By the time Diana Chao was in middle school, she had reached a crisis point.
“I grew up with all sorts of abuse and assault. I remember ever since I was young, I always thought that it would be better for everyone if I disappeared or went away. I don't think I actively tried to do something about it, that would be permanent, until I was around 13,” Chao, now a mental-health advocate for youth as the head of a global non-profit, Letters to Strangers, tells Yahoo Life.
But long before she'd be ready to help others, Chao, now 22, was plagued by suicidal thoughts — sometimes carried out as suicide attempts — and at 13 she was diagnosed with bipolar disorder. As a first generation Chinese American immigrant, living in Southern California beneath the poverty line, Chao says that navigating the healthcare system came with many obstacles. She feared that people would discover her mental illness and kept her diagnosis private.
“There was definitely a lot of denial at first, both from me and also from the people who were closest to me about the diagnosis. Because of that, I wasn't allowed to seek the consistent care that the psychiatrist who diagnosed me really recommended,” says Chao. “Instead what ended up happening was my mental health condition worsened to a point where it started to affect my physical health, what is commonly known as psychosomatic symptoms or physical manifestations of psychological distress.”
One of these psychosomatic symptoms resulted in an episode where Chao lost her vision. She ended up in a hospital, where a social worker helped to guide her treatment plan. “I think that was the surprising turn where I was able to integrate some mental health care, despite the fact that I was at the hospital for technically totally different reasons," says Chao.
Chao says that she wanted to heal — but it wasn’t until her little brother found her during her final suicide attempt that she hit a breaking point. “I decided no matter what it took, I can't drag anyone else down with me,” she says.
According to the Centers for Disease Control and Prevention, youth suicide has become an increasingly prominent public health issue. Research has found that conditions like major depression, suicidal thoughts and suicide attempts are on the rise. In fact, a report from the National Center for Health Statistics found that the suicide death rate among persons aged 10 to 24 increased 56 percent from 2007 through 2017.
Along with medication and therapy, Chao also started writing. At first she kept a journal, but found that she only filled with pages with the negative feelings she was experiencing. That’s when she changed her approach.
“I ended up writing letters instead to fictional characters and then to random strangers. And I think that just really helped me feel like I had a voice," she says.
Writing letters to a stranger made her feel more free, and shifted her perspective for the better. “If I'm talking with a stranger, I don't want to just be like, everything sucks. I feel like I have a responsibility as a fellow human being to at least think a little bit harder about that. It forced me to reevaluate some of the lenses through which I viewed life, not to say that everything I was experiencing wasn't valid, but to also recognize that there were other aspects that I can glean more from, if I open myself up to those possibilities," Chao tells Yahoo Life.
It was 2013, at the age of 14, when Chao took her passion for writing to launch Letters to Strangers, a global youth-run nonprofit seeking to de-stigmatize mental illness and increase access to affordable, quality treatment for youth aged 13 to 24.
The organization has chapters (usually student clubs on campuses) where members write anonymous letters, sharing their vulnerabilities, triumphs and struggles. Those letters are then distributed within chapters or to other chapters, in hopes of creating empathy and connection. During the pandemic, Letters to Strangers created a free online letter exchange platform where anyone can write a letter to a stranger or get one from a stranger.
Letters to Strangers also partners with schools to provide mental health training for youth, and encourages members to get involved in changing mental health policies on their campuses and local communities. In 2019, the organization released its youth for youth mental health guidebook which takes an intersectional approach, was written specifically for 14-21 year-olds, and was reviewed medical professionals.
“I like to say that Letters to Strangers is my way of living the second chance at life. A lot of people don't get to survive the things that I ended up surviving, and I think hearing that I might have helped someone else find their second chance is everything.”