Yearly Archives: 2009

2009-2010 Community Email Updates

Health and Awareness Facts

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Health and Awareness Facts

Here are the facts from the gallery walk during our GM meeting featuring health issues afflicting our community.

The powerpoint featuring information about CAPS can also be downloaded by clicking here: CAPS.

-Native Hawaiian men have higher rates of lung cancer than white men do, and the incidence of cervical cancer among Vietnamese women in the United States is more than five times greater than that among white women (Kuo & Porter, 1998).

-Historical events and circumstances shape the mental health profile of any racial and ethnic group. For example, refugees from Cambodia were exposed to trauma before migrating to the United States because of persecution by the Khmer Rouge Communists under Pol Pot after the Viet Nam War. During the four years of Pol Pot’s regime (1975–1979), between 1 and 3 million of the 7 million people in Cambodia died through starvation, disease, or mass executions. This national trauma, as well as the stressors associated with relocation, including English language difficulties and cultural conflicts, continues to affect the emotional health of many Cambodian refugees and other immigrants.

-Culture shapes the expression and recognition of psychiatric problems. Western culture makes a distinction between the mind and body, but many Asian cultures do not (Lin, 1996). Therefore, it has long been hypothesized that Asians express more somatic and internal symptoms of distress than white Americans.

-Mental illness is highly stigmatizing in many Asian cultures. In these societies, mental illness reflects poorly on one’s family lineage and can influence others’ beliefs about how suitable someone is for marriage if he or she comes from a family with a history of mental illness. Thus, either consciously or unconsciously, Asians are thought to deny the experience and expression of emotions. These factors make it more acceptable for psycho-logical distress to be expressed through the body rather than the mind (Tseng, 1975; Kleinman, 1977; Nguyen, 1982; Gaw, 1993; Chun et al., 1996).

-Many Southeast Asian refugees are at risk for post-traumatic stress disorder (PTSD) associated with the trauma they experienced before they immigrated to the United States. Refugees who fled Vietnam after the fall of Saigon in 1975 were mainly well-educated Vietnamese who were often able to speak some English and prosper financially. Although subsequent Vietnamese refugees were less educated and less financially secure, they were able to join established communities of other Vietnamese in the United States. Cambodians and Laotians became the second wave of refugees from Indochina. The Cambodians were survivors of Pol Pot’s holocaust of killing fields. Several groups of Laotians, including the Mien and Hmong, had cooperated with American forces and left Laos after the war from fear of retribution. One-third of the Laotian population had been killed during the war, and many others fled to escape the devastation.

-Studies document high rates of mental disorders among these refugees. A large community sample of Southeast Asian refugees in the United States (Chung & Kagawa-Singer, 1993) found that premigration trauma events and refugee camp experiences were significant predictors of psychological distress even five years or more after migration. Significant subgroup differences were also found. Cambodians reported the highest levels of distress, Laotians were next, then Vietnamese. Studies of Southeast Asian refugees receiving mental health care uniformly find high rates of PTSD. One study found 70 percent met diagnostic criterion for the disorder, with Mien from the highlands of Laos and Cambodians having the highest rates (Kinzie et al., 1990; Carlson & Rosser-Hogan, 1991; Moore & Boehnlein, 1991).

-Some subgroups of Vietnamese refugees may also be at high risk for mental health problems. Hinton and colleagues (1997) compared Vietnamese and Chinese refugees from Vietnam 6 months after their arrival in the United States and 12 to 18 months later. The ethnic Vietnamese had higher depression at the second assessment than did the Chinese immigrants.

-Two studies have found high rates of distress among refugee youth. Cambodian high school students had symptoms of PTSD and mild, but prolonged, depressive symptoms (Kinzie et al. 1986). Researchers also have noted high levels of anxiety among unaccompanied minors, adolescents, and young adult refugees from Vietnam (Felsman et al., 1990). Likewise, in a study of Cambodian adolescents who survived Pol Pot’s concentration camps, Kinzie and colleagues (1989) found that nearly half suffered from PTSD, and 41 percent experienced depression approximately 10 years after this traumatic period. Clearly, because many Southeast Asian refugees experienced significant trauma prior to immigration, rates of PTSD and depression are extraordinarily high among both adult and youth refugees. The Plight of Southeast Asian Refugees A Khmer woman (mid-40’s)

-Because of premigration traumas and the adjustment to relocation in the United States, many Southeast Asian refugees are experiencing great stress. The following excerpts were elicited in a mental health interview of a mid-40-year-old, Khmer woman from Cambodia by Rumbaut (1985).

