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2013 Cause Leadership Academy

Those Who Serve


A Report on Asian American/Pacific Islander Service Members
Jonathan Chen Tanya Edmilao Danny Chee Kwan Katrina Lei Lauren Richardson Christine Sun Jimmy Tran Edward Truong Kim Yamasaki

Foreword
On March 19, 2009, United States President Barack Obama declared, We also owe our veterans the care they were promised and the benefits that they have earned...But we know that for too long, weve fallen short of meeting that commitment. Too many wounded warriors go without the care that they need (Obama). As President Obama had stressed the need to increase resources for returning veterans, the 2013 CAUSE Leadership Academy chose to investigate how his initiative would affect Asian American and Pacific Islander (AAPI) service members. Our project, titled Those Who Serve: A Report on Asian American Pacific Islander Service Members, covers research on the current state of Asian American Pacific Islander service members, including active duty members, reserve members, and veterans. Along with research, interviews were conducted with various intellectuals and representatives from organizations in the community to further understand this issue. Although AAPIs have made significant progress in the military, there seems to be little documentation of their recent experiences in combat missions and their transitions back to civilian life. The lack of information makes it difficult to address the problems AAPI service members face. Most significantly, our intern class has a particular vested interest in this issue because it is a matter that affects some of our closest friends and family members. Within our own group, Danny Chee Kwan, served in combat for the wars in Iraq and Afghanistan. Throughout his time in service, he witnessed and experienced several traumatizing events. And since returning and transitioning back into civilian life, he has faced several additional challenges. This project highlights these struggles and aims to shed light to the AAPI service members in hopes of one day gaining the resources adequate for supporting this community. Thus, we hope to empower community leaders and government organizations to not only conduct more research, but also to document the experiences of this minority group in the military. In addition, we seek to educate our counterparts about resources already in existence. Upon completion of this project, we would like to encourage the establishment of services for AAPI service members that are both culturally sensitive and responsive. Assessing AAPI needs and experiences is a pivotal step toward helping veterans as a whole. Sincerely, 2013 CAUSE Leadership Academy Interns

Content
Foreword 2 Abstract, Introduction 4 A Portrait: AAPI Service Members 5 Recruitment 7 Mental Health 13 Military Hazing 23 Conclusion 29 Resource Guide 32 A Word of Thanks 33 About the Interns 34 Works Cited 36 About CAUSE 38

Photos Courtesy of JONATHAN KIM AND CHEE KWAN

Abstract
This research paper covers the lack of resources that are available and accessible to the Asian American and Pacific Islander (AAPI) service members and their families. Through researching the topic, it has been discovered that there is a specific lack of information pertaining to the prevalent issues that are currently facing AAPI service members. It is believed that there are minimal ethnic specific resources because there is a lack of data to illustrate the need. This project will discuss three subjects and will identify how each subject illustrates the importance of providing culturally and linguistically sensitive resources to AAPI service members and to their families. The project will first discuss matters related to the recruitment rate of AAPI members and how it is important to have culturally and linguistically competent recruitment officials. Secondly, the project will describe prevalent mental health issues that impact the AAPI community and explore how those same issues are magnified in its service member community. Third, the paper will cover the issue of hazing in the military and reveal how AAPI service members can be mistreated because of their cultural and ethnic background. This project will conclude with several recommendations on how the federal, state, and local government can impact the creation of more culturally sensitive resources.

Introduction
According to the Pew Research Center, the Asian American and Pacific Islander (AAPI) community is the fastest growing ethnic group in the United States. As reported by the 2011 U.S. Census Bureau estimate, there are currently 18.2 million AAPIs in the United States, constituting 5.8% of the total population. Traditionally, the AAPI community has maintained the lowest rate of enlistment and commissions into the United States military. Despite a recent surge in AAPI enlistment rates, AAPI service members still only constitute 4.3% of all active duty service members, a number that is not reflective of the overall AAPI population (Shavelson). Due to their disproportionately small size within the military, AAPI service members are often overlooked in terms of resource allocation and funding. In order to increase the amount of attention and support for AAPI service members and their families, government and community leaders must first acknowledge that there is a need for more services. However, there is no specific data to suggest that a need exists. Without the data to illustrate the need for more culturally and linguistically competent services, government officials and community organizations are less likely to act. Therefore, this project seeks to highlight some of the more prevalent issues that are facing AAPI service members and their families so that more awareness can be raised on their behalf.

A Portrait: AAPI Service Members


According to the U.S. Census Bureau, there are a record 18.2 million Asian American and Pacific Islanders (AAPIs) living in the United States, or 5.8% of the total population. In fact, the Pew Research Center found that AAPIs are the fastest growing racial group in the United States. Because of the growing number of AAPIs, there is a greater need for cultural understanding and tolerance. This further necessitates the availability of ethnic sensitive and specific resources. For example, if military informational pamphlets are available in Spanish, they should also be readily available and accessible for AAPIs in their native languages.

Service Stats

According to the 2011 U.S. Census, there are 21.8 million veterans in the U.S. and of those 21.8 million, 264,695 are Asian and 27,469 Hawaiian or Pacific Islander veterans, making that a total of 292,164 total AAPI veterans (Asian/Pacific American Heritage Month: May 2013). In addition, AAPIs make up 1.3% of the total veteran population, as reported by a 2008 AmericanCommunity Survey.

Rising Enlistment Rate

Statistics show that AAPIs have had a history of low military enlistment. For the past decade, AAPIs comprised less than 3% of all military recruits, only recently rising to 3.2% in 2010 (Semple). However, it is hard to ignore that over the last few years, there has been a dramatic surge in AAPI recruits. In the Los Angeles Battalion alone, there was an 80% increase in AAPI enlistment rate in 2009 compared to the previous year (Shavelson). Similarly, the total number of AAPI recruits from the Los Angeles County added up to an astounding 22% in 2009 (Shavelson). Since AAPI service members constitute a very small minority group within the military, they are often overlooked for resource allocation. Nevertheless, as an employer, the government must be held more accountable. Adequate resources distributed in a way that would be accessible to both the service members and their families must be ensured.

Graphics Courtesy of PEWRESEARCH.ORG

Service Academies

Additionally, AAPIs are also a rising presence in the United States service academies. Each of the service academies offers an elite, all-expenses paid, fouryear educational program, and upon graduation, students of service academies are commissioned as officersrising as important leaders in the military. The military service academies include: U.S. Military Academy (USMA aka West Point) in West Point, New York U.S. Naval Academy (USNA) in Annapolis Maryland U.S. Air Force Academy (USAFA) in Colorado Springs, Colorado U.S. Coast Guard Academy (USCGA) in New London, Connecticut U.S. Merchant Marine Academy (USMMA) in Kings Point, New York

Racial demographics of these service academies reflect a clear Caucasian majority, with AAPI community as a clear minority. At the United States Air Force Academy, the AAPI community comprises 8% of the student body. However, such a figure easily makes AAPIs a leading minority population within the military academy. Similarly, the United States Naval Academy has an AAPI population of 10% of the total student body, while African Americans follow close behind at 9% and Hispanics lead with 13%.

Graphics Courtesy of JONATHAN KIM

However, racial demographics were not readily available for the other service academies, which make it more challenging to track the overall increase of AAPI students in these academies. In addition, after much investigation and correspondence, ethnic demographics were even more difficult to find. Available data that was found took a great deal of unearthing. Demographic data that is ethnic specific is vital. As commissioned officers from service academies positions of higher leadership roles, understanding ethnic backgrounds will be essential. The provision of such data for public access will allow for improved services that directly cater toward a service members backgrounds. This information is valuable for military academy students and graduates as well as the overall AAPI service members. The lack of ethnic-specific data is a recurring theme throughout varying military sectors. The following segments highlight this issue within the areas of recruitment, mental health, and hazing in particular. 6

Recruitment
The Asian American and Pacific Islander (AAPI) community retains the lowest rate of enlistment and commissions to the United States military (Shavelson). According to the Demographics 2010 Profile of the Military Community, the AAPI minority group only constitute 4.3% of all active duty service members. To put that into perspective, the Department of Defense (DOD) found that only 61,000 service members out of over 1.4 million are of AAPI descent (2010 Department of Defense Military Demographics). Further dissection of the data reveals that AAPI service members make up only 4.4% of the enlisted population and 4.0% of the commissioned officer population (Demographics 2010).

