“Open in Emergency” Explores the Asian American Mental Health Crisis — and Offers New Tools for Care

Lawrence-Minh Bùi Davis and Mimi Khúc reinvented the tarot deck and “hacked” the psychiatric bible to call attention to wellness and care practices in the Asian American community.

The AALR’s “Open in Emergency” box. Support the reprint on Kickstarter

After the birth of her daughter some seven years ago, Mimi Khúc developed postpartum depression. She found it nearly impossible to find mental health resources that felt both helpful and reflective of her experiences as a Vietnamese American. “I was really unsatisfied with the ways people talked about — or didn’t talk about — postpartum depression,” she says. “I was like, there has to be another way to understand why life feels really awful right now.”

Khúc, who is the managing editor of the Asian American Literary Review (AALR) and is married to the publication’s founder and editor-in-chief, Lawrence-Minh Bùi Davis, began to think about how mental health is and isn’t addressed in the Asian American community. Together, Khúc and Davis began to work on what would become the AALR’s “Open in Emergency” issue, devoted to exploring “wellness, unwellness, and care” among Asian Americans.

“Open in Emergency” was more than a bound volume of essays and articles. It included a tarot deck focused on Asian American mental health, replacing the imagery of the Major Arcana with figures and tropes that reflect the Asian American experience — the Adoptee, the Refugee, the Model Minority, the Shopkeeper — designed by artists and community members. It also included a “hacked” edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the definitive classification of psychiatric illnesses. Their version critiqued mainstream psychiatry’s erasure of the perspectives and care practices of communities of color, and included a new catalog of mental health diagnoses and prescriptions, authored by and for Asian Americans.

With help from a 2016 Kickstarter campaign, Davis and Khúc were able to print and sell the issue and donate copies to community centers and classrooms worldwide. They’ve since developed a curriculum based on it, and Khúc has traveled around the United States, teaching and speaking to students about Asian American mental health. “In the last two and a half years I’ve done 50-something talks across the country with various universities, student groups, and community orgs,” she says. “It’s been crazy, but it’s really amazing to have these conversations that people are seemingly really hungry to have, and to give them new tools and new ways of talking about mental health.”

Now, Davis and Khúc are back on Kickstarter to reprint “Open in Emergency”, including seven new tarot cards that address disability and environmental justice, among other themes.

As they prepared to launch the new campaign, we caught up with them to learn more about the issue’s history and how it’s been received in the community.

— Rebecca Hiscott

Mimi Khúc and Lawrence-Minh Bùi Davis

Kickstarter: What motivated you to create the AALR’s “Open in Emergency” issue?

Mimi Khúc: I started thinking about mental health because of my own mental health issues after having my daughter about seven and a half years ago. I started thinking about what kinds of different frameworks would help me better understand this experience of why motherhood feels so hard.

From there, Lawrence and I got together and thought, if [the AALR] were to do something on mental health, what would that need to look like? What kinds of questions would we want to ask, and who would need to be involved? We decided to stage a set of “dreaming sessions” with various community members. We wanted to engage in a kind of community curation process, so it wasn’t just me figuring out what we should do, or Lawrence figuring out what we should do, but asking other Asian Americans about their experiences around mental health. We did this for three years.

Lawrence-Minh Bùi Davis: Some of this also comes out of our experiences as teachers, working with a lot of Asian American students and young people. They became one of the dreaming session groups over time. We already knew that Asian American students were suffering.

Khúc: They have the highest rates of suicidal ideation among all college students.

Davis: And that’s borne out in basic anecdotal experience and conversations with them: Life feels unlivable for many young Asian American students. And what we found is that there is a hunger for resources. It exists across the board, but I think it was announced to us most directly by students — students being able to articulate that they were hurting and that they wanted help, needed help, and wanted care.

There’s an idea that there’s a stigma about mental health and nobody talks about it, particularly in communities of color. That historically has been true, but we’re finding that that’s not uniform. Particularly with younger generations, there’s an increasing demand for resources and an increasing demand to look at why they’re suffering, and to understand it and to try and address it in meaningful ways.

Our project grew out of listening to that desire and wanting to honor it and amplify it. In the course of these dreaming sessions with students and with other communities, [we saw] that there were really important diagnoses of what’s hurting that didn’t exist in many standard mental health apparatuses. And also that what counts is care, and what is actually helping people, what is sustaining people, isn’t always labeled as such.

So “Open in Emergency” was about listing those things — not inventing care practices out of thin air, but gathering together what has been working for some time in our communities, but is maybe not recognized as working.

