Note from Author:
After extensively researching on suicide stigma, particularly on how it affects those with suicide ideation and suicide survivors, I felt compelled to dedicate my final project to those who struggle with suicide but most importantly with stigma. As an Asian and American, I have experienced varying scales of suicide stigma, both before my first and only attempt as well as after. While there is a difference in terms of how taboo mental health is in Hong Kong/East Asia compared to the United States, suicide is considered a serious mental issue that has many misconceptions and lack of understanding as well as awareness. Being Asian surrounded by similar racial groups, I have consistently faced stigmatization that remains problematic, as have my peers and friends.
Even though I grew up traditionally East Asian/Chinese/Cantonese, I have also developed many characteristics and cultural likings during the second half of my life, which has resulted in my evolving identity, yet the perspectives of those that only grew up traditionally East Asian and research in those countries is pretty similar to mine. I hope everyone who reads through this zine take away at least one thing – suicide ideation, suicide struggles and mental health recovery is a very lonely experience; it is important to never generalize anyone’s experience in this realm.
The “tattoos” (henna and sharpies were used in the photos) of the semicolon represent how I feel it oversimplifies the experiences of suicide ideation and suicide survivors. The semicolon is used as a message of affirmation and solidarity with those that have dealt with suicide and other mental health issues. It is a symbol used when the writer could have chosen to end the sentence, but chose not to – similar to how the person could have ended the life, but chose not to.
Similar to how being East Asian and Chinese is different for everyone, people’s experience is more varied and unique to each person and is a multifaceted issue. Part of the foundation of suicide stigma, specifically for East Asian and Chinese, is due to how we have generalized the suicide ideation and suicidal experience. To me, the semicolon is simply not enough to represent such a complex experience, journey and feeling, rather it perpetuates and powers the suicide stigma. By breaking down the semicolon, I created various symbols much like how my experience and my peers’ experiences are unique, offering a better representation to the myriad of people who choses everyday to live.
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Contributors:
Samantha Kuo
Miki Kainuma
Margaret Kuo
Kylie Moeller
Megan Horey
Tiffany Cheng
Arshdeep Kaur
Abby Ong
Henry Hong
Elizabeth Farlow
Thank You
This project wouldn’t have been possible without my contributors and volunteers, but most importantly for Dr. Carter. To be given space and resources to do this intense and personal research as well as turning it into a creative project is such a privilege. Thank you. I want to thank all my friends and supporters who rushed to help with my late-night photoshoots, to carving out time in their busy schedules, and to replying to my emergency texts (shout out to Miki who was fully onboard from Day 1, even though she isn’t a Yale affiliate), this project and my healing would have never happened without all of you. I want to thank Trudy from the hospital – you are a real inspiration. I want to thank Elaine Cheng – thank you for loving me unconditionally, but also picking up the phone that one time; I still think about that moment every day. I want to thank Dr. Laura Twersky and Dr. Aryeh Goldberg for being the best mental health team – you both taught me what it means to have a team that wants the best for you; I wouldn’t be here today without both of you. I want to thank my yaya – I love you so much. I want to thank my sister, Stefani Kuo, for being my role model and inspiration – you are my anchor. I also want to give thanks to my parents, Shirley Lin and Stanford Kuo – our relationship is far from perfect and there is a long way to go, but thank you for my life and for every opportunity I have been given. You both are always trying to do better, even if it seems like it’s not enough. I am immensely grateful. Lastly, I want to dedicate this project to my late sister and my guardian, Stacey Kuo. I have always felt deep regret and shame for my suicide ideation because I got to live and you didn’t. This project is an indication that everything happens for a reason, so thank you for being such an important part of my life, Stacey. I continue to live to my fullest and feel such great pride in all the good and the bad because of you. Thank you.
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My Favorite Number
My favorite number growing up was 14. It was my first class number, because K always landed me in the tens in the midst of the Chen’s and Chan’s. My fondness of that number was my first secret, because 4 is a terrible number in Asia. In almost every elevator, there was not a single floor that contained the number 4. 4 in Chinese meant death, and the Chinese are so superstitious that even saying a word that resembles death was a no no. Perhaps that’s why my fondness for the number 14 grew more and more. Like it was a forbidden love.