Recruitment Motivations

But after such a long history of AAPIs being underrepresented in the military, why has there been an increase now? The following outlines a few motives behind the decision to serve:

Education
First and foremost, after being signed into law in 2008, the Post 9/11 G.I. Bill now offers a handful of educational incentives that attract many young men and women each year. The Bill states that a service member who serves at least 90 days on active duty Graphic Courtesy of DEBATE.ORG may receive the most basic educational benefits. As long as a service member has served three years on active duty since 2001, 100% of his four-year public, in-state college tuition will funded for under this Bill. In addition, if a veteran serves 10 years on active duty, these benefits then become transferable to his spouse and children. In addition to educational support, monthly stipends and housing benefits are also allocated. Overall, the provisions under the GI Bill deeply encourage higher education.

Job Security
With the rising cost of tuition and lack of employment opportunities, military service provides veterans with not only college benefits but also job security after honorable completion of service. Many service members are able to enlist into non-combat roles that can provide transferable job skills, such as clerical or mechanical experience through working in offices or auto shops. As one Naval Academy senior believes, The Uniform opens the door for Asian-Americans to enter mainstream society... Powerful people in the U.S., including CEOs and politicians, often have backgrounds in the military (Nuasian). In essence, serving in the military generates unique technical skills that may be applied to a variety of jobs and sense of unspoken trustworthiness. Forbes Magazine also noted that employers prize military service because a veterans experience during military service enables them to become more versatile. Corporations such as Walmart are leading the way in publicizing the effort the provide jobs for veterans, launching the Veterans Welcome Home Commitment in May 2013, which offers any honorably discharged veteran a job in his or her first 12 months off active duty. 7

Leadership Opportunities
The growing number of high-profile AAPI officers in the upper echelons of the military could be another incentive encouraging AAPI enlistment. In fact, although AAPIs only make up 3.7% of the enlisted population, they represent 4.2% of the officer population (2010 Demographics). This demonstrates that AAPIs are relatively well represented in terms of leadership within military ranksoffering a bright and positive outlook for members of the AAPI community who plan on joining the military.

Photo Courtesy of CSMONITOR.COM

Path to Citizenship
For many, the military also offers the unique opportunity of receiving an American citizenship. Under special provisions of the Immigration and Nationality Act (INA), service members may receive expedited naturalization processes as well as more lenient qualifications. Rather than the normal five years of permanent residency history, under the INA, veterans qualify for an accelerated process which takes about 8 to 10 months from beginning to end (Powers 1). Also, the U.S. Army also offers a special citizenship program called Military Accessions Vital to the National Interest (MAVNI), in which immigrants with certain language expertise or medical training could enlist and receive citizenship in 10 weeks under the provision that they complete the 10 weeks of basic training (Schafer). This program was first piloted in 2009 and has since been extended until May 2014 after a brief period of suspension. As many AAPI students are studying in the U.S. on student visas, this program will give them the unique opportunity to obtain citizenship and remain in the U.S. However, this program has capped enrollment at 1,500 people until 2014, thus making the quota for each language category fiercely competitive. AAPIs are definitely taking advantage of this opportunity, and Koreans in particular have shown keen interest in this program (NuAsian). Programs like these, which provide citizenship that translates into lifelong benefits, could be another contributing factor for the increase in AAPI service members over the years.

Other Motives
Current recruitment trends tend to highlight that military service provides life experience, job training, and college benefits. However, factors such as diverse socioeconomic status, familial experience with 8

military service, and generational gaps do indeed affect a familys decision to either support or denounce military service. Although there is no specific research to support this claim, Dr. Jack Tsai, Assistant Professor of Psychiatry at Yale University, believes that AAPI members within lower socioeconomic status groups have a higher tendency to go into the military because they are looking for more opportunities, which service in the military can provide (Tsai). Regardless of the facts, military recruiters will continue to have difficulty responding to the needs of the AAPI community without the availability of data. As AAPI veteran Tim Hsia pointed out, an increasing AAPI population in the military can not only provide linguistic and cultural translations for military operations, but also facilitate better understanding of the AAPI culture in general (Hsia). According to a 2011 Department of Defense report, there are 7.1%, or 99,921 Active Duty troops stationed in East Asiaa figure that seems rather minute at first mention, but in actuality, bears great significance. While a majority of troops are stationed on American soil, the second largest group of stationed troops is in East Asia. Since a significant portion of U.S. troops are in East Asia, the push for more understanding of the AAPI culture is even more crucial. UltiGraphic Courtesy of DEFENSE.GOV mately greater understanding will be mutually beneficial and have the potential to make military operations in East Asia operate more efficiently. In addition, the AAPI soldiers stationed in East Asia can be at the forefront of these efforts to facilitate better understanding by sharing their own beliefs in an effort to promote general cultural understanding.

Recruitment Strategies
The Marine Corps launched a major ad campaign comprising a series of short videos targeting AAPI members for recruitment this year from May 8 to June 7, coinciding with the Asian Pacific American Heritage Month (Lanz, Vigeland). The ad campaign, known as A Warriors Education, featured AAPI officers who emphasized the importance of discipline and respect along with the value of service and self-betterment. The Marine Corps hopes that such efforts of outreach will generate a positive response and garner an increase in AAPI recruitment rates, especially since the AAPI makeup of the Marine Corps currently stands at 3.06%.

Graphic Courtesy of AFMIL.COM

However, a potential pitfall of ads that target specific ethnic groups is that it utilizes racialized recruitment strategies (Buenavista). Dr. Tracy Buenavista, who teaches Asian American Studies at Cal State Northridge, is critical of such an approach. She argues that such strategies stereotypes AAPI members as the model minority with hyper-disciplinary practices within their families. This stereotyping further perpetuates the stereotype that AAPI families inherently value a high level of discipline (Buenavista). The militarys strategic use of and reliance on stereotypes ultimately highlights the lack of genuine effort to understand the AAPI community. If actual data and research on AAPI service members were available, then using stereotypes for assistance would not be necessary in the effort to promote AAPI enlistment.

Graphic Courtesy of MARINES.COM

Recruiters & Recruitment Facilities: Their Role

The need for culturally sensitive recruiters and recruitment facilities that offer ethnic-specific resources is imminent . The recruiters and their offices are often the first and only means for families to bridge the gap between military service and civilian life. The recruiter is a representative for his or her specific branch and may often provide the only face-to-face contact that is readily available and accessible for an AAPI service member since recruiters are assigned to specific localities manage all recruits of those localities. Even after completion of service, recruiters can play a crucial role in receiving information at the local level because the Department of Veterans Affairs lacks adequate facilities to serve the ever-growing veteran population. Often, recruiters help bridge the gap between military service and civilian life. This may be done by guiding service members to available resources and serving as an overall support system. In order for recruitment facilities to become more sensitive to the needs of the AAPI community and offer more services geared toward the AAPI population, more research must be done. Such research would enable experts to conclude which services are needed for specific ethnic groups and figure out how to implement them. According to Sergeant Cory Jeffers, a Marine Corps recruiter, the recruitment field is the only military occupational specialty that is segregated by ethnicity (Jeffers). Recruiters are given the option of choosing their duty station but are ultimately placed according to the needs of their military branch. The Marine Corps, for example, strives to allocate its recruiters back into their communities of origin. This allows the recruiter to be more effective when it comes to recruiting from that specific community. Jeffers also 10

emphasized that there are often very few AAPI recruiters that can be tasked out to their communities simply because there are not enough of them. Though it would be ideal to offer services that are conducive to potential enlistees backgrounds, the absence of adequate resources makes this very difficult. When dealing with the family members of service members with varying backgrounds, recruiters are often expected to adapt to the best of their abilities in servicing the enlistees. According to Staff Sergeant Ramon Inzunza, a former Marine Corps recruiter, Having some ethnic specific pamphlets, brochures, or DVDs for the parents of AAPI potential recruits would have helped a lot (Inzunza). As one could imagine, the lack of such resources severely limits the effectiveness of communication. Often, it is extremely challenging for recruiters to help the families of different cultural backgrounds understand the process of enlistment. Although recent recruitment strategies have shown a greater interest in and understanding of AAPI outreach, the availability and accessibility of ethnic specific resources has yet to improve because AAPIs continue to remain a small minority group within the military. Dr. Anthony Hassan, Director of the Center for Innovation and Research on Veterans and Military Families at the University of Southern California, stated at the Veteran Homelessness and Services Forum, As a community we need the data to drive change and create improvements (Hassan). The rise in AAPI recruitment rates as well as the increase in funding for ethnic advertisement campaigns encourages the production of future research to create the data that drives change.

