Schizophrenic, suicidal, bipolar, delusional, and depressed. In her 28-year career treating Berkeley’s mentally ill, Chia-Chia Chien MSW, MPH ’74, saw it all.
But the most distressing cases for Chien, the city’s first Asian psychiatric social worker, involved patients who delayed getting help until they were in deep psychiatric tailspins. Many of them were Asian. “It was just a cultural stigma” to acknowledge mental illness, says Chien, a Chinese immigrant who came to the United States for graduate studies in 1970. “People don’t want people to know.”
The patients who eventually landed in Chien’s office were clearly in trouble. Among a hornet’s nest of problems, they might be hearing voices, experiencing paranoia, or at risk of harming themselves or others.
Alarmed by the consequences of shrouding the reality of mental illness—Chien notes that Asian American women have the highest suicide rate among women over 65 in this country—she wasn’t willing to sit idly by.
In 2001, she founded the Culture to Culture Foundation, an organization dedicated to shattering the barriers that prevent many Asians from getting psychiatric care—and committed to increasing the number of bilingual and bicultural mental health professionals in the Bay Area. “We wanted people to know that seeking help is nothing to be ashamed of,” says Chien, who earned a BA in sociology from Tunghai University in Taiwan and an MSW. from the University of Illinois at Urbana-Champaign before arriving at the School of Public Health in 1973.
Now retired from her city job, Chien runs her nonprofit as a fulltime labor of love. Her base of operations is an airy office in her suburban home in Alamo, California. Reflecting on her clinical practice at Berkeley’s Mental Health Division, she says “so many cases illustrated the need for Culture to Culture.”
In creating Culture to Culture, Chien launched a characteristically ambitious—and successful—plan of attack.
She sponsored educational seminars—an estimated 50 in all—throughout the Bay Area, intended to shine a bright light on mental illness and the importance of early intervention. Panels of bilingual therapists gave advice, often fielding questions written anonymously on slips of paper. With heavy fanfare from the Chinese language media, the events drew as many as 200 participants at a time. One of the most powerful gatherings was a talk by the family of acclaimed Bay Area author Iris Chang, who wrote the bestseller The Rape of Nanking. Chang had committed suicide the previous November at the age of 36.
Though in mourning, Ying-Ying Chang, Iris’s mother, said her family “decided it was a good idea if we could go help the community.” Chang believes the stigma of mental illness cuts across many cultures and thinks mental problems should be treated like such conditions as diabetes or heart disease. “You should open up and talk,” says the retired biochemist. “The important thing is to have family, relatives, and your community support you.”
Concerned that people may not know where to go for help, Culture to Culture and its network of bilingual mental health professionals published a directory of mental health resources in the Bay Area and a set of bilingual questions and answers. For several years, the organization ran a mental health hotline serving the local Asian community.
Today, dozens of Contra Costa seniors participate in free exercise classes, mahjong, and other activities organized by Chien and her corps of volunteers.
From past trial-and-error, Chien knows that clients often shy away from activities that bear a psychiatric or counseling label. “If I said ‘mental health,’ no one wanted to see me,” says Chien. At the Danville Town Meeting Hall each Wednesday morning, the exercise classes draw an enthusiastic crowd. “Some seniors tell me they always wait for this day,” says Chien, who leads a lively session in the Chinese exercise discipline of Luk Tung Kuen.
Participants include immigrants who might otherwise face language and cultural isolation. “We’re able to serve all seniors from all ethnicities,” says Chien, who greets attendees by name and invites them to count out exercise reps in Farsi, Japanese, Mandarin, and other native tongues.
“I wanted something to keep busy and not just vegetate,” says Champa Kripalani, a 74-year-old retired office worker who moved to the United States from India in 1984. Kripalani, a regular at Culture to Culture-sponsored classes, says, “Everybody’s a happy camper here. Chia-Chia has created a wonderful atmosphere.”
After back-to-back exercise classes, many head off to their afternoon mahjong game, also led by Chien.
Barbara Smith, former chair of the John Muir/Mt. Diablo Community Health Fund, says the loneliness endured by many elderly immigrants “wasn’t on our radar” until Chien approached the board for funding several years ago. “She was just determined she’d be a lifeline to those people so they’d feel connected to their country, and she’s done that,” Smith says. Today, Smith helps Culture to Culture with yearly prizes honoring outstanding senior volunteers in Contra Costa County. “She’s a pistol,” Smith says of Chien. “Nothing is going to stop her when she sees a need.”
That’s a common sentiment among those who know Chien. “I see Chia-Chia as a mental health heroine in the Chinese community,” says Wing Tse, a 33-year-old San Francisco man who suffered a mental breakdown in 1998. Tse now does mental health work at San Francisco General Hospital and is earning a college degree. In 2008, he became the first recipient of a Culture to Culture “Mental Health Warrior Award” recognizing people who have triumphed over mental illness. Culture to Culture also bestows annual scholarships to students pursuing mental health careers aimed at serving Chinese communities.
“I see Chia-Chia as a mental health heroine in the Chinese community.”
Chien credits a college entrance exam in her native Taiwan with steering her career path. “I took the exam and was assigned to go to the college for social work,” she explains. A seminal experience came when Chien did medical-social field work at a rural Taiwanese hospital. Facing language and cultural differences of her own, Chien was challenged but nonetheless inspired. “Not many people were in social work, and people needed help,” she recalls.
After earning her bachelor’s degree, she headed to Illinois for her MSW. and spent a year doing psychiatric social work at a state hospital. Chien hoped to advance her training and concluded that the best place to do that was at the School of Public Health. “People love Berkeley, and I wanted to go west,” she says.
At Berkeley, Chien met David Ying Chien, a young doctoral student in biophysics who had grown up in the same Taipei neighborhood. The two wed shortly after Chia-Chia’s graduation and lived in Albany Village’s married student housing while David worked toward his PhD, which he earned in 1978. Those were particularly happy times. “Everybody there was a poor student, but nobody felt poor,” she recalls.
David Chien, recently retired as a senior research director at Novartis Vaccines and Diagnostics, frequently rolls up his sleeves for Culture to Culture events. The couple has two grown daughters, Jo Chien-Meek, an oncologist at UCSF, and Shiao Chien Lee, a Berkeley Law graduate working for a New York-based nonprofit
In recognition of her tireless efforts, Chien has garnered a string of accolades. They include the 2005 Peter E. Haas Public Service Award from UC Berkeley, a 2008 Purpose Prize Fellowship, and a 2009 Lifetime Achievement Award in Social Work from the National Association of Social Workers.
“All my career, I didn’t do anything but mental health,” Chien says. And she has no plans to veer from that trajectory. “I still have a big energy and passion. Culture to Culture is my baby, and I want to see the baby grow.”