My love for the number 4 quickly fell apart. The same year I received my first class number, my parents got divorced in 2004. Suddenly, my home started falling apart piece by piece. From a happy family of 5, my mom left the original family house, where the 3 children were being bussed back and forth from a mere 15 minutes of distance every 2 weeks. Exactly 4 years later, in 2008, my sister announced that she was going to go to boarding school, my dad’s alma mater. In 2010, my youngest sister passed away in a car accident when we were on the way to go skiing in Japan for Christmas. At the age of 12 years old, I was sent to therapy at my church by my parents. My parents never asked how I was doing and if I understood what was going on. They asked if I wanted to go to therapy. I said “No, I want to go play with my friends and lay in bed (like any prepubescent teen).” I didn’t realize that this wasn’t my choice. Next thing, I was sitting every Sunday at 10am in front of my first therapist of many, Jackie. Within 4 months, my divorced parents were in the same room as Jackie and me to discuss their parenting and a proper allowance. I was furious at Jackie because she was destroying every bit of life that remained for me. As they say, “If it ain’t broke, don’t fix it.”
4 years passed since my sister passed away, and our family went from this searing image of all the kids on my parents’ lap, so joyful with our Christmas hats. I sat on my dorm bed that was holstered up so high to fit all my clothes. I peered out the window as I watched the sunset, and my friends just left our dorm to have a fun Friday night together. I stayed back, not because I didn’t like my friends. I thought I was depressed, but that day was my first encounter with suicidal thoughts. I had just experienced my first heartbreak. It was like the kind of heartbreak mothers warn their daughters about. It was the heartbreak that Taylor Swift has written about countless number of times. It was the kind of heartbreak where I should have listened to “Unwritten” by Natasha Bedingfield. At the age of 15, I did think that he was the only boy that I would ever love, and that we were meant to get married. I had just lost the love of my life. Even though 4
the nice boy, who had never left the country or owned a passport and whose favorite dish was pasta with no sauce, was not compatible with me. But this heartbreak, that was supposed to last half the time we dated for, according to Yahoo Answers, revealed the crumbling foundation of my mental state. What went from grieving over my first love turned into seasonal depression which turned into utter emptiness. And the start of my 10-year tango with suicide began.
I filled that emptiness with every possible thing for the next 6 years. From partying in college and saying yes to more experiences to devoting every bit of myself to my career, sacrificing the few moments where all my college friends and I would be together, to transforming myself to be the most viable wife that my now ex-boyfriend could ever imagine, I spent 10 years “discovering myself” where I looked outwardly rather from within.
Now, sitting in my East Rock apartment, comfortable in my fuzzy white bath robe, 10 years has passed since my first suicidal encounter. I have been in mental health recovery for some time.
The first step was to be as far from being readmitted to the hospital and having another attempt, but that also requires having the support, kindness and empathy from those around me. Unfortunately, stigma has prevented that, and so while the second step was being more comfortable with this part of my past, while I worked on my recovery, I had to also juggle being as open and vulnerable to help others empathize with me. I truly understood that recovery is never linear and that I will never know when the end of my recovery journey will be or if there will ever be one.
Post-coming out of the hospital, my traditional family made no attempts to reflect on how they could best help me or how they have indirectly contributed to the state of my mental health. My mother still calls me “crazy”, “insane”, “manic”, etc., whenever I accomplish anything great. My dad tells me that I am very capable, yet constantly tells me to ask for help and that I shouldn’t attempt many tough challenges – his lack of confidence shows how he treats my sister and I differently because the stigma often involves blaming the survivor instead of the circumstance.
I think the worst of all the stigmas is my ex-romantic partner. While I was recovering and doing my best to stay out of the hospital, he would weaponize my suicide. Although he encouraged me to distance myself from my mom as I tried to grow stronger, whenever he and I would fight, he would reach out to my mom and feed into her argument that I am weaponizing my suicide and that I used it to manipulate others. He once even told me that I couldn’t possibly be suicidal or else I would have
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successfully killed myself. I slowly noticed myself concealing my thoughts and issues, because I feared the stigma from my family and him as well, therefore I feared what my friends and the public thought – it must have been the same as them.
As I dedicate my career and life to advocating for those with suicide ideation and with suicide trauma as well as destigmatization against this group, I have encountered and bonded with those with similar experiences. Every single one of us feels similarly and hopes to make the world feel less lonely, but at the same time, we each have unique experiences, feel somewhat differently, and are at varying stages of recovery/journey. This is why the semicolon is not representative of my story.
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More than a Mark
(Set in a small, sunlit garden in the back of the Yale School of Management at 165 Whitney Avenue in New Haven, CT. Penny and Sally sit on a bench surrounded by blooming flowers, a gentle breeze stirring the air. Each holds a cup of tea.)