Photo Courtesy of SGT. RAMON INZUNA

Executive Order 13515, Renewed by 13625: Recruitment Plans in accordance to the White House Initiative on Asian Americans and Pacific Islanders

Executive Order 13515, in part, focuses on the renewal of the White House Initiative on Asian Americans and Pacific Islanders. In regards to AAPI military service members, the White House Initiative works with the Department of Veterans Affairs (VA) as Co-Chairs, according to section 3(b) (Obama).

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The VAs objective, in accordance with Executive Order 13515, will be to target the improvement, advancement, and overall recruitment rates along with health of AAPI service members. The following table outlines their four major goals of implementing Executive Order 13515.

Graphic Courtesy of VA.GOV

The current status of 13515 has been renewed by Executive Order 13585 and will be ending its two-year term on September 30, 2013. As of May 2013, the Department of Defense has initiated several new tactics to increase the the AAPI communities within the military. However, these strategies did not include culturally sensitive training for administrative staff (i.e high-ranking officers). With cultural training, this could lead to better communication and understanding among the AAPIs and their prospective superiors.

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Mental Health
According to the National Alliance on Mental Illness (NAMI), Asian American and Pacific Islanders (AAPIs) face many barriers when seeking mental health services, including lack of access to care, language challenges, and a shortage of culturally and linguistically responsive providers (NAMI). As a result of these challenges, AAPIs have the lowest utilization of mental health services, making up less than 9% of those who seek mental health services nationwide, which is significantly lower than the 18% of the general population who do (Lee). Subsequently, this underutilization of available mental health services is echoed within the AAPI military community.

Cultural and Language Barriers and the Taboo

In order to treat AAPI service members with mental health issues, it is imperative to understand how mental health is perceived through different cultural lenses and how this sparks the reluctance of AAPI service members to seek treatment. In this section, we will explore the different barriers to care faced by AAPIs, including the stigma typically associated with seeking treatment.

Cultural Influences
Cultural beliefs are an important factor that affects how AAPIs deal with their mental health issues. According to a report released by NAMI, many individuals choose to stay in denial or remain silent about their situations because of the cultural adherence to avoidance of shame and stigma (NAMI). Such determination to deny mental illnesses stems from the desire to maintain appearances. Further, AAPIs avoid seeking mental health treatment due to the fear of being mislabeled as crazy (SAMHSA). For AAPI veterans, admitting mental health issues such as Post-Traumatic Stress Disorder (PTSD) is often considered [to be a] weakness (Cohen). As a result of these myths that still need to be dispelled, many have resorted to simply remaining silent and continue to choose not to receive treatment. In addition, the AAPI community is composed of several ethnic groups, which all have their own means of coping and treatment. Among the Chinese, Japanese, Korean, and Vietnamese communities, these cultural beliefs justify seeking historically traditional treatments originating from their respective homelands (see chart below).

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Such explanations could help clarify why AAPIs have the lowest utilization of mental health services. In short, cultural beliefs can potentially act as barriers to adopting the Western perspective of mental health issues as psychological concerns in need of treatment such as therapy, psychiatric medicine, or peer-topeer counseling.

Generational Gaps

Graphic Courtesy of GAMBASSA.COM

Many of the studies conducted found generational differences among the first, second, and third generations. The results of the National Latino and Asian American study revealed that third-generation Asian Americans were twice as likely to use any services and more than three times likely to use formal services (i.e. professional services) than first-generation individuals. Second-generation status was associated with a lower likelihood of use of informal services (i.e. home remedies) than first-generation status (Spencer). This was the first national survey of AAPIs which examined 600 Chinese participants, 508 Filipinos, 520 Vietnamese, and 467 other Asians totaling up to 2095. Our analysis concludes that the third generation was more open to treatment since their perception of mental health treatment is more aligned to American perceptions than their second or first generational counterparts. In fact, at the national level, AAPIs are one third as likely as Whites to use available mental health services (Matsuoka JK, Breaux C, Ryujin DH). As for the first and second generations, AAPIs have been found to perceive mental health as a stigma that resulted in a lower likelihood of using any services. Given that these participants associated shame with coming forward due to the highly stigmatized nature of mental illness in many Asian cultures, loss of face is a key interpersonal dynamic in Asian social relations that defines an individuals social integrity and the perception of the individual as an integral member of a group (Spencer). In order to break through this dynamic, AAPIs need programs that will translate into the need for treatment by understanding the cultural stigmatization; otherwise, this cycle of silence to save face will continue.

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Language Barriers
Although language barriers do not seem to be a problem for AAPI service members as they are prescreened for basic English proficiency, such linguistic challenges may be an issue to the families of servicemembers. According to The Rise of Asian Americans, a demographic study published by the Pew Research Center, among those who did not speak English very well, 5.9% were born in the U.S and 46.8% were born outside of the United States. Based on the results of this study, there is a strong possibility that AAPI service members with parents who were born outside of the U.S. grew up in a household that did not use English as a primary language. If so, growing up in such a household could place an AAPI servicemember at a disadvantage in terms of seeking family support for mental health issues. Often, family support may be the driving factor behind a service members decision to seek or not seek treatment. The encouragement of family is key, but without the adequate resources available to help them comprehend the importance of such support, we cannot hope to expect any results. According to the 2001 U.S. Surgeon Generals Report on Mental Health and Race, there are approximately 70 Asian providers for every 100,000 AAPIs of the general population. Given the scarce number of providers who are linguistically capable of bridging this gap, employing more bilingual or multilingual clinicians will help encourage AAPIs service members to seek treatment.

Model Minority Myth


The Model Minority Myth (MMM) defines all AAPIs as overachieving and affluent intellectuals (Lewin). However, the reality of the AAPI community is that this success is disproportional. For example, while 49% of the AAPI population earned a Bachelors Degree (Pew Research Center), 35-40% of other ethnic subgroups such as Southeast Asians do not finish high school (2006 American Community Survey). The MMM assumes all AAPI do not need any social programs as a result of this stereotyped success. Although some AAPI populations are in need of culturally and linguistically appropriate mental health programs, the MMM dampens the possibility of adequate resource allocation for specific ethnic subgroups. This shortage of resource allocations has even trickled down to AAPI service members.

Military Suicides

A study released in January 2013 revealed that the military suicide rate hit a record high in 2012 at one suicide per 25 hours (Briggs). In fact, soldier suicide rate outpaced combat deaths in 2012 (Briggs). This ratio has become more alarming than the data presented just last year. In the first four months of 2013 alone, 161 potential suicides have been reported among active-duty troops, reservists and National Guard members at a record pace of one suicide per every 18 hours (Briggs).
Photo Courtesy of INFINITEUNKNOWN.NET

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According to a Pentagon correspondent, Tom Bowman, the majority of those who commit suicide are young men ages 18-24. In addition, he pointed out that a third of the deaths were among troops who were never deployed, and about 80% had never been in combat (Bowman). Such shocking statistics pose questions as to what exactly is triggering suicides among active duty service members. Although the numbers may be startling, these statistics do not factor in the number of veterans who commit suicide once they leave the military. According to the Department of Veteran Affairs, suicide among veterans occurs at a rate of 22 lives a day (Hoh). Among soldiers of AAPI descent, the rate of suicide is dramatically higher than those of other racial groups. Researchers say that their risk can potentially be double or triple that of other soldiers, and four times higher in war zone (Zoroya). Until further research is done regarding AAPI service members, it will be difficult to find out why suicide rates for AAPIs can quadruple in Graphic Courtesy of 3RD BATTALION, 3RD MARINE REGIMENT war zones. Moreover, more research in general needs to be done in light of the suicide epidemic faced by the military. The military must figure out why suicide rates keep rising each year and what can be done to prevent more troops from taking their own lives. Only then will the suicide epidemic begin to wind down. Even so, the military announced that its suicide rate is lower than that of the American civilian population, citing that the civilian suicide rate for males aged 17-60 is 25 per 100,000 compared to the militarys rate of 17.5 per 100,000 in 2012 (Chappell). Still, the facts cannot be ignored. The issue of suicide is becoming an increasingly prevalent problem among active duty troops and veterans alike, acting as the deadly enemy within. It is clear that the military, as well as organizations such as the VA must take the initiative to resolve this growing epidemic. Year 2008 2009 2010 2011 2012 Deaths in military action 352 346 456 472 311 Suicides 268 309 295 301 349

Graphic Courtesy of GUARDIAN.CO.UK

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Post-traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a form of psychiatric disorder that usually develops after exposure to traumatic or life-threatening events. Symptoms of PTSD often include recurring nightmares, insomnia, irritability, and a severe sense of detachment. It is one of the primary mental health issues that characterize the type of wound suffered by todays service members. Also known as the invisible wounds of war, PTSD is a serious, yet often times, untreated issue among veterans (Reno).

