Mental Health of Hmong Americans: A Metasynthesis of Academic Journal Article Findings

By Lee, Song E. | Hmong Studies Journal, January 1, 2013 | Go to article overview

Mental Health of Hmong Americans: A Metasynthesis of Academic Journal Article Findings


Lee, Song E., Hmong Studies Journal


Abstract

The mental health of Hmong Americans has been studied since their arrival in the United States. The purpose of this metasynthesis is to utilize a qualitative approach to analyze academic journal article studies that assess mental health issues in Hmong Americans. Forty-eight published articles from 1983 to 2012 were chosen for analysis. Each of the selected articles focused on Hmong participants and contained findings relevant to the psychological well-being of Hmong Americans. Results of this study revealed several common themes: trends in research, depression, anxiety, adjustment issues, family issues, substance abuse, other mental health concerns, factors linked to mental health, help seeking behavior and perceptions, effectiveness of mental health treatments, strengths and resiliency, and supportive factors.

Keywords: adjustment, anxiety, depression, family issues, Hmong, mental health, metasynthesis, resiliency, treatment effectiveness.

Mental Health of Hmong Americans: A Metasynthesis of Academic Journal Article Findings

Hmong Americans are one of the fastest growing Asian groups in the United States, with a population of 260,076 (Hmong National Development Inc., 2011). The Hmong are refugees who fled Laos in the 1970s after the United States withdrew from the Secret War in Laos. Their aid to the U.S. during the Secret War made them targets of the communist party. The Laotian and Vietnamese communists attempted to eradicate the Hmong, resulting in the death of an estimated half of the Hmong population (Meredith & Row, 1986). Many of those who survived suffered from shot gun wounds, witnessed the death of their loved ones, and/or were in constant fear for their safety before their arrival at refugee camps and in the U.S. (Hamilton-Merritt, 1993).

Past traumatic experiences and current adjustment issues have impacted the mental health of Hmong Americans (Culhane-Pera, Vawter, Xiong, Babbitt, & Solberg, 2003; Lee & Chang, 2012a, 2012b). Although Lee and Chang's (2012b) review of the literature found that incidence rates of mental disorders in the Hmong population were understudied, previous studies found that prevalence rates of mental health disorders are higher in Hmong Americans than among the general U.S. population and other Southeast Asian refugees (Lee & Chang, 2012a; Vega & Rumbaut, 1991; Westermeyer, 1988). Summarizing the findings of various research studies and estimates by the U.S. National Institutes of Mental Health (NIMH), Lee and Chang (2012b) estimated that the current mental health incidence status for Hmong Americans is close to 33.5%. Depression, anxiety, and posttraumatic stress disorder seem to be most prevalent (Nicholson, 1997). Additionally, experiences and situations while living in the U.S. are stronger predictors of mental health than pre-emigration issues (Nicholson, 1997; Westermeyer, 1988b). Some of the problematic post-immigration issues that Hmong Americans encounter include family conflicts, intergenerational gaps, a culture clash (Rick & Forward, 1992; Su, Lee, & Vang, 2005; Ying & Han, 2008); changes in cultural practices (Helsel & Mochel, 2002); health concerns due to new diets and environments (Franzen & Smith, 2009); barriers in medical care (Hoang & Erikson, 1985); barriers in education, poverty (Hmong National Development, Inc. & Hmong Cultural and Resource Center, 2004); various mental health issues (Lee & Chang, 2012a, 2012b); sudden unexpected nocturnal death syndrome [SUND] (Adler, 1991, 1994, 1995, 2007; Young et al., 2012), and suicide and domestic violence (Lee & Chang, 2012a, 2012b).

The obstacles that the Hmong face in the U.S. may also be exacerbated by adjustment stress, limited English language acquisition, having large family household sizes, and living in poverty. Researchers and the U.S. census have shown that Hmong families have larger household sizes and lower income than other ethnic groups (McNall, Dunnigan, & Mortimer, 1994; Reeves & Bennett, 2004). …

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