PENNY: (holding up her wrist, contemplative) I’ve been thinking about getting a semicolon tattoo here. It feels like it would be a reminder to pause and keep going when things get tough. Plus, it might help others who see it feel less alone.
SALLY: (smiling gently, then the smile slowly fades) I understand the sentiment, Penny, but why do you think it is a good symbol for what you’ve been through? Doesn’t it feel like it would simplify everything? Our stories and experiences are so complex and so personal. A semicolon couldn’t possibly capture all that, could it?
PENNY: (pauses for a second) I guess I see it as more of a conversation starter, a way to connect with others. But I do see your point about simplification.
SALLY: (carefully choosing her words) And isn’t there a concern for privacy? When you wear such a visible symbol of your struggles, you open yourself up. Not just to support, but to also be judged and subject yourself to stigma, especially here (points to the general area but emphasizes the school building), where mental health isn’t openly discussed and is so taboo.
PENNY: (nodding, slightly frowning) That’s true. It could make vulnerable moments even more challenging.
SALLY: Exactly. And while symbols like the pink ribbon for breast cancer awareness do unify people, they also create a sort of expectation. Everyone’s battle is different, and sometimes these symbols can lead others to expect your story to fit a certain narrative. Your journey, your survival—it’s unique to you.
PENNY: (pausing, looking down at her wrist) I hadn’t thought about it that way. The pressure to live up to the symbol, even on days when I feel far from strong.
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SALLY: (reaching out, touching Penny’s hand) It’s okay to just be you, without a symbol. You’re not alone because of a lack of a tattoo; you’re supported because of who you are and the strength you carry inside. We can find other ways to reach out, to share our stories in our own words.
PENNY: (squeezing Sally’s hand, grateful) You’re right, Sally. Maybe it’s enough to find strength in our own ways, without making it visible for everyone else to interpret.
SALLY: (smiling warmly) Let’s keep our stories ours. We can support each other by just listening and being present, not by wearing our past for the world to see and judge.
PENNY: Our stories are just more than just a pause; they’re about everything that comes after, and how we choose to continue.
(They sit together in comfortable silence, the garden around them a reminder of growth and renewal, their conversation a bridge to deeper understanding.)
SALLY: And every day, we get to decide how our stories unfold, with or without marks.
PENNY: (smiling) With or without marks.
(The scene fades out as they continue their conversation. It pans to show the solar eclipse.)
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Ode to the Silent Journey
O to the hushed voyages of the mind, Where shadows cling in quiet desperation. Through the dense mists of stigma unkind, A search for solace in a restless nation.
In every heart, there’s a hidden cry, Veiled by the smiles in the bustling crowd. The quiet strength that Asian spirits ply, Beneath the weight of cultural shrouds.
O brave souls tread through silent fears, Where the echoes of judgment harshly sound. Seeking help in the vale of secret tears, In whispered truths, profound hope is found.
For each step taken in the quest to heal, Breaks the chains of silence with steadfast zeal. Through the dense terrains of mental strife, They carve a path for a healthier life.
O honor the courage that comes with the dawn, Of minds that seek to understand and mend. In unity and support, they’re drawn, With every outreach, a hand to lend.
Thus, let us sing of the journeys made, In seeking aid where shadows fade. For in the quest of mental grace, Lies the strength of the human race.
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The Balancing Act
Jenny always felt like she was walking a delicate tightrope between two skyscrapers – her academic aspirations and her emotional wellbeing. There was immense cultural pressure to succeed. Her immigrant parents worked tirelessly to give her opportunities, which often reminded her of the sacrifices made for her education. “We did all this for you, Jenny,” her father would say, his voice mixed with pride and expectation.
At school, her classmates seemed to effortlessly juggle assignments, social lives, and personal projects, while she always felt overwhelmed, and her thoughts were always close to despair. Her mental health deteriorated the most during her sophomore year. Deadlines that she would have met easily before just felt like impossible tasks. Sleep became elusive and her joy in her studies completely vanished. Yet, she kept these feelings to herself, fearful to appear ungrateful or weak.
One evening, confined to her small apartment, the walls felt like they were closing in. Papers and textbooks lay scattered around her, a physical manifestation of her internal chaos. She thought about the recent study session where her friends openly discussed the pressures of college life and using university counseling resources to seek help. Unlike her, they didn’t seem or feel ashamed. Why was it so hard for her to admit she needed help?