Treatment
According to the Los Angeles Times, at least 20% of the 2.3 million troops returning from Iraq and Afghanistan will suffer from some form of PTSD (Zarembo). Roughly half of all service members who are affected by PTSD will refuse to receive treatment and among the half that do, 20% to 50% will not complete their treatment plans (Robson). The resources that are available to service members affected by mental health issues can be obtained through local Veterans Affair (VA) clinics and facilities. The VA has physicians, clinicians, and PTSD specialists that are capable of providing on-site support to those who are in need. The services that are offered include one-to-one mental health assessment and testing, medications, one-to-one psychotherapy, and group therapy (Department of VA). Although not all VA facilities offer the same programs, some smaller facilities are capable of providing treatment through telemental health (using technology to communicate) or by referral to Vet Centers or community clinicians (Department of VA). According to the VA, research has shown that the treatments they provide are effective in treating veterans.

A Need for Culturally Competent Resources


A service members reluctance to seek help for PTSD necessitates the need for more culturally sensitive resources. Although the VA has been making efforts to improve outreach and promote more widespread professional services, the lack of accessible culturally sensitive services still remains a problem. According to the VA, the total mental health clinical staff adds up to 22,000 professionals, dedicated to helping veterans with PTSD transition to civilian life (Reno). The main problem, however, lies not in getting veterans to admit to having PTSD, but in persuading them to receive treatment (Reno). As mentioned before, less than half the veterans with PTSD receive treatment for it (Veterans statistics: PTSD, Depression, TBI, Suicide). In many cases, veterans believe that seeking treatment will cause them to be mislabeled and thus jeopardize their future job opportunities. Because of this negative association with PTSD, veterans may see their job opportunities shrink as employers are less likely to hire employees who are deemed crazy by society (Tsai). Many, in fact, refuse to come to terms with the fact that they have PTSD and thus never receive treatment.
Graphic Courtesy of CLIPART.COM

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Case Study: Chee Kwan

We often underestimate the impact of mental health issues upon our service members, an issue that is particularly magnified in the AAPI community. From generation to generation, the AAPI community has failed to acknowledge the existence of mental health issues because of cultural barriers and its perception as a taboo subject. In addition, many AAPI soldiers have been brought up in households that have perpetually reinforced mental issues as mere imaginations and will fade away as time progresses. But do they? The following case study shows the severity of mental health issues in the military among AAPI service members. Corporal Chee Kwan answered the call of duty shortly before his 18th birthday and as an under-aged applicant to the United States Marine Corps, Kwan needed his mother to sign his enlistment contract for him. She did so only after he convinced her that he would enlist with his friends. He told her he would enlist anyway after turning 18 years old, even if she did not support him. Upon graduating from Gabrielino High School, Kwan was sent to boot camp at the Marine Corps Recruit Depot in San Diego on August 8, 2005. He was only 17 years old at the time. After completing Boot Photo Courtesy of CHEE KWAN Camp and infantry training at Camp Pendleton, California, Kwan was permanently assigned to the 2nd Battalion, 7th Marine Regiment, 1st Marine Division, in Twentynine Palms, California. He served as an Infantry Assaultman for the duration of his enlistment and deployed to Iraq in January 2007, and then Afghanistan in April 2008.

My first experience in theater was something surreal and out of the movies. As soon as I stepped out of the C-130, three Cobra attack helicopters flew overhead and lit the heck out of some town off in the distance. If I had any illusions of where I was that notion quickly faded away. Iraq was characterized by sniper fire and indirect mortar fire. The enemy was never any closer than 300 meters away unless they were speeding towards you in a dump truck filled with explosives. Afghanistan was worse. Close quarters battle and complex ambushes preceded by IED strikes were typical of the type of combat that we experienced in Afghanistan. Although many of my friends were wounded in Iraq, none of them were killed in action until my deployment to Afghanistan. The overwhelming trauma resulting from my experiences in combat will continue to stay with me for as long as I live.
As a combat veteran of Operation Iraqi Freedom and Operation Enduring Freedom, Kwan has experienced the horrifying tragedies of war. His first deployment to Iraq had left him questioning the morality of [his] actions while [his] second deployment had left [him] as a broken shell of [his] former self. 18

As common for veterans of his generation, Kwan suffered from post-traumatic stress (PTS), depression, and traumatic brain injury. What characterizes his PTS is his inability to sleep, frequent intrusive memories, and extreme sense of hyper vigilance. In addition, Kwan experiences severe bouts of depression and survivors guilt that can be triggered by various circumstances. The mere mention of troop fatalities or watching war movies such as Black Hawk Down and Saving Private Ryan can trigger his depression. As noted by Kwans friend, Terry Vaughn, a former British Royal Marine Commando and Haptics expert, Every time [Kwan] laughs theres a slight pause at the end followed by a look of guilt. Having experienced the realities of war, Kwan has often had to struggle with his experiences in combat. He suffers from hyper vigilance, an over-exaggerated form of alertness, which often borders on paranoia, because of the need to stay constantly on guard while deployed in Iraq and Afghanistan. Kwan explains that he cannot even eat a meal at a restaurant without first scrutinizing every person in the room because they may be potential threats. During his service, Kwan was taught to embody the belief that every Marine should be polite and professional, but to also have a plan to kill everyone [they] meet. In order to understand this belief, one must understand that the service members are trained to win wars. Only then can civilians understand the need for indoctrination. This mental conditioning cannot be easily turned off.

Photos Courtesy of CHEE KWAN

According to Kwan, he did not fully experience the effects of post-traumatic stress until six months after he returned home from Afghanistan in 2008.

When I returned home on October 28, 2008, I didnt think much about the war that I just survived. I was simply happy to return home. I dated, I went out, and I enjoyed my life as happily as I could. But then everything changed after I realized just how much my fellow Marines and I had lost on my last deployment. The battalion had suffered over 200 wounded and 21 of its members were killed. Many of them were my friends. My war at home didnt begin until I had fully realized just how much we had truly lost. And from then on, I grew depressed. My relationships with others suffered to the point where I simply lost the will to communicate to my friends and family. I experienced so much guilt from having survived when others did not. I often wondered, Why did I come home unscathed when others didnt? But that feeling of survivors guilt wasnt the only emotion that continued to haunt me. I believe that it was Robert Leckie that said, There are things men can do to one another that are sobering to the soul. It is one thing to reconcile these things with God, but another to square it with yourself. I also had to deal with the emotional cost of taking another mans life.

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Despite choosing to suffer alone, his mother and friends refused to allow him to isolate himself any further. Kwans mother often related stories of how she had suffered terribly as a result of her own experiences being a target of racial genocide and the guilt she felt for being responsible for her fathers death. She understood the emotions that he felt and begged him to seek professional help or at the very least confide in her and his friends. Kwans willingness to accept his mothers advice and openly talk about his experiences helped him understand the feelings that he was experiencing. In time, Kwan was able to come to terms with his emotions and accept the experiences he had in war. Although Kwan was able to come to terms with his experiences, many veterans are still unable to grasp the reality of their own experiences and either suffer alone or cause their loved ones to suffer along with them. Kwan believes that many veterans refuse to seek help because they are afraid that any mention of PTSD or depression on their medical records will reflect poorly on their job applications and that they will not be hired. He also believes that many service members simply dont believe themselves to be affected. However, as Kwan points out, every combatant will inevitably suffer from some form of PTS, depression, or traumatic brain injury if they have actively participated in combat. While the military does offer pre-and post-deployment screenings to service members that travel to Iraq and Afghanistan, Kwan does not believe that they do enough to actually screen outgoing service members for mental health issues. In his experience, military corpsman only asked him if he either felt like he was a danger to himself or to others and that if he said no then that was the extent of the questionnaire. However, Kwan felt that nothing was seriously done for those that did answer yes. Kwan ultimately believes that the issue with PTSD and depression is that service members simply do not want to come forward with their problems because of some perceived stigma that is associated with being weak and crazy. Regardless of ethnicity, Kwan believes that in order for service members to come forward and seek the help that they need, society must first create the conditions in which there is no stigma associated with seeking help for mental health issues. To Kwan, it is societys understanding, compassion, kindness, and love towards its service members that will truly make the difference. As a society, People must first understand that because the militarys sole purpose is to win wars, the military must condition its troops to lose a certain part of their humanity in order to accomplish its mission. When society begins to understand that war is nothing like Call of Duty: Modern Warfare, where the trauma and emotions can be turned off with the end of each gaming session, then it can come to accept that service members are flesh and blood individuals who are sometimes deeply affected by their experiences.

