Dr. Song (Ntxhoo) E. Lee, a counsellor, an Associate Professor and Department Chair in the Counsellor Education and Rehabilitation Department at California State University, Fresno who has done a metasynthesis research about Hmong mental health in the United States by analyzing 48 mental health research journals from 1983-2012 to find out what are the main issues that discouraging Hmong communities' understanding and seeking mental health services.
Dr. Song Lee says that there are three main reasons why someone is likely to experience a mental health issue. Firstly, she says, it is due to heredity or family history that we are born to be more prone to depression, anxiety or mental health issues. Secondly, it is due to the biology or the imbalance of chemical within our bodies that lead us to mental health issues. Lastly, it is due to the environment we live in, either be our family, our community or where we live, that could contribute to mental health issues.
According to a research by Culhane-Pera, Vawter, Xiong, Babbitt, & Solberg, 2003; Lee & Chang, 2012a, 2012b, which Dr. Lee cited in her research journal paper, there are two main factors which are the 'past traumatic experiences and adjustment issues that play a very significant role to Hmong mental health issues. Other factors like depression, anxiety, family issues, substance abuse, other mental health concerns are the trends study as well as limited English language acquisition, having large family household sizes, and living in poverty,'' says, Dr. Song Lee, also contributing to Hmong mental health issues.
The most important aspect is that there is not enough research done specifically targeting Hmong mental health, the community does not hold a seeking help behaviour, Hmong culture that still taboo discussing about mental health as well as the perception of treatment and resilience toward this issue.
This research found out that Hmong have a high prevalence of mental health issue than the other groups in the United States of America due to what Dr. Lee says 'it is because we experience war (The US secret war-the Vietnam War) despairs, lost and dying during the exodus where we have to migrate and resettle in many different western countries across the world that are totally alienated to us.'
Starting a new life in those countries requires Hmong to adapt to a new way of life, to adopt a new culture, to learn a new language and to acquire new skills in those new countries where you don't speak the language, have no education and unemployed. Therefore, it is very challenging to be able to support yourself, your family, your relatives or your communities to successful new life.
Moreover, mental health is a very challenging issue for the Hmong community, that is because there are many factors from different circumstances from Hmong individual, their families and their relatives and their communities that can contribute to a mental health issue.
Though, after decades of resettlement in western countries, Hmong are now more educated, employed and settled, mental health issues tend to shift from those early struggles to more family bases.
In terms of seeking help for mental health like counseling, "Hmong community still misunderstand about the services fearing if they sign a consent form when accessing counseling services their social security will be deducted, or Hmong still don't understand about counseling services as they thought, there is no point if just having a discussion or conversation with a counselor, they rather discuss with their loved ones. But from Dr. Song Lee personal experience, she can see that those using these services can help her clients get their mental health in better shape."
Hmong parent's generation is still struggling between two cultural identities between Hmong and American, they may have a different view of the world around them. This may lead to an intergenerational cultural clash.
It is due to either parent don't have the know-how to nurture their children or don't have enough time for their kids, that is making both parties even more depressed. Hmong never have a word for mental health and never talk about it except when someone fell ill, Hmong cultural rituals such as soul calling or shaman are being performed.
News study shows Hmong children experience difficulties with their education. Hmong children are not just experience learning difficulties at schools but when they are coming back home, they are not only just do their homework but they may have to help other chores around the house including minding their younger siblings.
Hmong boys are more prone to being discriminated by their peers than girls, leading to either they have to self-defence which results in brawling or verbal conflicts and they might end up in court, while girls seem to be more well behaved.
Dr. Song Lee also said that some teachers may have some misconception towards boys who are quiet because they may think that these boys might be criminals or having some sort of ill-intent. Therefore, it stresses them further down the track and they might fail their academic performance because their concerns haven't been dealt with.
Hmong parents should realize that their children should fulfil their full potential and recognize that school is not for everyone, and so their kids might choose the other paths.
Hmong parents have a very high expectation from their children to do well academically hoping to change their life for the better. But they don't realize that some of the kids might not have the capability to cope with study pressure and academic success or that particular field is not for them. If parents have high expectation from their children, and put more pressure on their kids to study harder without any help, this is no use but this could make their children feel even more depressed.
Dr. Song Lee said that "Hmong tend to be very modest and we don't usually value ourselves highly. But we should praise our children as we see appropriate when they do something wonderful, and to correct them when they do something wrong, so we can have open communication to deal with any issue that may exist. We tend to learn from our parents and our environments, and if that environment is a positive one we will think positively and vice versa."
She said that "self-esteem in Hmong youth is very important. It is how you perceive yourself whether if you can do what you want to achieve. So if you have low self-esteem you are likely to be pessimistic, and you believe that you can't do it then you are unlikely to be motivated to achieve your education as others would, but if you have a positive mindset and always think that if anyone can do - I can too, then sky is the only limit."
One last note Dr. Song Lee would like the Hmong community to pay more attention is emotional safety, which is as important as physical safety. "You may want to protect your family from any sort of harms for instance cut or abrasion to the body or inhospitable environment such as hot or cold but emotional well being is also important. Though Hmong parents may not smack their kids, if they do so they could end up in court. But scolding, shouting, and use profane language is certainly will create an unsafe environment that would impact our children emotional well-being because emotion is a state which a person will love or hate oneself or think that they are capable or incompetent. So I want every one of us to carefully watch our words as they could be seen as an encouragement or a deterrent that could tarnish others' self-confidence to do something."
Disclaimer:
This information from Dr Song Lee is for generic information only, it doesn't consider the need of individuals' health circumstances. You must consult with the relevent licensed or trained health professionals if you experience mental health issues.
These are some of the helpline and organisations that provide mental health services you could check or seek help.
- Lifeline on 13 11 14
- Headspace on 1800 650 890
- Beyond Blue on 1300 22 4636
- MensLine Australia on 1300 789 978
- Kids Helpline on 1800 551 800
- QLife (LGBTQIs) on 1800 184 527
- Suicide Call Back Service on 1300 659 467
