Mental Illness in Southeast Asian Communities

youtube=http://youtube.com/watch?v=j-wMP2Q0Ifs]
*** My little sister, Khonsavanh works in the mental health industry.  I asked her to write this article to increase awareness about this issue that may be overlooked by Laotians and everybody in general. If you think you have a mental disorder, do not be afraid to seek help with a professional health care provider. In case some of you are not quite sure what exactly mental illness or disorder means, here\’s a good definition/example from answer.com:\”Serious mental illness or disorder impairing a person\’s capacity to function normally and safely: brainsickness, craziness, dementia, derangement, disturbance, insaneness, insanity, lunacy, madness, psychopathy, unbalance. Psychiatry mania. Psychology aberration, alienation.\”

I have worked in the behavioral health field since 1994-both with children, teenagers, and adults. I have worked in Kansas, Arizona, New Mexico, and Washington state inpatient and outpatient. In these 14 years I have only had 3 Asians on my caseload and these were within the last two years-at my previous job here in Phoenix as a Clinical Liaison for adults who were court ordered for treatment. I saw one Vietnamese man in Kansas who was involved in the mental health system but he was not my consumer (client). He was with another agency in another city and we had gone to a picnic in which that agency had invited us. I only saw him for a few hours but I can say that I am not sure that he was mentally ill or if he was placed with them because he did not speak English. Even though my grandfather is  Vietnamese I never learned to speak the language so I was unable to communicate with him.

There are a great deal of diagnoses that could qualify someone to have a serious mental illness (SMI) but the major ones are Bipolar Disorder, Schizophrenia, and Major Depression. Bipolar disorder is basically severe mood swings; Schizophrenia usually means the person hears voices, and Major Depression basically means you are so depressed you cannot function normally for 2-4 weeks. A person usually has to take medications to help relieve them of their symptoms. This is just a brief explanation-please read more about these diagnoses if you want to know more about them.

A person has to take medications for these diagnoses. The 3 Asians that I had personally worked with were Cambodian, Vietnamese/Caucasian, and Vietnamese. They were all men and their ages ranged from early to late 20’s to early 40’s. They were all court ordered to receive treatment because their behaviors were deemed a danger to themselves and others. Being court ordered meant that they had to see the psychiatrist monthly if they took medications and/or see their case manager monthly who would monitor their progress. The court order would last a year but if the person exhibits a need for a longer period of time-the psychiatrist can extend it. The Cambodian man was also developmentally delayed (low IQ) and was diagnosed with Schizophrenia. What made him interesting was that he could not speak English-but he had a Cambodian interpreter. The half Vietnamese half Caucasian man was diagnosed as having Bipolar-he stayed up for days on end, acting erratic, and had been off his medications. He spoke perfect English. The Vietnamese man had made some statements to his wife and others around him that he wanted to kill himself and others. He spoke limited English. I mention how well they speak English because it does matter in regards to how easy or difficult it is for them to get services and/or how they follow the court order. I found out that at times it does not take a lot to be court ordered and at times it takes a lot more than what someone says they overheard or saw.

I saw these 3 men at the beginning because I had to complete the assessment and their treatment plan. Then the case managers that I supervised took over the actual home visits and follow up. I also did some of these when the case managers could not. It still amazes me that there are not a lot more Asians-especially SE Asians receiving services. I am sure we all know some of the reasons such as: we do not ask for help, the community or family takes care of us or we don\’t recognize it as a problem. etc.

In Washington state-there was actually an agency called the Asian Counseling agency. However,I did not work for them. In fact, I did not know they even existed until I was moving. I thought this was great. Los Angeles also has a couple of agencies that cater to Asians with mental illness and New York City has a few too. One of my goals is to work in an agency that specifically works with Asians but there are none here in Phoenix. Just like with anything else. There are pros and cons in me working with just the Asian population.

Mental illness is still something that people hide-especially the Asian community. On the one hand they might like it that they see someone who looks like them but on the other hand they might feel ashamed or apprehensive about working with someone who looks like them. I have a double edged sword to deal with because there are even less SE Asians seeking mental health services. As some of you are aware :the biggest Asian population are Chinese, Japanese, and Filipino. There are even more Cambodians than Laotian or Thai people who seek out these services. Even in the agencies in Los Angeles, Seattle, Tacoma, New York-that target Asians-it is rare that they mean Lao and Thai people. In order for me to get hired in these agencies-there has to be a lot more Lao and Thai consumers than there are now. This is the reason why I work in agencies that work with the mainstream population. So when I do see an Asian consumer (client) both of us look at each other in surprise but it also gives me hope that in the future more of us will not be afraid or ashamed to seek help. I also see a little relief at times that they see someone who looks like them and can understand their culture. I am sure everyone knows that Asian (all kinds) have the same problems as Caucasians, African Americans, and Hispanic population. If any of you see a loved one or someone in your Asian community who needs services-please help them get these service. For further info, go to http://www.nami.org/Hometemplate.cfm or go to http://www.mhasp.org/coping/quiz.html to take a quiz on this issue.

