Objectives
Terminology In the Vietnamese culture mental illness is known as “Benh tam than” in the Vietnamese culture. This means madness or severe psychiatric disorder. The severity of the disorder is determined by how it will affect the people around the victim instead of how the victim is affected and potential of self -harm the client could do. Psychiatrists are called, “bac si tam tham”. This means “doctors who treat madness.” Benh tam than carries the stereotyped connotation of wild, unpredictable, and dangerous people. Bac si tam than implies the ridiculousness of those obligated to care for them. Daien and khung are the informal terms meaning crazy and nuts. These words are used to joke around but when used in a serious tone they bring on fear and apprehensiveness. These words reflect Vietnamese biases but also shows how they feel about mental illness (A, Nguyen, 27). Belief System The Vietnamese explain all misfortunes by linking them to offences committed in a previous life. A person suffering from a mental illness is inheriting punishment for their own previous sins or for the sins of the whole family while penalizing the whole family because of the one person’s dysfunctional behavior. Another cause of the insanity is possession by angry ancestral spirits. Family members do not offend their ancestors in fear of might happen. The importance of family cannot be understated in the Vietnamese culture. A typical Vietnamese family is considered a fundamental unit of respect and cohesion. It is normal for three or four generations too live in the same home together. Having a mental illness in the family is shameful ( Brower, 650-651) Causes of Mental Disorder The causes vary between social economic status and the type of education each family receives. Most causes of mental illness are viewed as natural causes. According to the Vietnamese it is believed that mental stresses or emotional strain due to events such as trauma, lovesickness, or simply thinking too much, produces weak nerves that make one susceptible to a psychotic disorder. It is a common belief that high school and college students can fall ill from studying too much. Even in the hospital, psychiatrist are issued shorter worker hours than other doctors, lest the strain of being mentally ill patients for too long cause the doctors to go crazy as well. Organic causes of mental illness include heredity and head injuries. Although in recent years the Vietnamese government has tried to get rid of the idea that Psychiatric disorders are passed on by inheritance which reduces marriage prospects for the health of future generations for the whole family. These misunderstandings become painfully apparent when immigrants seek mental health assistance. Health assessments show that immigrants suffer from many types of mental health problems that are far more severe than those of voluntary immigrants and native born. The most commonly reported disorders are depression, anxiety, schizophrenia, and other neurotic disorders (A. Nguyen,28) Traditional Medicine Families who believe in supernatural causes of illness will seek the assistance of fortunetellers (thay boil) along with witch-doctors. Traditional healing is more received among the masses than psychiatry because of its history of integration into Vietnamese culture. Traditional healers are also makes them more likely to be accessible eliminating the cost of transportation to a large mental health facility. There is no shame going to a traditional healer who treats all diseases as there is with going to a doctor who only treats mental illness. Going to a psychiatry is usually the last place someone of the Vietnamese culture will go because they feel embarrassed about what ever is wrong with them (A. Nguyen, 28). Mental Health Problems Vietnamese people are generally unfamiliar with psychotherapy and mental health facilities (Nguyen Duy San, 1969). Because of this someone with problems usually goes to someone older in the family. In Vietnam a person would go to a “healer” or Buddhist monk known to be adept in such matters. Because of religious beliefs the Vietnamese believe that mental or nervous difficulties, and problems are caused by evil spirits and are solved by religious means (Hickey, 1964) (Brower). With a history of thirty years of war the Vietnamese have dealt with the loss of loved ones and property. For the immigrants, the stress has been prolonged in dangerous escapes, often in crowded, leaky boats, followed by many months in squalid refugee camps where rape and robbery were common. Because the Vietnamese unfamiliarity with mental health and are hesitant to approaching strangers, counselors need to be aware of the evidence of stress and the emotional scars of war and immigrant experiences (C. Brower, 651). “Despite this, little is still known about the health status of these older Vietnamese Americans.” Mental health issues rarely are talked about in the Vietnamese community. “In fact, there’s not even a word in Vietnamese for ‘depression,’'( A.Nguyen) Depression and Anxiety Costello (1976) believes that depression is often caused by loss of structure and meaning in life. According to an HEW report (1978) severe depression and other mental health problems could be three times more common among immigrants than the whole population. Vietnamese people with severe depression is difficult to detect because Vietnamese people do not want to reveal anything different about their health and feel along with the fact that there are very few professionals available. The few times that a Vietnamese person will go see an American psychiatrist it is not very successful because off the language barriers and the unfamiliarity with the Vietnamese culture. The Vietnamese culture tends to manifest their emotional problems in physical symptoms. Such as stomach aches, and unexplained aches and pains (C. Brower, 650). Family conflicts A traditional Vietnamese family becoming “like an American” may mean loudness, disobedience, disrespect, and lack of concern for the elderly. When younger generations want to be more like Americans they do not have experience in seeing the differences between behavior levels that their parent’s fear and the extreme behavior modeled by peers that is unacceptable even to most Americans. The counselor therefor needs to model acceptable behavior for social events (Sullivan, 1979) (C. Brower 651). Because the Vietnamese are insecure because of what has happened in their past they are reluctant to plane for the future in America. The Buddhist Philosophy, to which 80% of the Vietnamese adhere, instills a passive fatalism rather than active striving to shape the future (Nguyen Thanh Liem, 1976) (C. Brower, 651). Most of Vietnamese people came to America simply to save their lives and if the Communist regime adopted different policies they would return to Vietnam. Because of this older Vietnamese adults do not want to learn English or adjust to American culture. The result may conflict with younger family members who seek to be more bi cultural in America. Adults of Vietnamese descent who do not want to learn English and about the culture prefer to live in the past and when a younger member goes to a counselor to help adjust to the American culture, the counselor will find that the whole Family will need help in some way adjusting to their new environments. An American counselor when conducting a session for Vietnamese people should word their questions like, "How do hurt? or "Where does it hurt" rather than "How do you feel"? The wording makes a big difference because Vietnamese people take the question and not know how to respond. They will not give more information then what is asked for. The questions have to be very specific so the Vietnamese clients know how to answer. If the client is a female and is being asked for their opinion on what they think is best for themselves they will feel that it is their place to say anything. The female will look to most likely their father to answer the questions and make a decision( Gold PhD). This goes for any situation including school when the guidance counselor asks a Vietnamese female student about her schedule and what she thinks are the best changes they should make? the student will feel uncomfortable and feel it is not her place to say anything and looks for her father to answer for her, when in reality in the American culture we speak for ourselves. References Nauer PhD, R. (n.d.). Mental Health Problems Among Vietnamese Americans. Retrieved June 19, 2015, from http://psychcentral.com/news/2008/09/08/mental-health-problems-among-vietnamese-americans/2889.html Nguyen, A. (n.d.). Cultural and social Attitudes Towards Mental Ilness in Ho Chi Minh City, Vietnam. Retrieved June 19, 2015, from http://web.stanford.edu/group/journal/cgi-bin/wordpress/wp-content/uploads/2012/09/Nguyen_SocSci_2003.pdf Gold, S. (n.d.). Mental Health and Illness in Vietnamese Refuges. Retrieved June 20, 2015. Brower, I. (1980). Counseling Vietnamese. The Personnel And Guidance Journal, 646-651. |
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