On September 11, 2001, May Chen stood in front of Confucius Plaza, a 44-story residential tower on the outskirts of Chinatown.
It was the first day, an important day for Chen, whose husband was running for New York City Council. The streets were full of voters going to the polls and workers on their way to their offices.
But one morning that started out full of optimism suddenly turned into one of the most traumatic in American history.
“We saw this giant fireball hit World Trade buildings,” Chen, now 73, told NBC News. “And we thought a bomb exploded inside the building. And then there was a big orange ball of fire. “
Chen watched the air fill with thick dust and debris and remembers the smell of burned plastic in the air.
“People were kind of walking around like zombies,” she said. “It just felt so incredible and confusing.”
Nearby, Peter Lee, whose family has been running the Cantonese restaurant Hop Kee in the heart of Chinatown since 1968, was shocked.
“I’ve lived in this area all my life,” said Lee. “I saw the empty ground before they built the towers. I played on these empty lots. Then, in your youthful days, you see it build up and you go visit it. Suddenly everything is gone. “
When the Twin Towers collapsed on September 11th, more than 80,000 residents of Chinatown were only 10 blocks from the World Trade Center. But in the months and years after September 11, few outside the area focused on the physical or mental health of this densely populated neighborhood. Chinatown fell just outside the immediate impact zone around Ground Zero. As a result, residents and workers there were entitled to fewer resources, which made the trauma they suffered after the terrorist attacks worse.
“It felt like Chinatown was being ignored after 9/11,” said Daniel Huang, clinical director of behavioral health at Hamilton-Madison House, an Asia-focused mental health clinic in Lower Manhattan.
Huang joined Hamilton-Madison House 10 years after the attacks.
“I still heard stories about 9/11,” he said. “People who had dreams and nightmares about what happened; People who are still taking medication who are still receiving advice. “
It wasn’t just the image of the towers collapsing that day that affected the people of Chinatown. In the following weeks, their tourist hotspot neighborhood was completely closed.
“There were police officers everywhere, federal officials. They made sure no residents or people went in or out of Canal Street, ”Lee recalled. “You had to have proof that you lived in the area before they let you down because they didn’t want anyone down here.”
Jo-Ann Yoo who did that. directs Asiatic-American Federation in New York, said Chinatown never fully recovered after 9/11.
“The fact that so many of the small shops closed because all the trucks couldn’t get into Chinatown because all the arteries were blocked wiped out the entire clothing industry in Chinatown,” she said. “So I know there was a lingering ripple effect.”
At that time, almost a third of the population of Chinatown lived below the poverty line, compared to 21 percent of the general New York population.
After September 11, many of the mental health resources earmarked for World Trade Center survivors were either unavailable or underutilized for the people of Chinatown.
In November 2001, a program supported by the Federal Emergency Management Agency launched a massive public awareness campaign for free crisis counseling in New York. but none of the TV, radio, or subway advertising that was used was targeted at the Asian community in Chinatown, according to the Mental Health Association of New York City, now known as Vibrant Emotional Health. And a 2015 report found that the Asian community received only 0.2 percent of the contract dollars spent by the New York Department of Health from 2002 to 2014.
The 9/11 Mental Health and Substance Abuse Program provided financial support for mental health care costs for people affected by the attacks on the World Trade Center. But of the more than 9,000 people who participated in the program between 2002 and 2004, only 4.6 percent identified themselves as Asian, according to Vibrant Emotional Health.
In addition, after 9/11, Chinatown residents were more prone to a more permanent and intense course of post-traumatic stress disorder than other New York City residents, experts say.
“We know from so many PTSD studies that the closer you were to ground zero, the more likely you are to develop long-term mental health problems,” said Yuval Neria, director of trauma and PTSD at the New York State Psychiatric Institute.
In the weeks following September 11, about 8.2 percent of people who lived south of 110th Street in New York City had symptoms consistent with likely PTSD a survey.
Among people who live south of Canal Street – the heart of Chinatown – the prevalence of PTSD rose to nearly 20 percent. Another study, which was conducted several years after September 11, found that the prevalence of PTSD among Asians exposed to the attacks had decreased only slightly to 14.6 percent.
Asian Americans are according to the American Psychological Association. Some of the reasons are community stigma about mental health, the “model minority” myth, the stress of biculturalism, PTSD from history that includes fleeing war-torn countries, and more.
“It has an impact when you get a job. It affects who you marry. It affects how people start to look at you and your family and think that there is a mistake, ”Yoo said.
Chen, who turned to her family for emotional support after the terrorist attacks, recognized the challenges.
Twenty years later, Huang said they were still faced with a lack of resources.
“We just don’t have the resources to meet the staffing needs to keep our programs open to new patients year-round,” said Huang. Beyond Hamilton-Madison House, “there are probably only a handful of organizations focused on our community,” said Huang.
The result is a serious shortage of mental health providers who are fluent in Chinese.
“You can’t go to the phone book and find a Mandarin-speaking, Fujian-speaking advisor,” said Yoo.
The ongoing pain of 9/11 was also made worse by the Covid-19 pandemic and an alarming surge in anti-Asian hate incidents.
“For those who were traumatized by 9/11, those trauma usually reappear,” said Huang.
Huang said it is never too late to talk about the 9/11 pain, and he is encouraged by signs that people in the area are more open to psychiatric treatment now than they were during those terrible days in 2001.
“It’s something that has to be worked through,” he said.
Chen, who still lives in Chinatown, said she was “very sad and frustrated” when she thought about how 9/11 affected her neighborhood. But she credits her support system for helping her cope.
“My family is all around this area,” she said. “So just being able to talk to each other, comfort one another and just have normal family life together and appreciate that we got through this was very helpful.”
And like Huang, she is hopeful.
“Seeing this next generation and this community’s ability to reinvent itself and find new ways to survive … is a good thing,” said Chen. “There is progress.”
For anyone looking for mental health resources:
text HOMELAND or NAMI at 741741 for 24/7 support from the Crisis Text line
text WELL at 65173 or call 888-NYC-WELL to speak to a mental health advisor
Call the US HelpLine at 800-950-NAMI for mental health information, recommendations, and support
Call the Lifeline of suicide prevention at 1-800-273-TALK