Why are Laotians afraid to get help for mental illness?  Is it shame? Fear?Distrust? Lack of information or education? </blockquote

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15 thoughts on “Mental Illness in Southeast Asian Communities

  1. I can’t say this for other Asian groups, but as the Laotians and the Thais, I believed that it’s a cultural thing. It’s very rare to find a psychologist in Thailand and Laos, and mainly because it’s not very popular and most don’t seek help from a psychologist but instead turn to alternative treatment. I believe that most seek help, but instead of getting help from a psychologist, it’s the PsychicCosmos, we love to get advice from “Mor Due” or a popular one is “Khone sung Jao” (spirit in a person), fortune telling is a big thing amongst the Laotians and the Thais, and some would go to the extreme as seeking advice for their everyday problems, you’d see this in the Laotians and Thais living in the US as well. I think it’s embarrassing for us to admit that we might have a mental disorder, which means that we might need help because to us face is everything. It would be a disgrace to the family, especially to the parents to have child(ren) that is mentally ill. I understand that from a professional point of view, this way of thinking is wrong, but it’s hard to try to convince these individuals when mental illness is not well received amongst our community.

  2. Laotian Teacher

    Ginger, I agree it is a cultural thing. It seems that a lot of things we experience has to due with cultural beliefs: from health issues to relationship to our actions. You would think that the thirty something generation or younger would be more willing to seek help for the disorder since we are more knowledgeable.

    I know my mom believes in fortune tellers, spirituality and the Psychic Cosmos. I will have to ask her some more on this topic.

  3. To add on to this, our culture also believe in ‘Gum Gao’ or ‘Vain Gum’, and if something was wrong with their children, brothers or sisters then they would believe that it’s something evil that they themselves or their parents did, but in reality it might be a birth defect or mental disorder that can be cured with modern medicine. If back in Laos, I believe still practice to this day that they would go to ‘Mor Pee’ (ghost doctor) that would try to chase evil spirit out from the person. I think sometimes it’s sad to see something like this but you can’t get the older generation to understand.

    As for the younger generation, crazy people won’t admit that they are crazy. 😉

  4. Laotian Teacher

    Ginger, my mom as well as the older Laotians really believe in “Vain Gum” a lot. In fact, my mom usually say, “Vain Gum” all the time when she is mad at us or are not please with our actions. I always remind her, she is actually very lucky to have five kids who all graduated from college, are not trouble makers and send her money when she needs it.

    When you mentioned the “Mor Pee” it reminded me of when my big sister passed away because she had internal bleeding. There was no hospital near us so my grandmother got a “Mor Pee” to help my sister because they thought she was possessed or her body was taken over.

    Also, another term I often heard growing up is pee bah ( crazy). Sometimes we used that jokingly, but many adults use it to describe someone who doesn’t think before they act or they use it to describe someone whose behavior they don’t understand . The word crazy in English as well as the translation to Lao is broadly used to describe someone with a mental disorder as well. When we do not quite know exactly what is wrong with the person we say they are pee bah. We don’t go further than that to find out if they are bipolar or schizophrenic or a sociopath.

  5. I was hoping to hear what your sister thought of our comments, if she has to learn the cultural aspect of the patient during her studying. If you have a chance, can you ask her?

  6. Molly

    Hi,
    I was wondering whether anyone could help me with some research I am doing with regards to the treatment of the mentally ill in Laos. Are there any journals or articles that talk about how mentally ill people in Laos are treated? Are there prejudices against them? Do they receive the required health care? Anything and everything will surely be helpful.

  7. amphone

    Wow, this is a very interesting query. Can’t wait to read up on what you will find. In the mean time, let me ask around and see what people say.

  8. Laotian Teacher

    Molly, that is a very interesting question because you are asking what kind of treatment do mentally ill people get in Laos. I will have to research that for you.