Conclusion
Although our research deals specifically with AAPI service members who lack culturally sensitive and responsive services, their situation is reflected in the experience of other minority groups. It is therefore important to provide programs that are culturally sensitive to other minorities backgrounds. This push for more AAPI mental health services is the first step in instigating more research and development for Hispanic, African American, American Indian, and other minority mental health services.

Photo Courtesy of CHEE KWAN

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Legislative Action Towards Mental Health Access: Mental Health ACCESS Act: Public Law 111-163

U.S. Senator Patty Murray (D-Wash), Chairwoman of the Senate Veterans Affairs Committee, introduced a bill to reform the Department of Defenses behavioral health and suicide prevention programs. This law, known as the Mental Health ACCESS Act became effective on January 2013 and seeks to reduce the high suicide rates by creating a comprehensive suicide prevention program, expanding VA mental health services, and establishing peer counseling opportunities that pair returning service members with those who have already made the transition to civilian life. Although the Mental Health ACCESS Act proposes to create a comprehensive [and] standardized suicide prevention program, improve training and education for our health care providers; create more peer-to-peer counseling opportunities, it has not addressed the cultural sensitivity of the AAPI community within the militaryand [expanding] such services to their families (Murray). Furthermore, this expansion of mental health services to family members will be neglecting the needs of AAPI members, unless this legislation includes suicide programs, culturally sensitive training and education for health care providers appropriate to the AAPI community as well as other minorities.

Patient Protection and Affordable Care Act

Under the Affordable Care Act, mental health care will be one of the coverages that will be expanded. According to the APSE Department of Health and Human Services, about 3.9 million people currently covered in the individual market will gain either mental health or substance use disorder coverage or both. Furthermore, about 1.2 million individuals currently in small group plans will receive mental health and substance use disorder benefits under the Affordable Care Act (Beronio, Po, Skopec, Glied). However, despite the increase in coverage, the underutilization of such resources may be a problem for the AAPI community. In order to negate this occurrence, provisions to include culturally sensitive training to mental health facilitators and linguistic material to provide inclusive mental health services. To implement such training and to target communities with the most AAPI service members and families, funding for ethnic-specific demographic data must be available.

Public Law 112-213: Regarding Mental Health Services

Section 716 and 731 of Public Law 112-213 detailed plans to implement a consolidated Military Health System, which is a singular database to increase access to healthcare for all service members in general. According to Stephanie Wong, the Field Representative of Assemblymember Jimmy Gomez who focuses on Veterans Affairs, expanding on the database network is a start. However, establishing an online database alone will not solve this issue based on Wongs experience with the troubled students of East Los Angeles High school systems, many of which deal with lack of mental health resources.

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Wong has communicated with numerous school nurses demanding more funding for counseling programs rather than funding for an electronic database of these limited resources. Wong concluded that, although this issue deals with the East Los Angeles students, it is imperative to understand the correlation with the veterans, especially the AAPI service members (Wong). Rather than consolidating insufficient resources in a mental health database, the entire military population would also benefit from having a more mental health programs in general. Furthermore, the AAPI community would benefit from cultural training and understanding from their healthcare providers in order to deconstruct the cultural barriers that prevent AAPIs from seeking treatment.

Executive Order 13515: Presidents Advisory Commission on AAPIs and the White House Initiative

The history of Executive Order 13515 was established by Executive Order 13125, signed by President Bill Clinton on June 7, 1999. The most current renewal of the initiative is Executive Order 13515, signed by President Barrack Obama on October 14, 2009 (Bau).

Photo Courtesy of EXAMINER.COM

In accordance to 13515, the Presidents Advisory Commission on Asian Americans and Pacific Islanders was established to function to address the concerns of the AAPI community, according to section 2(a), which will provide sufficient advice [to increase AAPI] participation of Federal programs by compiling data (Obama). Since this Advisory Committee, defined in section 3(ii), is committed to increase public and privatesector collaborationin improving the health, education, environment and well-being of AAPIs, the community should be involved being aware of the data compiled by the Committee in order to address their problems (Obama). To extend proper outreach to AAPIs, the publication of research reports should be readily accessible, along with the access to services.

Photo Courtesy of NYTIMES.COM

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Military Hazing
Though military enlistment rates among the AAPI community are currently on the rise, military hazing, especially of AAPI service members, has been emerging as an increasingly pervasive issue that requires immediate attention. The suicide case of Private Danny Chen in particular opened the eyes of many AAPIs to the extreme harassment that soldiers were subjected to in the military. As a result, members of the AAPI community found the need to display a united front, rallying behind Danny Chen and even introducing legislation to fight the battle against military hazing. Similar to this outcry for justice, AAPIs must also stand together and support AAPI veterans in their transition back to civilian life. Currently, there is little data on AAPI hazing incidents and a shortage of information on services that could possibly be used to access care.
Photo Courtesy BLOGSPOT.COM

Corporal Punishment v. Military Hazing

In the military, there is a fine line between corporal punishment and military hazing. It is essential that the military maintain good order and discipline in a unit in order to successfully participate in battle, but discipline in such a volunteer organization is a delicate topic. Members of the military need to understand how to perform appropriate discipline, but at the same time, understand that discipline should never cross the line of becoming abusive (Lesson 20). In order to create a balanced environment in the military, the differences between authorized corporal punishment and unnecessary military hazing need to be defined. Essentially, corporal punishment is a type of physical punishment inflicted as a type of corrective training. The punishment results with hopes of instilling higher discipline and correcting unacceptable behavior. On the other hand, Military hazing is any conduct whereby one military member or employee, regardless of service or rank, unnecessarily causes another military member or employee, regardless of service or rank, to suffer or be exposed to an activity which is cruel, abusive, oppressive or harmful (Army Board Study Guide 3).

Photo Courtesy of STUFFICIONADO.NET

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According to the Army Study Guide, a non-government, privately-sponsored website for educational benefits, hazing includes, but is not limited to any form of initiation, rite of passage or congratulatory act that involves inflicting pain or engaging in illegal, harmful or demeaning acts. Hazing does not need to involve physical contact among or between the military members. Unnecessary verbal or psychological abuse that is degrading to another service member is also considered military hazing. Common practices of military hazing include: Physically striking another in order to inflict pain Piercing anothers skin in any manner Forcing or requiring the consumption of excessive amounts of food, alcohol, drugs, or other substances Sexual harassment Racial insults At the same time, discipline is also a core principle in the military. Military discipline helps to create individuals who can complete certain jobs with accuracy and efficiency. The military provides discipline in the form of penalties for tractions like disobeying lawful orders or neglecting ones duties. With discipline possibly turning into or being recognized as military hazing, the fundamental breakdown in military order could be jeopardized. For example, a command by the commanding office to do 20 sets of pushups due to misbehavior could be considered excessive. Individuals may then consider it military hazing, therefore jeopardizing the units authority to discipline. Also, because of the publicity many high profile military hazing cases have been brought to the attention of the U.S. Congress, there are now strict rules banning all military hazing as well as most corporal punishment (Vandiver 2012, 10). This is a significant step in diminishing unnecessary harassment among service members. However, we must also ask ourselves whether or not we have passed legislation that is chipping away at the core of disciple within the military in exchange. We must not let military hazing continue, but concurrently, the military needs regulations to uphold its pillars of excellence for our countrys sake.

Lack of Data on Military Hazing

Currently, there are few statistics on military hazing occurrences, especially within minority groups. Therefore, it is difficult to create an approach that can sufficiently combat this issue. In order for any progress to made, there needs to be more detailed research documenting the individuals who are victims of military. For example, racial breakdowns for military hazing could be particularly useful in helping the military pinpoint which areas of research to focus on as well as in creating culturally sensitive programs that promote tolerance and awareness. From there, more services and programs can be catered toward training service members, especially officers, so that unnecessary abuse is weeded out and put to an end. Next, we will examine a case study on Private Danny Chen, an unfortunate victim of the heinous crime known as hazing.

