Even before these attacks, incidents of anti-Asian hate had been on the rise. The Center for the Study of Hate and Extremism at the California State University in San Bernardino released findings in early March that showed hate crimes against Asian Americans in 16 of the largest cities in the United States had spiked 149 percent between 2019 and 2020, even though hate crimes overall declined. The coalition Stop AAPI Hate estimates there have been roughly 3,795 anti-Asian bias incidents from March 19, 2020, to February 28, 2021. The center says that the number of hate incidents reported represent only a fraction of the number of hate incidents that actually occur. These incidents include not only physical assault (11.1 percent), but also verbal harassment (68.1 percent), shunning or deliberate avoidance (20.5 percent), and online harassment (6.8 percent). About 8.5 percent of the incidents involved civil rights violations, such as workplace discrimination, refusal of service, and being barred from transportation. Before the recent shootings led to a flood of media coverage about escalating violence toward Asian Americans, President Biden had recognized that the problem was increasing. During his first week in office, he signed a Presidential Memorandum to condemn and combat racism, xenophobia, and intolerance against Asian Americans and Pacific Islanders in the United States. Following the killings, Biden issued a statement condemning “in the strongest possible terms the ongoing crisis of gender-based and anti-Asian violence that has long plagued our nation.” Negative perceptions of Asians in America aren’t new. In a paper titled “The Anxiety of Being Asian American: Hate Crimes and Negative Biases During the COVID-19 Pandemic,” published June 2020 in the American Journal of Criminal Justice, researchers from the department of sociology at Yale University detail the prevalence of racism toward Asian Americans throughout the country’s history, and how the COVID-19 pandemic has fueled hate crimes. “The pandemic has brought about a lot of uncertainty, anxiety, fear, economic concerns, and changes to everyday life like social distancing and staying at home,” says Hannah Tessler, a PhD student and one of the coauthors of the Yale report. “Because of these fundamental shifts in people’s lives, I think many are dissatisfied and looking for some kind of way to direct blame or release that dissatisfaction.” On top of the overall pressures from the pandemic, inflammatory rhetoric directing blame for the outbreak at Asian Americans has incited prejudice and violence. Lok Siu, PhD, an associate professor of Asian American and Asian Diaspora Studies at the University of California in Berkeley, suggests that former President Trump has continually encouraged racism toward Asian Americans by referring to COVID-19 as the “Chinese virus” and the “Kung flu.” “Trump persistently and repeatedly deflected blame on to the Chinese,” she says. “This type of talk brews sentiments and racism against the Chinese, and makes people see them as the culprit.” Even with a change in rhetoric from the White House, vaccinations steadily increasing, and a potential end to the pandemic on the horizon, Tessler fears that certain radicalized segments of the population may be “more frustrated and angry, and dig their heels in” — potentially stepping up attacks against the Asian American community. Though she’d managed to defend herself, Xiao Zhen Xie suffered severe bruising to the face, and was left feeling “very traumatized and very scared.” Violent episodes like this cause trauma, fear, and anxiety for the victims and their families, and these feelings also ripple out to the population as a whole. “A lot of folks in our communities are feeling outrage and anxiety about whether they feel safe when they are walking around in their communities,” says the president of the Asian American Psychological Association, Richelle Concepcion, PsyD, who works as a clinical psychologist at Schofield Barracks Health Clinic in Hawaii. As Dr. Concepcion points out, Asian Americans are “a very community-oriented group of folks,” and recent racially motivated violence has led many to restrict their activities. “It has created a sense of isolation for many of them,” she says. Dr. Siu adds that many Asian Americans now go out with a feeling of uneasiness, fearing they may be attacked at any moment. “Living with constant fear creates a tremendous level of mental and emotional distress,” she says. Joo Han, the deputy director of the Asian American Federation, points out that many Asian Americans see a stigma connected with seeking professional mental healthcare. “It’s not just about not wanting to be labeled as ‘crazy’ — there’s a lack of understanding that mental health is actually a health issue — just as legitimate as physical health,” says Han. Stress from traumatic events, however, does lead to a decline in physical health. The mental anguish may manifest itself in the form of headaches, stomachaches, tension, and sleep difficulties — a fact that many in the Asian community may not be aware of, according to Han. Keith B. Churchwell, MD, the president of Yale New Haven Hospital and an associate clinical professor of cardiovascular medicine at Yale School of Medicine, emphasizes that the physical health impact from overshadowing anxiety is very real. “There is a very strong correlation between persistent emotional stress and an increase in the number of cardiovascular events in any population,” he says. “I wouldn’t be surprised at all if we see an uptick in terms of heart events in our Asian American communities because of this particular stress.” Han is advocating for more efforts to help normalize mental healthcare in Asian communities and provide more culturally appropriate mental health services. She envisions incorporating mental health concepts in existing services, such as programs that may be addressing women’s empowerment or domestic violence, or programs for seniors that conduct wellness activities such as yoga or tai chi. Resources are out there to help. Concepcion suggests that Asian Americans seeking professional guidance and care reach out to organizations such as the Asian Mental Health Collective, the Asian American Federation, and her organization, the Asian American Psychological Association.

Taking Action to Make a Change

While the recent murders in Atlanta have been devastating, Siu believes the attention now being paid to violence against Asian Americans could serve as an opportunity for change. “This is a moment of reckoning — a point where I think we realized there is a problem, and we’re defining this problem,” she says. Many Asian Americans are also responding with a desire to fight back — as exemplified by Xiao Zhen Xie. “There’s a sense that we can’t be victimized by this kind of threat,” says Siu. “We need to be out there, calling out these actions as a form of injustice that is just so wrong and has to stop. This has served as a rallying call for our community to recognize that we need to come together and say no more, enough is enough, we are unwilling to be victims, and this has got to change.” Asian Americans can take constructive action through organizations such as Stop AAPI Hate and AAPI Progressive Action. Tessler urges people who are non–Asian American to engage in this topic as well, and have more self-reflection on this issue. “It’s much harder for somebody to turn the lens on themselves, and realize ‘Oh, actually, I’ve also done things that are racist or misogynist or are somehow negatively impacting other people,’ because we don’t like to think of ourselves as part of the problem.” Sometimes people may exhibit microaggressions — comments, actions, or assumptions they may not be aware are hurtful. Concepcion gives the example of complimenting a person of color on how good their English is, when the person has lived in the U.S. their whole life. In the fight against racism, Asian Americans need allies outside their community. Concepcion wants to see non-Asians step up and speak out if they see wrong actions against Asians. “Help amplify our voices, whether it be through advocacy or fighting alongside us as an ally or intervening when you notice something that isn’t right.” Knowing how to intervene can be difficult, but professional bystander training programs are available online, and many are free. “Many of us are suffering, and we can come together and support each other, especially during this time when we’re just trying to navigate things like this pandemic and the future after this pandemic is over,” says Concepcion.