Her phone buzzed, a message from her classmate, Emily: “Hey, just checking in. You left the study group pretty quickly. Everything okay?” Feeling the tightrope swaying underneath her, Jenny’s fingers hovered over the keyboard while she stared at the message for what seemed like an eternity. Taking a deep breath, she typed a response she’d never dared to before: “Actually, could we talk? I think I might need some help.” She felt like she just stepped into the unknown. The following day, Jenny met with Emily, who listened without judgment. She spoke of the pressures, the loneliness, and the fear. It was terrifying and liberating all at once. Emily suggested they go together to the counseling center.
Walking into the counseling center, Jenny felt the tightrope beneath her slowly transformed into a path or a bridge—she could walk with more confidence. The skyscrapers still loomed, but the path felt steadier with each step forward, supported by empathy and compassion, rather than a thin wire that used to be her own internal thoughts. At that moment, Jenny realized that asking for help didn’t mean she was failing—it meant she was doing her best to find her balance.
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Whispers of the Unseen
In crowded spaces, whispers hide Winding through the streets, side by side
A tale seldom spoken, yet vividly heard In the silent anguish of every word
Under the glow of the city’s light Secrets nestle in the blanket of night Faces pass, a streaming guise
Carrying burdens, veiled from eyes
A whisper of despair, a muted plea
Chains of stigma, a longing to be free
Where judgment casts a shadow, stark and gray And the vibrant soul’s hues bleed into dismay
Youths and elders, bound by the same line Where gender bears no barrier to the sign Of struggle, reaching out, breaking chains
Seeking understanding, amidst the pains
Louder grow the whispers, calling for light In the ocean of minds battling the night
Each silent tear tells its tale
A call for listening, beyond the veil
We tread around stigma, on threads so fine Woven through thoughts left to align Yet in whispers, there’s might, there’s power To illuminate the dark, make the unseen flower
So, let’s heed these whispers, not with dread But with open hearts, let them be read For in every crowd, every place
Compassion begins with an embrace
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The Silent Divide
Beneath the vast dome of Eastern skies, scholars meticulously trace the contours of sorrow, their fingers run across the cold, hard data—the somber rise and fall of numbers.
Each statistic whispers the echo of a hidden struggle, a quiet devastation etched into the soul of a community.
Far across the oceans, where the sun both rises and sets on unfamiliar horizons, the Asian diaspora nurses its own quiet battles, harboring secret pains. In these lands, voices from old worlds and new ones mingle, caught in the liminal space between silence and outcry.
Here, Stigma weaves its dark, relentless threads through the fabric of daily lives, a cloak of invisibility that shrouds the pain of those who bear it. Walking through streets lined with foreign sights and sounds, they move softly, unobserved, their battles silent, their losses unseen.
The solitude of assimilation weighs heavily on their shoulders— a balancing act of retaining one’s identity while seeking to meld into another world.
The silence around their anguish, thick and suffocating, builds walls made not of brick, but of air and misunderstanding.
Researchers, distant yet connected by their quest for understanding, unfold sheets of data, their pages filled with the ink of earnest endeavor. They seek to bridge the emotional, cultural, and geographical chasms with the meticulousness of their methodologies and the depth of their inquiries.
Through the statistical landscapes and the personal narratives they gather, a tapestry of understanding begins to take shape. Tales of resilience and vulnerability, of identities lost and fears found, emerge from the rigor of academic scrutiny.
These stories, told and untold, form the backbone of a growing archive of empathy, a repository that spans continents and cultures, offering solace and solutions.
This collection of research and reflections serves not only to inform but to
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heal, bridging the gap between the world left behind and the world they now navigate.
As this community of scholars expands, so too does the network of empathy, a dynamic flow of insights that connects disparate experiences under a common cause.
This bridge they build—a construct of data, stories, and shared humanity— stands as a testament to the power of understanding to unite and uplift.
In the narrative of each individual within the diaspora, from the elderly immigrant reminiscing in a language not spoken here, to the young student struggling with the dual identity of ‘neither here nor there,’
there lies a thread that, when pulled, unravels the complex fabric of diasporic life.
These threads, woven into the larger story of migration, adaptation, and survival, highlight the unique challenges and triumphs faced by those who live between worlds. The research undertaken, both vast and deep, aims not just to document but to change, challenging Stigma, and fostering a broader, more inclusive understanding of mental health.
In every questionnaire completed, in every interview conducted, there is a voice being amplified—a story being elevated from the shadows of Stigma.
This collective endeavor lights a beacon for those navigating the turbulent waters of diaspora, illuminating a path forward, guided by understanding and marked by hope for a dawn less silent.
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