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Case Study: Danny Chen

Background and Cultural Barriers


One soldier who committed suicide because of the hazing he endured was Army Private Danny Chen. Danny Chen was a Chinese American U.S. Army Private, born and raised in New York, who was deployed to Afghanistan for six weeks. He was 19 years old when he took his own life in October 2011 (Semple). Because Private Chen grew up in a first generation household, he was not especially Americanized or integrated into the American society. In fact, he was born and raised in New Yorks Manhattan Chinatown. In addition, his parents were first generation immigrants. While his father worked as a chef in Chinese restaurants, his mother worked as a seamstress in a garment factory. As a result, they did not speak English fluently Photo Courtesy of NYTIMES.COM and did not understand too much about the military culture (Semple).

The Trials
During the resulting court-martials that concluded in December 2012, Private Chens parents could not even advocate for themselves when they tried to hold the military accountable because of the language barrier. The justice they sought was greatly hindered by their inability to speak the English language, thus they remained powerless and ultimately voiceless during the trials and sentencing (Semple). In the end, only one officer was implicated in the death of Private Chen while others were given brief prison sentences and demotions. As Elizabeth R. OuYang, President of the New York chapter of the Organization of Chinese Americans, had stated, These light sentences do not give justice to the life of Pvt. Danny Chen.

The Tragedy
In the Army, Private Chen served with C Company, 3rd Battalion, 21st Infantry Regiment, 1st Stryker Brigade Combat Team, 25th Infantry Division and was the only Chinese American in the group. He not only had to endure taunts and racial slurs, but also received severe physical maltreatment, enduring harassment beyond the standard corrective training (Elie). In fact, on the day of his death, Private Chen reported for guard duty without his helmet and after going to retrieve it, other soldiers forced him to crawl over gravel for 100 meters while they threw rocks at him. On October 3, 2011, Private Chen was found dead in a guard tower from a self-inflicted gunshot wound, two months after he was deployed. From the details released from the trials, his suicide can be attributed to the extreme emotional and physical abuse Private Chen received. In December 2011, the Army charged eight soldiers in Private Chens battalion in connection with his death, including the charges of manslaughter and negligent homicide.

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During the investigations that ensued, more and more details of Private Chens mistreatment were revealed. In addition to racial taunts, he was even forced to wear a green helmet and shout orders in Chinese even though the battalion consisted of no other Chinese American soldiers (Chen case: AsianAmerican soldiers endure bias). Though the initial charge of involuntary manslaughter was ultimately dropped, in December 2012, First Lieutenant Daniel L. Schwartz was implicated in Private Chens death and thrown out of the military. The court concluded that Lieutenant Schwartz had failed in his leadership, and he was formally charged with dereliction of duty for neglecting to foster camaraderie and prevent extreme maltreatment. Though Private Chen was inexperienced and made frequent mistakes, such lapses were normal for inexperienced military soldiers, and thus the problem lay ultimately in how his superiors were helping him overcome his deficiencies. Instead of employing corrective training to improve his deficiencies, they resorted to hazing, and even refused to transfer him to a nearby base where he could have received further help (Chu). In contrast, they continued to haze him, even to the point where they were throwing rocks at him to simulate artillery. Thus, failure of leadership in preventing hazing among fellow service members is a serious issue that needs to be addressed and worked on.

Photo Courtesy of WNYC.ORG

Sergeant Adam M. Holcombs trial revolved around what caused Private Chen to take his own life. In addition to being charged with one count of assault and two counts of maltreatment, he was sentenced to one month in jail a substantially shorter time than the 17 years he could have faced had he been found guilty of negligent homicide. His lawyers argued that Private Chens personal failures as a soldier and fraught relationship with his parents were the ultimate causes of his death (Semple). According to Holcombs lawyers, Private Chen had told a close friend that his parents had disowned him because of his imminent deployment and was later found curled up in a fetal position. Defense lawyers of Sgt. Holcomb cited this incident as proof of Private Chens personal life undermining his duties. 26

Support from the Community

Many advocates for the family in the AAPI community, from local Chinatowns to college students, came together to demand a full investigation as well as to lobby the Army to crack down on military hazing and improve conditions for minorities. Many minority advocates have expressed their concern over the treatment of AAPIs in the military, especially in regards to malicious and unnecessary taunting. In fact, OuYang pointed out that there needs to be an environment where they are integrated, protected and supported [but] its unclear that thats the case (OuYang). This could have easily been done had Private Chens superiors taken a more constructive approach to hazing, or corrective training, rather than pure punishment and abuse. Wellington Chen, Executive Director of Chinatown Partnership, also expressed her concern, stating that the verdict will have profound implications, not only for our ethnic group but for all Americans who expect their government to give them both freedom and protection. As Americans, it is reasonable to expect the government to protect our individual freedoms and rights, but in terms of Danny Chen, his right to life was taken away from him as he was inhumanely treated by his superiors. Through her statement, Chen firmly believes that the government is responsible for this miscarriage of justice. After initially feeling frustrated and angry by the news, Vassar College student, Julia Chung, decided to take action, signing petitions, staging protest marches, and even contacting military officials to push for justice on American soil (Dobnik, 2012). Furthermore, in August 2012, Congresswoman Judy Chu wrote an Op-Ed piece in the New York Times and expressed her thoughts on the Danny Chen case, and in particular, spoke out against hazing. As seen through the actions of AAPI individuals, the AAPI community came together and rallied behind Private Chen and his family to provide support. Similarly, it is just as important for the AAPI community to rally behind its veterans by committing time and effort to research the challenges faced by the service members and push for more resources and services instead of waiting and relying on the VA.

Photo Courtesy of RACISMREVIEW.COM

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Corrective Training v. Hazing in the Danny Chen Case: Just When Does It Become Too Much?

Ultimately, the fine line between hazing and corrective training must be more clearly defined. While hazing threatens unit cohesion, morale, and productivity, corrective training can foster professional development and conduct. In the case of Private Danny Chen, his chain of command had clearly failed him in his time of need. Rather than employing proper corrective training to Photo Courtesy of KTSF.COM help Private Chen correct his individual deficiencies, his superiors, in dereliction of their duties, chose to harass and taunt him because of his race. Although the case of Private Chen speaks volumes about the harassment of AAPIs in military service, it also points to the larger problem of military hazing in general. While the military has implemented policies to prevent hazing among its service members, the military should also strive to produce more data on military hazing so that a more proactive and comprehensive prevention plan can be established to protect individuals like Private Chen while also ensuring superiors are not abusing their power.

Conclusion

Hazing is emerging as a serious issue in the U.S. military, especially because of the tragic consequences that have recently resulted from it. It also poses as a valid threat against the credibility of the military as the lack of accountability in many hazing cases raises the publics skepticism and is detrimental to the militarys name. Though hazing is strictly prohibited in the military, the fact that it is not part of the military code detracts from its enforceability (Chu). If hazing were incorporated in the military code as a crime, only then would the military be able to take more immediate actions on it (Chu).

Legislative Action Towards Military Hazing: Public Law 112-231, The results of the Harry Lew Military Hazing Accountability and Prevention Act of 2012
On April 3, 2011, a Marine Lance Corporal named Harry Lew committed suicide in response to multiple incidents of abuse, which were revealed after further investigation. Outrage from the community and representatives led to the first congressional hearing on military abuse since 1979 (Chu).

In response to the death of Harry Lew, the nephew of Congresswoman Judy Chu, a congressional hearing was held on March 22, 2012 to introduce legislation addressing military abuse. The Graphic Courtesy of TWITTER.COM Harry Lew Military Hazing Accountability and Prevention Act of 2012 was incorporated into the FY 2013 National Defense Authorization Act: Selected Military Personnel Policy Issues, which was signed into Public Law 112-213 on January 2, 2013. 28

Conclusion
In order to increase the number of ethnic specific resources which are available to Asian American and Pacific Islander (AAPI) service members and their families, the Department of Defense (DOD), Department of Veterans Affairs (VA), and the AAPI community must first collaborate to research the problem at hand. By working together, the DOD and VA can collect data to identify the issues that AAPIs face and determine how to develop the appropriate programs. Ultimately, this project serves as the initial point of dialogue, starting from AAPI issues as a pipeline to address possible issues among other minorities within the military. In terms of mental health resources, it is important to provide multilingual services which will help non-English speaking family members identify symptoms of PTSD and refer service members to appropriate treatment. However, many of the resources that are available to veterans are simply inaccessible because information regarding who might utilize those services is lacking. In fact, many of the VA resources that are accessible to service members and their families are primarily in English or Spanish, which puts AAPI family support at a disadvantage. For example, in order to obtain a brochure in Chinese, a series of requests through the District Office and National Headquarters is necessary. Even then, the information will not be mailed directly to the recipient, but will go back to the District Office and then to the local office (Inzunza). Because the DOD is ultimately responsible for any and all issues pertaining to active duty and reserve members of the military, it would greatly benefit from further support to handle the vast number of veterans who have served this nation. Therefore, it falls upon the VA to supplement the efforts of the DOD by improving AAPI access to resources. In addition, ethnic breakdowns will help point out the subgroups that are more inclined to suffer from PTSD. Because there is no data on the number of AAPIs who are currently afflicted with PTSD, we can only infer from both the overall AAPI population and the general veteran population of what their numbers are today. With the specific ethnic breakdowns, it is possible to determine which ethnic groups are more inclined to develop PTSD and other mental health issues. Such data will allow us to cater specific multiethnic support plans to these service members and family members.