-“I lost my husband, I lost my country, I lost every property/fortune we owned. And coming over here, I can’t learn to speak English and the way of life here is different; my mother and oldest son are very sick; I feel crippled, I can do nothing, I can’t control what’s going on. I don’t know what I’m going to do once my public assistance expires. I may feel safe in a way— there is no war here, no Communist to kill or to torture you—but deep down inside me, I still don’t feel safe or secure. I feel scared. I get scared so easily.” (p. 475)

-Gee and Ishii (1997) describe a case that illustrates the difficulties that some Asian Americans have in using mental health services. An was a 30-year-old bilingual, Vietnamese male who was placed in involuntary psychiatric hold for psychotic disorganization. After neighbors found him screaming and smelling of urine and feces, they called the police, who escorted him to a psychiatric emergency room. An had been hospitalized several previous times for psychotic episodes. He was the oldest of five children and was living at home while attending college.

-His parents had a poor understanding of schizophrenia and were extremely distrustful of mental health providers. They thought that his psychosis was caused by mental weakness and poor tolerance of the recent heat wave. They believed that they themselves could help An by providing him with their own food and making him return to school. Furthermore, the family incorrectly attributed An’s facial injury, sustained while in the locked facility, to beatings from the mental health staff.

-These misconceptions and differences in beliefs caused the parents to avoid the use of mental health services.

-About 21 percent of Asian Americans and Pacific Islanders lack health insurance. However, within Asian American subgroups, the rate varies significantly. For instance, 34 percent of Korean Americans have no health insurance, whereas 20 percent of Chinese Americans and Filipino Americans lack such insurance. Furthermore, the rate of Medicaid coverage for most Asian American and Pacific Islander subgroups is well below that of whites. It has been suggested that lower Medicaid participation rates are, in part, due to widespread but mistaken concerns2 among immigrants that enrolling themselves or their children in Medicaid would jeopardize their applications for citizenship (Brown et al., 2000).

-AA/PIs have the lowest rates of utilization of mental health services among ethnic populations. This underrepresentation is characteristic of most AA/PI groups, regardless of gender, age, and geographic location. Among those who use services, severity of disturbance is high. The explanation for this seems to be that individuals delay using services until problems are very serious. The unmet need for services among AA/PIs is unfortunate, because mental health treatment can be very beneficial.

-The low utilization of mental health services is attributable to stigma and shame over using services, lack of financial resources, conceptions of health and treatment that differ from those under-lying Western mental health services, cultural inappropriateness of services (e.g., lack of providers who speak the same languages as limited english proficiency clients), and the use of alternative

-1 in 6 UCLA students received clinical treatment – more than 7,000 students last year

•        35% screened positively for harmful levels of  alcohol or drug use

•        3 to 5 students per week were seen in the ER for psychiatric or substance abuse crises

•        47 students were treated as psychiatric inpatients (FY07-08)

•        Suicide

–     22% of women, 9% of men seriously considered suicide at UCLA

–     1.3% reported at least one attempt in past year

–     Incidence = 7 in 100,000 =  half of non-student rate

•        Stalking:

–     13% of female students stalked in study year

–     25-30% of college women and 11-17% of college men report ever being stalked

-Vietnamese Manicurists have been exposed to skin infections, toxic chemicals, and HIV/AIDS through the work that they do on a daily basis.

– Vietnamese-Americans ages 56 and older are twice as likely as whites to report needing mental health care and also less likely to discuss such issues with a professional, according to a study published in the Journal of the American Geriatrics Society, the Los Angeles Times reports.

-Researchers found that 21% of Vietnamese-Americans reported having depression or anxiety, compared with 10% of whites.

-Twenty percent of Vietnamese-Americans discussed the health issues with a medical provider, compared with 45% of whites.

-One out of two Vietnamese students have a family member affected by Post Traumatic Stress Syndrome, depression, anxiety, or other mental health illnesses. (Surgeon General Report)