Mental health among the Hmong population in the U.S.: A systematic review of the influence of cultural and social factors

Abstract

Summary As refugees of the war in Southeast Asia, Hmong experienced various traumatic events. Evidence suggests the persistence of psychiatric disorders related to trauma in refugees even after prolonged resettlement in their host country. This systematic review aimed to summarize the mental health literature on the Hmong population with a focus on cultural and social factors. The databases PsycINFO, PsycARTICLES, Social Services Abstracts, Web of Science, and PubMed were reviewed for peer-reviewed articles published up to April 2018. Forty articles were included in the final review. Findings Results highlight three primary themes: (1) mental health outcomes were associated with a variety of premigration and postmigration factors, (2) group and community-based treatment and interventions provided promising results, and (3) barriers to mental health care were primarily stigma, communication challenges, discrimination, and mental health literacy. The results of this systematic review shed light on the limited and small studies with the Hmong population. Applications Implications for social work and culture-sensitive research, practice, and policymaking for this population are discussed.

Unemployment and mental health in a community population from a border city in Mexico

“…Concerning the specific objective [ 3 ]; analyzing the relationship between mental health and gender, the category used as a basis was that of “male.” As can be seen, belonging to the “female” category is significantly associated with an increase in the GFI score (β= 0.066; p < 0.001), being indicative of worse mental health regarding the “male” gender (β= 0.234; p < 0.001).…”

Calling our souls home: A HMong epistemology for creating new narratives.

“…Here we also see the violence of psychology where a majority of research on HMong mental health was published soon after their arrival to the United States and noted high rates of PTSD, depression, and anxiety in the context of dislocation and acculturative stress (see reviews of research by Lee, 2013; Vang et al, 2020). 3 Vang et al’s (2020) systematic review of research identified barriers to care, including stigma, communication, mental health literacy, and lack of cultural brokers; these factors largely place emphasis on a cultural difference explanatory model even as it addresses social factors. This focus is evident in attempts to increase the awareness of HMong culture, such as the widely read The Spirit Catches You and You Fall Down that has become a canonical text for producing cultural competence in health care professions (Taylor, 2003).…”

“…Similarly, white and colonial lenses have also distorted understandings of HMong psychology and limited its contours by singularly focusing on HMong peoples as objects of trauma and tragedy. Here we also see the violence of psychology where a majority of research on HMong mental health was published soon after their arrival to the United States and noted high rates of PTSD, depression, and anxiety in the context of dislocation and acculturative stress (see reviews of research by Lee, 2013;Vang et al, 2020). 3 Vang et al's (2020) systematic review of research identified barriers to care, including stigma, communication, mental health literacy, and lack of cultural brokers; these factors largely place emphasis on a cultural difference explanatory model even as it addresses social factors.…”

“…The problem is not simply limited psychological research, but that the extant research in this area is dated and limited in foci. Over 40 years after the migration of the first HMong to the United States, the initial assessments of a culturally, socially, psychologically maladaptive refugee group in early research (see reviews by Lee, 2013; Vang et al, 2020) continue to drive understanding of HMong. Meanwhile, there has been less attention to HMong forms of cultural strength and resilience (Lee, 2013).…”

Applying Anti Oppressive, Empowerment, and Strengths Based Approaches to Social Work Practice with Hmong Clients

“…While Hmong have experienced many gains over the last 46 years, many continue to be underemployed, under educated, live in poverty, and face overt and covert discrimination and violence due to racism and xenophobia. Hmong face challenges such as severely unaddressed and untreated behavioral health issues (Lee & Chang, 2012;Vang et al, 2020;Vang & Bogenschutz, 2011), increasing chronic health conditions (Chen et al, 2013;Fang & Steward, 2018), barriers to adaptation (i.e., gender role conflicts) (Thor, 2020), and an array of diminished social support, poor economic well-being, and educational disparities (Pew Research Center, 2020). Hmong also vary in terms of their acculturation to U.S. society.…”