Graphic Courtesy of BLOGS.LAWYERS.COM

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Furthermore, it is imperative to research the reasons veterans refuse to seek PTSD treatment in order to effectively target service members and develop programs that will help them overcome barriers. For example, by dispelling the misconception that a service member receiving treatment for PTSD is perceived as being crazy, employers would not be as reluctant to hire service members afflicted with PTSD. In turn, this will help increase the willingness of veterans to seek help as they would not feel as burdened by the threat of lifelong unemployment. Similarly, there is great potential that the overall community will benefit economically from addressing the problems that AAPI service members face. These efforts will ensure that the immense military spending invested in each service member would result in highly trained and skilled populations entering the general workforce as veterans. In fact, Secretary Robert Hale from the DOD has stated that $850,000 is spent each year to maintain one soldier in Afghanistan (Shaughnessy). However, the monumental amount of time and money invested in each service member would reach full potential only if these veterans receive the proper resources to help them transition into productive members of society. Because of the lack of these services, many are left suffering from mental health issues in silence and even becoming victims of suicide. Therefore, it is beneficial to both the general population and the economy as a whole to increase resources helping AAPI service members. In regards to military hazing, while the DOD recognizes that AAPI service members are a small minority within the armed forces, it has yet to provide definitive research on the discriminatory problems AAPI members face. The case of Army Private Danny Chen and Marine Lance Corporal Harry Lew brought to light that differences in culture, background, and race could create conditions that cause minorities to feel marginalized and become the targets of cruel and degrading acts. Their suicides drew national attention by exposing an issue that was relatively unaddressed in public and galvanized the AAPI community into rallying for a change in the way military officials address the issue of hazing Both suicides, in fact, were largely due to the failure of military leadership. In Danny Chens case, his superior was charged with dereliction of duty for failing to foster camaraderie and failing to put an end to the extreme harassment. Thus, military leaders should be better trained, both in protecting minority groups and in handling cases of hazing, especially those involving racially-based harassment. Along these lines, the DOD must ensure that the chain of command is responsible for implementing policies and procedures regarding the ethical treatment of its service members. Meanwhile, the VA should continue to invest its time and resources into documenting what challenges the AAPI service members are facing. As Congresswoman Judy Chu recommended, though hazing is indeed prohibited in the military, including it in the Uniform Code of Military Justice will allow the military to take more immediate actions on it (Chu).

Graphic Courtesy of VA.GOV

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Ultimately, the goal of this research project is twofold. It is our duty to encourage service members, who have been deployed to Iraq and Afghanistan, to seek screening for mental health issues regardless of whether or not they believe themselves to be affected. Although the VA is accountable for taking care of our nations veterans, the AAPI community must share this responsibility by leading the way in researching the issues faced by AAPI service members. In addition, it falls upon the entire community to help assess the issues that AAPI service members are facing and to document these findings for the general population and the military to see. Establishing public service announcements will be a great way to publicize these findings and encourage the AAPI community to exercise care and support in dealing with its service member population. More importantly, these announcements can help dispel the stigma associated with mental health issues by highlighting AAPI service members who have gone through successful treatment. Only by encouraging open dialogue on this issue and implementing solutions to these problems can we fulfill President Abraham Lincolns desire to care for him who shall have borne the battle and his widow and his orphan.

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Graphic Courtesy of DEFENSE.GOV

Resource Guide
The Center for Innovation and Research on Veterans and Military Families at USC Social Work is a research center that works to facilitate the transition of veterans and their families to their respective communities. The research Graphic Courtesy of USC.EDU center has many ongoing projects ranging from helping homeless veterans in Skid Row to refining military social work training. One particular project of interest is The Los Angeles Veteran Survey, which is launching this August through October. This survey seeks to identify current local needs of veterans in Los Angeles County, barriers to care issues, opportunities for program and service development, policy change, and community collaboration. For more information, contact Margaret Thomas, community liaison, at margaret.thomas@usc.edu or visit CIRs website at http://cir.usc.edu/. National Alliance on Mental Illness (NAMI) is a mental health advocacy organization that aims to support research on mental health, increase parity of mental health services, and ensure treatment for those who are in need. NAMI is at the forefront of the effort to shape national public policy on mental health, providing resources, skills, and tools to grassroots leaders to help remedy this problem. More recently, NAMI has organized listening sessions regarding the AAPI populations experience with the mental health Graphic Courtesy of NAMI.ORG field and addressing the barriers and gaps they faced while accessing supportive services. For more information, please visit www.nami.org. Pacific Clinics is an outpatient mental health agency that seeks to provide innovative behavioral health care services to diverse populations in Los Angeles, Orange, Ventura, San Bernardino and Riverside counties. Their scope of services ranges from prevention to early interGraphic Courtesy of PACIFICCLINICS.ORG vention, including integrated treatment programs for those with substance abuse problems and mental health disorders. In regards to AAPI mental health, Pacific Clinics has facilitated much research and conversation on this topic. More recently, a report by Pacific Clinics C. Rocco Cheng found that AAPIs face a lack of culturally appropriate services. To learn more about Pacific Clinics services, please visit http://www.pacificclinics.org/ or call (877) 722-2737. Asian Pacific Counseling and Treatment Centers (APCTC) was established in 1977 as a directly-operated satellite program of Los Angeles County Department of Mental Health. With over a hundred highly trained staff, APCTC takes a multidisciplinary and culturally competent approach to serving the social and psychological needs of its clients. APCTC provides child and family outpatient care, adult outpatient care, full-service partnerships, among others. To learn more about APCTC, visit http:// www.apctc.org or call (213) 252-2100. Graphic Courtesy of PACIFICCLINICS.ORG 32

A Word of Thanks
Apart from our own efforts, the success of any project depends largely on the encouragement and guidance of many others. Without the mentorship we received, this project simply would not have been possible. First and foremost, we would like to thank the dedicated CAUSE Board and staff members for their invaluable insight and endless advice. We cant thank them enough for their tremendous support and unwavering faith in us. Special thanks to: Charlie Woo Gary H. Arakawa Carrie Gan Grace Hsieh Sophia Islas Alex Phung Chair, CAUSE Board of Directors, CAUSE Executive Director, CAUSE Director of Programs, CAUSE Director of Communications, CAUSE Director of Marketing, CAUSE

It is equally important to highlight the generous contributions of many of our guest speakers along with our legislative offices. As such, we would like to express our sincere gratitude to these individuals who have been instrumental in the successful completion of our project. Our work would have not been complete without their crucial help and support. Special thanks to: Janet Chin Albert Gianatan Kimler Cruz Gutierrez Razon Inzunza Dr. Wenli Jen Cory Jeffers Gene Kim Jonathan Kim Christina Lay Monica Lee Samuel Mori Eugene Moy Hiroku Murakami Mark Masaoka Larry Pham Myron Dean Quon Enrique Robles JP Tremblay Tammy Tran Dr. Jack Tsai Mirtha Villarreal-Younger Stephanie Wong Winston Wu Maxwell Zhu Office of CA State Senator Ed Hernandez CAUSE Volunteer Asian Pacific Policy and Planning Council United States Marine Corps Pacific Clinics United States Marine Corps Congressional Asian Pacific American Caucus United States Naval Academy National Asian Pacific American Families Against Substance Abuse Former CAUSE Leadership Academy Intern CAUSE Volunteer Chinese American Citizens Alliance National Asian Pacific American Families Against Substance Abuse Asian Pacific Policy and Planning Council CAUSE Volunteer National Asian Pacific American Families Against Substance Abuse Office of Congresswoman Judy Chu California Department of Veterans Affairs Southern California Edison Yale School of Medicine California Department of Veterans Affairs Office of CA Assemblymember Jimmy Gomez Chinese American Citizens Alliance CAUSE Volunteer 33

