Mental health is one aspect of health that Vietnamese Americans notoriously ignore. Often treatment is delayed (or worse avoided) because of the stigma associated with mental health problems. Factors such as language and culture barriers increase the likelihood that mental health problems in the Vietnamese American community are not addressed.
The figures are striking.
Asian-American women over the age of 65 and those 15-24 have the highest rate of suicide of females in their respective age groups in the U.S. (Centers for Disease Control and Prevention, National Center of Health Statistics.)
Smoking and drinking rates are very high for Vietnamese men. (Ethnomed)
Vietnamese Americans are more likely to experience PTSD, depression, anxiety, psychosis and adjustment reactions due to their refugee background and cultural struggles. Vietnamese Americans prefer to keep suffering to themselves.
Cultural Barriers to Seeking Help
Traditions: Most Vietnamese believe in organic causes of illness and tend to seek traditional means to cure their diseases. Many treat disease with herbal and folk medicine before consulting with doctors. During these periods, doctors may have lost valuable time that could have been used to diagnose and treat illness.
Distrust of Western Medicine: Many Vietnamese Americans seek western health care only after more traditional methods have failed. A stigma of distrust still surrounds western medicine (less so for american born Vietnamese Americans). Due to language barriers, some Vietnamese feel doctors may not understand their problem or understand what they are trying to say. Language barriers often impede the relationship between doctor and patient.
Older Vietnamese may not understand the concept of using further techniques for diagnosis. They may think procedures are meant to cure and feel upset or frustrated when pain continues after initial diagnosis. Continued observation and tests may imply lack of ability or effectiveness to those that do not understand the procedure. This leads to many Vietnamese Americans that do not seek follow up care.
Disregard for experience: Many Vietnamese believe that only Asian people can fully understand them. Often Vietnamese patients alter their medication dosage or change their regiments due to a feeling of “knowing better”. The distrust between cultures presents problems regarding proper treatment.
Poor physician-patient relations: Vietnamese Asian culture values politeness, respect for authority, avoidance of shame, and privacy. Because of this, many will not ask questions even if they do not truly understand directions or procedures. They will not voice concern, and will not reveal intentions or actions that seem to disregard physicians wishes. If patients disagree or do not understand, they may simply listen and answer yes to all physician questions, then not return for further care or follow through with physicican recommendations.
Lack of Information
Frankly there is no helpful information for Vietnamese Americans seeks mental health care. If there is – it’s not easily attained and might as well not exist.
Here are some links about Asian American mental health, but the Vietnamese specific information is sparse.
Low Utilization/Lack of Cultural Specific Services
The low utilization of mental health services is attributable to stigma and shame over using services, lack of financial resources, conceptions of health and treatment that differ from those under-lying Western mental health services, cultural inappropriateness of services (e.g., lack of providers who speak the same languages as limited english proficiency clients), and the use of alternative resources within the AA/PI communities. (From AA/PI Report)
Many Vietnamese Americans deny that mental health problems are true illnesses. Depression is often disregarded and mocked. Victims of PTSD are treated as crazy people. Older generations of Vietnamese Americans deny western labeling of mental health problems and continue to teach their children that these problems do not truly exist. Newer generations of Vietnamese experience increased mental health problems due to conflicting cultural definitions of illness.
What needs to happen?
Culture-specific and accessible solutions must be developed for the Vietnamese American community. Both language and cultural barriers need to be addressed before proper treatment of Vietnamese American health can occur. More research must be conducted on the Vietnamese American population.
Bi-cultural acceptance will improve mental stability within the newer generations.
The Vietnamese American community needs to support newer generations into developing interests in the mental health field. Psychologists, Social Workers, and Asian American Studies have been severely undersupported within the Vietnamese American community – this needs to change. Vietnamese American psychologists need to emerge to serve the growing need of the Vietnamese American community.
Cultural mentality needs to evolve. Depression is a disease. People with mental health problems need help.