AALR pamphlet on postpartum depression

Is that how you landed on the idea of creating a “hacked” DSM?

Khúc: Yes. The hacked DSM was a way for us to think about diagnosis and prescription in a very different way. The traditional DSM is a psychiatric bible that lists out all the different diagnoses and symptoms and various treatments. We thought, what if we allowed Asian Americans to diagnose their own suffering? What would it look like to have a DSM written by Asian Americans, for Asian Americans, about Asian American life, by those who aren’t normally thought of as authorities in mental health? Artists, humanities scholars, writers, survivors, community organizers — people who we don’t usually think of as the ones who would be able to diagnose [mental health issues]. What if we authorized them to do that and allowed them to tell us what hurts and how we can make it better?

Davis: It was important for us to use the frame of the DSM and say it was “hacked” to acknowledge the ways in which existing structures — even as they are intended to be helpful, and are helpful and meaningful — can often be limiting and damaging.

So many of the [care practices] we are gathering are delegitimized by the DSM — delegitimized by psychology as not scientific, not coming out of academic study, and therefore not valid. We wanted to challenge that. The fact that it doesn’t come out of this particular body of knowledge, this particular field, or this particular industry, does not automatically invalidate it.

It’s important to recognize the damage that it does to automatically make that large-scale assumption. It’s necessary, as we are rethinking wellness and unwellness, to challenge existing norms and challenge a system that automatically deprivileges certain kinds of knowledge-making and certain communities’ ways of thinking about care and wellness. What if we treat [our communities] as authorities about their own bodies and feelings and experiences and histories? What if we give them the credit, authority, and license to talk about what they think their care might look like?

“What if we treat [our communities] as authorities about their own bodies and feelings and experiences and histories?”
Artist-designed cards from the AALR tarot deck

The tarot deck is a very different approach to mental health than the hacked DSM. Why create a mental health tarot deck?

Khúc: Yeah, the tarot deck is very different. The DSM more directly engages mental health. When we were first talking about the tarot cards, people were like, “What does that have to do with mental health?” Because they understand tarot cards as divination, as fortune-telling. And what does fortune telling-have to do with mental health? We actually think it has quite a bit to do with it.

Lawrence and I go to an annual conference where Asian American studies scholars get together and share their research. One year a friend of ours, during downtime after sessions, whipped out a deck of tarot cards and started doing tarot readings for people. Lawrence and I watched as he told people’s fortunes, as he had conversations about their experiences, their suffering, their futures. And we saw how meaningful this was for people, the kind of community space it was creating. We were like, something is going on here. This is a way of engaging our life that is dismissed among scientific thinkers.

We thought, what if we took the tarot and made it for Asian Americans, by Asian Americans? Using Asian American categories instead of European ones to make them more relevant to our communities, but also to draw on Asian American studies frameworks of understanding what Asian American life actually looks like. Could this create a new kind of wellness practice?

Davis: All of the tarot decks [we see today] are grappling with wellness and unwellness, at least indirectly. I think that in some ways the decks come out of this need to address the cultural moment that we’re in. There’s a real power to this form. It feels really empowering to be able to tailor and shift it according to the needs and wants of the community.

The practice also opens that power up to everyone who takes part in it because it’s so interpretive and requires this participation and connection. They are able to enter into this practice and create new practices of their own. To use the cards when and where and how it feels meaningful to them. In that interpretive ambiguity, that space of possibility, there’s so much potential for care, and for a kind of self-determination that people are really excited about.

From the AALR tarot deck

Have there been any responses to “Open in Emergency” that have really stuck with you?

Khúc: I’ve gotten responses from students who are engaging with it in the classroom; I taught the whole issue in my own class on Asian American mental health. The students were mesmerized by the project and the kinds of conversations it was opening up for them.

I remember a student, she was a psychology major and this was her senior year, saying that in all her years in psychology she had never heard anyone talk about mental health with such compassion and with such dignity for those who are experiencing mental health issues. That was so meaningful to me. And I’ve had people write to me saying that they’ve never seen themselves reflected in mental health materials before. To get resources that actually gave them tools to understand their lives was mind-blowing to them.

Davis: There were also two Asian American dancers named Amanda Ng Yann Chwen and Maddy Mikami who put together a dance film inspired by the [tarot] cards. That was really lovely to see and watch. Having it go out in the world in these unexpected places and seeing how people make use of it and make it their own has been really moving and powerful. It makes us feel like this project was worth doing. And worth, now that it’s sold out and we are no longer able to send it to people who need it, being able to recreate it and reproduce it, and send it out in the world again.