About the Interns

Chee Danny Kwan


University of California, Irvine Rising Junior U.S. Congresswoman, Grace Napolitano

Jonathan Chen
University of California, San Diego Incoming Freshman California State Senator, Lou Correa

Katrina Lei
University of California, Los Angeles Rising Senior U.S. Congressman, Ed Royce

Tanya Edmilao
University of Southern California Rising Senior California State Assembly Member, Jimmy Gomez

Lauren Richardson

University of Southern California Rising Junior California State Senator, Ted Lieu

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Edward Truong
San Jose State University Rising Junior U.S. Congressman, Adam Schiff

Mengyuan Christine Sun


University of Pennsylvannia Incoming Freshman California State Assemblymember, Ed Chau

Kim Yamasaki
University of California, Los Angeles Rising Junior U.S. Congresswoman, Judy Chu

Jimmy Tran
Pasadena City College Incoming Freshman California State Senator, Ed Hernandez

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Works Cited Affordable Care Act Expands Mental Health and Substance Abuse Benefits for 62 Million Americans | Juvenile Justice Reform | Adolescent Substance Abuse Treatment | Reclaiming Futures. Affordable Care Act Expands Mental Health and Substance Abuse Benefits for 62 Million Americans | Juvenile Justice Reform | Adolescent Substance Abuse Treatment | Reclaiming Futures. N.p., n.d. Web. 26 July 2013. <http://www. reclaimingfutures.org/blog/affordable-care-act-expands-mental-health-and-substance-abuse-benefits-62-million-americans>. Africa,Jei, and Majose Carrasco. Asian-American and Pacific Islander Mental Health Report from a NAMI Listening Session. National Alliance on Mental Illness, Feb. 2011. Web. 4 Aug.2013.<http://www.nami.org/Template. cfm?Section=Multicultural_Support1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=115281>. Air Force. <http://s.wsj.net/public/resources/images/OB-TB621_airfor_G_20120523131733.jpg>. Air Force Personnel Demographics. Air Force, n.d. Web. 15 July 2013. <http://www.afpc.af.mil/library/airforcepersonneldemographics.asp>. Albrecht, Brian. Post-traumatic Stress Disorder Hitting World War II Veterans. Post-traumatic Stress Disorder Hitting World War II Veterans. Cleveland Live LLC, 1 Nov. 2011. Web. 10 July 2013.<http://www.cleveland. com/news/plaindealer/index.ssf?/base/cuyahoga/1247733140222090.xml>. APAC. Northwestern Universitys Asian-American Interest Magazine, 15 Jan. 2012. Web. 24 July 2013. <http://nuasian.wordpress.com/2012/01/15/magazine-gearingup-asian-americ an-military-enlistment-is-on-the-rise/>. Asian/Pacific American Heritage Month: May 2013. United States Census Bureau. N.p., 27 Mar. 2013. Web. 19 July 2013. <http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb13-ff09. html>. Asian American and Pacific Islander Mental Health: Report from a NAMI Listening Session. National Alliance on Mental Illness. N.p., n.d. Web. 22 July 2013. <http://www.nami.org/Template.cfm?Section=Multicultural_ Support1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=115279>. Asian American-Pa cific Islanders. American Psychiatric Association. N.p., n.d. Web. 26 July 2013. <http://www.psychiatry.org/mental-health/people/asian-americans>. ASPE. ASPE. N.p., n.d. Web. 26 July 2013. <http://aspe.hhs.gov/health/reports/2013/mental/rb_mental.cfm>. B, Elie. Shocking Details of Private Danny Chen Case Revealed. Bowery Boogie. N.p., 6 Jan. 2012. Web. 18 July 2013. <http://www.boweryboogie.com/2012/01/shocking-details-of-private-danny-chen-case-revealed/>. Berglass, Nancy C., and Margaret Harrell. Losing the Battle The Challenge of Military Suicide. Center for a New American Security. N.p., Oct. 2011. Web. 24 July 2013. <http://www.cnas.org/files/documents/publications/ CNAS_LosingTheBattle_HarrellBerglass.pdf>. Briggs, Bill. Military suicide rate hit record high in 2012 NBC. N.p., 14 January 2013. Web. 26 July 2013. <http://usnews.nbcnews.com/_news/2013/01/14/16510852-military-suicide-rate-hit-record-high-in-2012?lite>. Briggs, Bill. The enemy within: Soldier suicides outpaced combat deaths in 2012. NBC. N.p., 3 Jan. 2013. Web. 24 July 2013. <http://usnews.nbcnews.com/_news/2013/01/03/16309351-the-enemy-within-soldier-suicidesoutpaced-combat-deaths-in-2012?lite>. Casual to Deadly: Anti-Asian American Racism. Racismreviewcom RSS. N.p., n.d. Web. 07 Aug. 2013. <http://www.racismreview.com/blog/2012/01/09/casual-to-deadly-anti-asian-american-racism/>. Chappell, Bill. U.S. Militarys Suicide Rate Surpassed Combat Deaths In 2012. National Public Radio. N.p., 14 Jan. 2013. Web. 26 July 2013. <http://www.npr.org/blogs/thetwo-way/2013/01/14/169364733/u-s-militarys-suicide-rate-surpassed-combat-deaths-in-2012>. Chen case: Asian-American soldiers endure bias. The Wall Street Journal . N.p., 19 Feb. 2012. 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MAVNI_program>. Mental Health and Asian Americans. The Office of Minority Health. N.p., 5 Dec. 2012. Web. 26 July 2013.<http://minorityhealth.hhs.gov/templates/content.aspx?ID=6476>. Mental Health Issues among Asian American and Pacific Islander Communities. National Alliance on Mental Illness. N.p., n.d. Web. 23 July 2013. <http://www.nami.org/Template.cfm?Section=Fact_Sheets1&Template=/ ContentManagement/ContentDisplay.cfm&ContentID=123209>. Michael, Spencer, Juan Chen, Gilbert Gee, Katherine G. Fabian, and David G. Takeuchi. Discrimination and Mental HealthRelated Service Use in a National Study of Asian Americans. American Public Health Association. American Journal of Public Heath, Dec. 2010. Web. 27 July 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978178/#bib41>. Military Service Members, Veterans, and Their Families. Military Service Members, Veterans and Their Families. American Psychological Association, n.d. 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Center for Asian Americans United for Self Empowerment (CAUSE) is a 501(c)(3) nonprofit, nonpartisan, community-based organization with a mission to advance the political empowerment of the Asian Pacific American (APA) community through nonpartisan voter registration and education, community outreach, and leadership development. Founded in 1993, CAUSE is comprised of committed professional, business, community and political leaders, and has established itself as a unique nonpartisan APA organization dedicated solely to APA civic and political participation. Based in the Greater Los Angeles area, CAUSEs influence reaches throughout California.

CAUSE BOARD OFFICERS & DIRECTORS


Chair Charlie Woo Megatoys Vice Chair Marcella Low The Gas Company Vice Chair Emily Wang East West Bank Legal Counsel Kenneth K. Lee Jenner & Block LLP Secretary Ben Wong Southern California Edison Treasurer James Hsu Squire Sanders (US) LLP Board of Directors Gary H. Arakawa Covington Capital Management Ling-Ling Chang City of Diamond Bar Sandra Chen Lau University of Southern California Alan K. Kims, M.D. Ardmore Medical Group Inc. & Advantage Health Network Fred Rowley Munger, Tolles & Olson LLP Nita Song IW Group, Inc. K. Luan Tran Lee Tran & Liang, APLC Kenny Yee Imuarock Partners Ron Wong Imprenta Communications Group Robert Yap Total Call International Albert Young, M.D., M.P.H. Network Medical Management Executive Director Carrie Gan Director of Programs Grace D. Hsieh Director of Communications Sophia Islas Director of Marketing Alex Phung

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A Special Thanks to Our Sponsors

Mr. Nelson Tan Mr. Peter Woo


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CAUSE Leadership Academy Center for Asian Americans United for Self Empowerment (CAUSE) 260 S. Los Robles Avenue, #115 Pasadena, California 91101 Office: 626.356.9838 Fax: 626.356.9878 Email: info@causeusa.org Website: www.causeusa.org
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