Treating psychiatric disorders among Mien refugees from highland Laos

• Published in: Social science & medicine (1982) Vol. 32; no. 9; pp. 1029 - 1036
• Main Authors: Moore, Laurie J., Boehnlein, James K.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 1991; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adult; Attitude to Health - ethnology; Biological and medical sciences; Cultural aspects; Cultural Characteristics; Female; Health care; Humans; Laos - ethnology; Male; Medical sciences; Mental disorders; Mental Disorders - ethnology; Mental Disorders - psychology; Mental Disorders - therapy; Middle Aged; Mien people; Oregon; Patient Compliance; Physician-Patient Relations; Psychiatric disorders; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy - methods; Refugees; Refugees - psychology; Self-Help Groups; Social psychiatry. Ethnopsychiatry; Sociocultural environment; USA; Oregon; Laos; Asia; Belief; Social environment; Human; Sanitary program; Crosscultural study; Rural environment; United States; Mental health; Refugee; North America; Health policy; Treatment; Asia; Cultural environment; America; Laos; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/0277-9536(91)90160-E

The Mien, a Southeast Asian hill people, have immigrated to various countries throughout the world since the mid-1970s. They have brought their ancient culture with them, including beliefs and practices related to health, illness, and healing. During the last several decades they have suffered much war-related trauma, including extensive human, material and symbolic losses. This report describes our clinical experience with Mien refugees in the Indochinese Psychiatric Program of the Oregon Health Sciences University. We discuss symptom presentation among this group of patients, diagnostic and treatment issues, and the impact of cultural health beliefs upon illness and treatment. Major depression and post-traumatic stress disorder have been the most commonly encountered psychiatric diagnoses, usually revealed through somatic symptoms. Not only must clinicians take careful medical and psychiatric histories, but they must also be alert to the high probability of an extensive history of trauma. Clinical improvement in response to psychotropic medications has been limited. As a result, psychosocial and psychotherapeutic approaches to treatment have been developed and expanded and now are commonly employed, effectively combining support and education in the creation of a holding environment that includes both individual and group formats. Two case histories are presented which describe symptom presentation, health belief systems and therapeutic issues involved in treating Mien patients. They also illustrate that traditional and Western healing approaches can co-exist in the optimal care of these patients.