“Why can’t you give back to a stranger?”
An interview of Nary Kith on language barriers, intergenerational trauma, and collective approaches to mental health care
Meerabelle Jesuthasan
Who Cares is a series of Q&As about care—the many definitions and applications of the word, from individual to collective, as it manifests across contexts, from friendships to grassroots organizations to neighborhoods to group chats. What are the radical potentials of care under capitalism and how does care—in the many forms of work and relationships that it takes—let us reimagine the current conditions?
Nary Kith is a mental health clinician and co-founder of KITHS, a service-oriented organization that connects refugees and immigrants to resources that are vital to their livelihood. The daughter of Cambodian refugees, Nary started KITHS with her sister in 2017 in the North Philadelphia neighborhood that they grew up in. We spoke over a video call about language barriers, the rigidity of traditional mental health practices, and how collective approaches to care can address intergenerational trauma.
— Meerabelle Jesuthasan
On starting her organization. KITHS started with a conversation about how we give back to the community. The way I’m shaped, the way I live my life, is really influenced by the community that brought me here. The immigrants and refugees who resettled here 40 years ago continue to live at poverty lines, not really sustaining any wealth. So KITHS is born from the idea of building economic self-sufficiency among immigrants and refugees. Our clients don’t have to live check to check. This work requires understanding; empathy, to me, is all about providing care.
Wedge [the behavioral health medical centre where Nary worked for two years] was focused on quantity—the more people they see, the more time they can bill, which means the more money they make. KITHS looks more at the quality of work, which means really incorporating the cultural aspect of providing care services. There’s an assumption that language and culture should be the backdrop, but those are things that need to guide how organizations operate. You need to understand people’s culture and language barriers to provide them with the care and services that they need.
On being a community resource. The only thing our building is missing is an awning, to show who we are. We have one of those cheap vista-type banners, but we really want an awning in our language that says “Welcome.” But people still know who we are, a lot of them from word of mouth. They’ll say “Oh, the sisters are open today.” We’ve been open close to four years now, so even the non-Cambodian community members feel comfortable coming in asking for support.
Recently, people are out of work and need help with unemployment compensation, medical benefits, Social Security benefits, immigration benefits. A lot of places closed down for a period of time, everything was remote, so it was so hard to get in contact with different systems: all immigration services kind of stopped, people had pending appointments to get fingerprinted and take civic exams that were cancelled.
The people that we serve, we collaborate with them, we don’t do things for them. You have to build that relationship so that the people you support and serve and care for trust you. Communities of color, and traumatized populations, are very vulnerable: they’ve been taken advantage of, are still being taken advantage of, because people believe they don’t know the system. This is often accurate: our clients don't know the resources that are available to them, and people often charge them for certain things that are free.
On being an interpreter. With the community that we work with, there’s a huge language barrier. Sometimes they come in with junk mail, and they’re so anxious about what the letter means. They might worry that they missed a request for verification documents for Medicaid, for example. In Philadelphia, if you miss a deadline they deny you, quickly.
I grew up speaking both languages so that I could translate for my parents. As young as eight years old, I’m translating bills and telephone calls and doctor’s appointments for them. Back then, they allowed you to translate for your family, now they want professional interpreters for medical appointments. In hindsight, I’m thankful that I learned both languages. But in the middle of it I was very resentful— why do I need to do this, I’m a kid! I thought my parents were lazy. How come they’re not learning? But I think about it now and it’s like: When would they have the time? Who would teach them?
On boundaries. It’s an everyday struggle finding the line between business and personal. We have a community center, where a lot of our clients know our family, they know who we are as a community, so they’ll say, “Oh, can I come to your house instead?” We have to create that boundary for ourselves. What we do is we compare—if you called a regular doctor’s office and asked for an appointment, would you just walk in? Especially during a pandemic, you can’t just walk in anywhere.
On what makes her feel cared for. It’s the thought that counts. The concern of “Do you need anything?” or “I’m stopping by Starbucks, do you want something?” Self care is very subjective—whatever it is that makes you feel better about yourself or better in general. I am a homebody, so my self care is Netflix, like picking a Netflix series and bingeing on it while having Ben and Jerry’s. So things like that make me happy. Also, supporting other organizations that support others.
On the limits of mental health licensing. We are working on becoming an outpatient clinic. There are so many steps that you have to go through, just to get licensed. We already have a list of clients who want mental health services, we just can’t offer those traditional client-to-clinician therapy services right now.
The oversight entities that give out licensing have set it up so that mental health services can only be used for those with a diagnosis. So how you can provide the service is very restrictive, very rigid; like one-to-one talk therapy and art therapy. But when you provide programs that are about care and care for other people, then you can think outside the box. Care can be a multitude of things, besides talk therapy.
On collective care and intergenerational trauma. Although the children of survivors [of the Khmer Rouge] did not experience the trauma firsthand, they see their parents’ symptoms, and that’s what leads them, I guess, to a kind of self-worthlessness. How do I survive day to day? They left a war-torn country to come to a country that does not support people of color. How do you break that cycle? How do we start to destigmatize mental health symptoms so that people can utilize mental health therapy? Because when that happens, they can pass on the effects to their children, who are surviving whatever it is that they’re surviving.
Before the pandemic, we were working on a project called From Genocide to Tableside. In our culture, a lot of the time, we gather around food. We honor each other, we respect each other with food. So we were thinking of doing tableside gatherings. Different community people would host, and we would come together to share stories, to have a safe space for people to share their experiences.
Mental health therapy is underutilized because it’s so stigmatized. The West is very accepting [of therapy], because it’s very individualized, too—“Oh yes, for me, I want to feel better about myself. So let me go seek some help.” Whereas for us it’s like, we’re not going to share our business with an outsider, whatever is happening with us is within the family, that’s it.
On giving back. I’m not obligated to give back in any kind of way but how can I show my gratitude to the community, to the universe, when they’ve given so much to me? Why can’t you give back to a stranger?
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You can read Meerabelle’s essay “The Internet Is Not Forever” in issue 1.