Depression in the Vietnamese American community: stats, silence, suppression, speaking?

*This article was originally published by the Viễn Đông on 7 November 2011. It was reported by Vanessa White.

http://www.viendongdaily.com/tram-cam-trong-cong-dong-noi-ra-hay-la-lam-thinh-YfArmCID.html

ORANGE COUNTY, California—For the Vietnamese American community, the absence of physical pain generally equates to good health in an individual.

But, what if an individual has a pained mind?

According to an Orange County Health Needs Assessment (OCHNA) 2010 report, many Vietnamese American immigrants feel a deep grief covered up by their daily lives in the United States. The report is called “A Look at Health in Orange County’s Vietnamese Community” and uses information gathered from a 2007 survey.

Escaping Vietnam and eventually arriving in the United States resulted in profound loss as theVietnamese who fled left behind their homes, families, and possessions.  Many refugees left with only their lives and the clothes on their backs.

Such loss can contribute to mental health problems like depression. The Merriam-Webster Dictionary defines depression as “a psychological disorder marked especially by sadness, inactivity, difficulty in thinking and concentrating and feelings of dejection,” or feelings of a lowered spirit.

Within the Vietnamese American community, there is often a denial of depression’s existence, as stigmas around depression, being a mental illness, link the problem to genetic defects and ancestral flaws, causing people experiencing the problem to be less apt to seek help.

However, the Vietnamese American community is not alone in its suffering. There are others, specifically from various other ethnic minority groups, who have put their depression aside so they could focus on survival in the United States.

Understanding depression within the Vietnamese American community can help to better connect it with other communities in the United States, both ethnic minority and mainstream.

Lack of mental health care, coverage

In 2008, a California Health Interview Survey found that Vietnamese Americans over age 55 were more likely than Whites their same age to report needing mental health care, though were less likely to actually speak with their doctors about it.

The OCHNA report mentions a high regard Vietnamese Americans tend to have for doctors, often keeping Vietnamese American patients from disclosing health problems with their doctors for fear of disappointing them.

However, if Vietnamese American patients do confide in doctors and ultimately receive care regarding health issues, specifically mental health issues, they are more likely to do so with their primary care doctor, according to a scholarly article abstract from 2009, “Discussing depression with Vietnamese American patients.”

For this reason, primary care doctors need to build “culturally informed strategies for addressing stigmatizing illness,” the article suggests.

The OCHNA report shows that there are 11,232 who have been told by the doctor or health care professional that they have emotional, mental, or behavioral health issues, like depression. However, of the OC Vietnamese Americans with mental health issues, like depression, fewer than 6,127 have received health care for their issues.

Among the reasons for OC Vietnamese Americans not receiving health care were: not thinking about getting care, feeling they did not need help, shame and embarrassment, and lack of affordability.

As over half of OC Vietnamese Americans do not have mental health coverage, the group has the lowest rates of mental health coverage of all ethnicities in OC.

A view from outside the Vietnamese community

In her book, Black Pain, Ms. Terrie M. Williams exposes depression within the African American community. She writes that denial and the community’s failure to recognize depression perpetuate the illness.

Ms. Williams argues that the African American community’s historical resilience has helped the group survive yet has also been used to convince individuals within and outside of the community that depression is not a valid or significant illness among African Americans. 

Instead, she writes that depression can manifest itself in behaviors that are detrimental to the community: crime, violence, substance abuse, eating disorders, and addiction.

Ms. Williams addresses the African American community’s historical silence about depression and how it has contributed to multigenerational depression, perpetuated by older community members who might unknowingly teach this silence to younger members.

These younger members perpetuate the same silence, continuing the cycle and accepting it as a way of life. They will not seek outside help for the depression because they will not think they need it or will be too ashamed because of the stigma the community knowingly or unknowingly places on depression.

Thoughts to consider

Is the Vietnamese community similar to the African American community in its collective denial, or lack of recognizing its depression?  Are there other ethnic minority communities sharing the same denial?