu, recalled that during that time, he noticed her wife’s mental stress and don’t know how to help her: "She was easily getting nervous during the day whenever there was a visitor or a delivery. I tried very hard to comfort her, but seems useless."

Yuejuan's experience may also be the common experience of many people during the pandemic. According to a report from the US Centers for Disease Control and Prevention, 40% US adults have experienced a mental health crisis during the pandemic. "There were more than 40,000 cases of anxiety and depression in 2020, and over 70% in all cases was caused by isolation." Echo Song, Public Information Speaker of Division of Mental Hygiene, Department of Health and Mental Hygiene, revealed that in a NYC Health Opinion Poll from May 2020, 44% of NYC adults reported symptoms of anxiety related to COVID-19;and many report symptoms of

depression. These factors put many adults at high risk of developing mental illness.

"Since the beginning of the pandemic, we’ve seen a rapid increase in patients diagnosed with anxiety and depression." Dr. Xiaochun Lu, a psychiatrist in Chalse B. Wang Community Medical Center, said: " There used to be many senior centers in the metropolitan area of New York. For many Asian elderly, Senior Centers played an important role in their social lives. But since the pandemic, the centers closed down and seniors had to stay at home.” In addition, seniors are at higher risk of serious illness if infected, which brings them even more mental stress. "Lots of patients would have no history of mental wellbeing issues, but are now experiencing serious anxiety and loss of sleep. "

Hong Yao lives with her parents who are both in their 80s. Before the pandemic, her parents would go to the elderly center five or six days a week. Every morning around 7 o’clock, a car from the senior center pick them up, then they enjoy their breakfast and lunch at the center with old friends. After chatting, doing some exercise and activities, they go home in the afternoon. "We heard a lot about the pandemic in March last year. Since the elderly center was still open, my parents insisted on going there. My two children were already at home, they often questioned why the grandparents were still going out." Hong recalled: "My parents stopped going to the senior center a week before they closed. The senior center called and informed us that they closed. Only later, we learned that their driver and the staff all had COVID-19.” Not going out does reduce the risk, but Hong’s parents did not have the opportunity to communicate with friends. "At first the senior center tried to continue some of the activities online. But quickly ran into a lot of issues. " Yao Hong said that many times he couldn't even help his parents solve technical problems with computers: "When the government closed down, senior centers also followed suit, the online activities paused for almost a year. Boredom started creeping in as the pandemic dragged along." 

"There are indeed little specific metrics or criteria in the mental health. How do we properly measure the mental wellbeing?" Dr. Xiaochun Lu, who served the Chinese American community for many years as a psychiatrist, explained: "  We often resort to looking at the functions. For example, emotional instability or changes in behavior. These changes are very obvious. If you notice that your family members or seniors are experiencing or lost appetite, if you notice these two changes, the first person you can call for help is your primary care doctor."

Dr. Henry Chen, the President of SOMOS Community Care and a primary care doctor who served the Chinese community for more than twenty years, said that since the beginning of the pandemic, he has seen a large number of elderly people suffered from mental health issues. "We encountered a very common situation. The patients were coming for physical examinations, but started sobbing when we asked in details.And then they would start to tell you they can’t fall asleep during the night." Dr. Chen mentioned that  in the Chinese community, there is a shortage of psychiatrists. And even fewer can speak Chinese, Cantonese, and Fuzhou dialect, while psychiatrists highly depends on language in diagnoses and treatments. Therefore, in many cases, primary care doctors play a role of "half psychiatrists": "We are not professional psychiatrists, but we are the first doctors who communicate and treat the patients. I will talk to them and try to solve some problems. If the symptom is mild, we can prescribe some light medication, to help them overcome the diffcuilties. If it doesn’t work, we will refer the patient to a psychiatrist.”

"Usually, we don’t talk about mental health issues in Asian communities, and the awareness of mental health was relatively low, but in recent years there has been a significant improvement." Echo Song said that since 2018, Division of Mental Hygiene, Department of Health and Mental Hygiene launched several programs to rise the awareness of mental health in Chinese communities. "Espeically during the pandemic, we designed and launched an online seminar called COVID-19 Community Conversation. Since our first session on July 1st, 2020, we’ve hosted more than 50 presentations in Cantonese and Mandarin, with special consideration for the elderly in our community."

"Suppose when we are dealing with diabetes, it is common to read and learn a lot about the disease, to prevent or lower the risk of getting diabetes. Our reaction should be the same towards mental health diseases. " Echo said: "Today, it is impossible to talk about health without mentioning mental health. There is no health without mental health.”

Editor's words:

May is Asian Heritage Month and Mental Health Awareness Month. We launched our special programs paying attention to the crisis in the mental health of Asian elderly people during the COVID pandemic in the past year. The program is sponsored by The Gerontological Society of America, The Journalists Network on Generations and the Silver Century Foundation. We hope to promote the mental health while call for more attention to the equal access to the mental health resources.