  9. Laotian Teacher

    http://www3.baylor.edu/~Charles_Kemp/laotian_health.html

    Molly, the article above is pretty interesting about the treatment of mental illness in Laos. It goes with what I personally have experience in the Laotian community. Any sickness whether physical or mental is usually dealt with, within the family or community. It is not like in America where if you think a loved one is mentally ill you take them to seek professional help. I don’t think that has changed much in Laos, but I would have to research in detail.

  10. Dear writers above (Molly, Amphone, and Laotian teacher),

    I hope all of you still active in discussion about mental health in Laos. I am very happy when I found your discussion online. I have been looking for people whom very know and understand mental health and at least get to work and learn about mental health service from school or agency in US to help me and my team to develop mental health service for Laos in the near future. Before I start writing more detail, please let me introduce myself to all of you first. My name is Dr. Manivone. I have my medical degree from Laos and a master degree in Public Health from Boston University and I am now finishing up my Ph.D. in clinical psychology at the University of Rhode Island. I have worked in Mental health field in US for more than 10 years and I did understand how you feel about mental health service to Laotian and Thai commuities. My research and teaching are focus on multicultural with tailor to underserved and refugee trauma. I have been provided training about “Cultural Competence in Providing Mental Health Service to Culturaly Diverse Client.” and “Working with traumatized refugee from culturally diverse background.” I also provide cultural training interm of working with Asian population to the mental health agency around RI. Besides having degrees in medical and mentla health field, I was trained by Harvard University Medical School in 2007 on Global Mental Health Trauma and Recovery in Italy which gave me another mastery certificate in trauma work. Since I have been in US, I have always thouht about bringing mental health knowledge back to Laos. I have been working with my major professor and other psychiatrist and psychologist from US, Norway, Australia, Thailand, and Cambodian to develop a mental health training and intervention for Laos. We went to Laos early this year to conduct a mental health needs assessment for Laos and we will be going back again next year around March to conduct a one month mental health training for medical doctor in Vientiane as our Pilot project. After I grauduate September next year, I will take a lead as a long term mental heath coordinator person who will spend longer years in Laos. All of our team members now volunteer their time to travel to Laos to do teaching there. Of course we are looking for more volunteer who can speak the language to joint our team. You done’ need to have MD pr PH.D degree to joint our team. You have experience that we think will help our team to success in provding mental health training and treatmentfor Lao doctor and Lao people in the near future. I have all material about mental health treatment in Laos and US. If you need information for your study or research, please let me know I will share with you what I have. I encourage you to consider to joint our team to help us provide teaching and training in Laos. You will be part of the team and travel to Laos on your own time. When I move to Laos, I will try to look for funding to pay for accommendation of our staff in Laos. At this time, we have not yet received any funding to cover our travel and living expense in Laos. We all take money out of our pocket to do this for lao people. Please reply my email when you receive it. i will be more than happy to call you for more conversation and tell you what organization has been involve and support us in doing mental health service and training in Laos. By the way, our project have been aproved by the Laos government and WHO in Vientian. Our long term goal in Laos is develop residency training program for medical scool of Laos and out patient service unite in each provincial hospital. again, I am very happy that I found your conversation here because I very need many people who speak lao to be part of our team. Our volunteer doctors speak only English that make it harder for Laos doctor to understand and communicat with them during lecture. I ended up doing both lecture and translation when we were there in March. Please reply my email.

    Sincerely,

    Manivone

  11. Laotian Teacher

    Dr. Manivone, I’m extremely excited about what you are doing. I am amazed by it because the area of mental health is largely ignored by our community. I will spread the word of what you are doing and see if more Lao people would be interested. I will email you my info.

  12. Many thanks to your help speading the word out. I believe that if we, Laotian-American, can contribute some of our time and generosity to help disadvantage Laotians in Laos and US, that means we have done a lot for our people. Again, I am very sincerely thank you for all of you who keep this conversation going and I hope to hear from you and others very soon. You can also email me directly to my yahoo email at mthikeo@yahoo.com.

    Sincerely,

    Manivone

    1. Laotian Teacher

      Dr. Manivone, I will email you and give you my phone number so we can discuss this matter further. I have to talk to my sisters who are in the mental health field as well as other community leaders. Looking forward to talking to you.

    1. I missed taking to you and I left a message on your cell phone yesterday. When you get a chance, please give me a call. Nighttime and weekend are work best for me. I am not available during the daytime because I am seeing patients at clinic everyday from 9am-8pm everyday.

      Talk to you soon.

      Manivone

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