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Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers’ wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers’ perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.

Culture and socialization influence how individuals perceive and express emotional distress. Research therefore, must consider the context to capture individual experiences. However, the majority of studies on factors associated with emotional distress among migrants use quantitative approaches, limiting an in-depth understanding. This study investigates emic themes of emotional distress among Vietnamese migrants by integrating anthropological and psychiatric approaches. The mixed methods study first quantified differences in reported themes of distress between Vietnamese ( n = 104) and German ( n = 104) patients, who utilized two psychiatric outpatient clinics in Berlin, Germany. Based on these differences, ethnographic interviews were conducted with 20 Vietnamese patients. In the quantitative part, differences in frequency of reported distress between Vietnamese and German patients indicate cultural and migration-related issues among Vietnamese migrants, such as the upbringing of children in a transcultural context. In the qualitative part, interviews with Vietnamese patients elicited contextualizing information and additional themes of distress. Besides commonly expressed socioeconomic themes, such as work and finances, we identified affectively charged themes concerning roles toward partnership and children. A central emic theme is expressed as “moments of speechlessness,” which go beyond a lack of language proficiency and challenge patients in different spheres of life. Migration entails complex affective dynamics, determined by a specific migratory and post-migratory context. Within this context, norms and values determine which themes of distress patients articulate openly. Therefore, an interdisciplinary, mixed-methods approach can yield a contextualized understanding of emotional distress and the complex nature of migration.

The present study investigated what complaints are prominent in psychologically distressed Vietnamese in Vietnam beyond standard symptoms assessed by Western diagnostic instruments for anxiety and depression. To form the initial Vietnamese Symptom and Cultural Syndrome Addendum (VN SSA), we reviewed the literature, consulted experts, and conducted focus groups. The preliminary VN SSA was then used in a general survey (N = 1004) of five provinces in Vietnam. We found that the VN SSA items were highly and significantly correlated with a measure of anxious-depressive psychopathology (a composite measure of the General Anxiety Disorder-7; Posttraumatic Diagnostic Scale; and Patient Health Questionnaire-9). The VN SSA item most highly correlated to anxious-depressive psychopathology was “thinking a lot” ( r = .54), reported by 15.8% of the sample. Many other symptoms in the addendum also were prominent, such as orthostatic dizziness (i.e., dizziness upon standing up; r = .41), reported by 22.9% of the sample. By way of comparison, somatic complaints more typically assessed to profile Western anxious-depressive distress, such as palpitations, were less prominent, as evidenced by being less strongly correlated to Western psychiatric symptoms and being less frequent (e.g., palpitations: r = .31, 7.1% of the sample). Study results suggest that to avoid category truncation when profiling anxious-depressive distress among Vietnamese that items other than those in standard psychopathology measures should also be assessed.

While involvement of family caregivers can play an important role in the recovery process of persons with serious mental illness (SMI), family caregivers often endure poor health and mental health issues due to caregiving-related distress. These challenges may be exacerbated for Vietnamese American families due to cultural values (e.g., familism and stigma). This qualitative exploratory study examined how Vietnamese American family caregivers of persons with SMI describe their caregiving experience. Using convenience and snowball sampling, the study recruited 21 participants who took part in two Vietnamese-language focus groups. Key findings of the study addressed three themes: (1) the influence of cultural and religious values on caregiving and mental health; (2) the negative impact of caregiving on caregivers’ wellbeing; and (3) the stigma attached to mental illness. The study offers useful insights to assist mental health practitioners in tailoring culturally appropriate and effective services for Vietnamese caregivers.

Viewed historically and cross-culturally, orthostatic-induced dizziness, i.e., dizziness caused by standing up from a sitting or a lying position, forms a key aspect of many syndromes: irritable heart (American Civil War), effort syndrome (World War I and World War II), chronic fatigue syndrome (contemporary USA), Gulf War syndrome (contemporary USA), and orthostatic dysregulation (contemporary Japan). Among Vietnamese refugees attending a psychiatric clinic, this study documents a high rate of orthostatic panic (OP), as well as certain processes seemingly generating these panic attacks, viz., flashbacks and culturally specific catastrophic cognitions. Case examples are used to demonstrate OP's phenomenology and relevance to clinical care. To illustrate the mechanisms producing OP, we adduce the multiplex model of panic generation. Culturally appropriate care of Vietnamese refugees should include assessment and treatment of OP.

We investigated acculturative hassles in a community cohort of Vietnamese refugees in Norway ( n = 61), exploring cross-sectional data and longitudinal predictors of acculturative hassles using data from their arrival in Norway in 1982 (T1), with follow up in 1985 (T2) and in 2005–2006 (T3). To our knowledge, this is the first longitudinal study of predictors of acculturative hassles in a refugee population. Results indicated that more communication problems and less Norwegian language competence were related to most hassles at T3. Higher psychological distress, lower quality of life, lower self-reported state of health, and less education at T3 were associated with higher levels of hassles at T3. More psychological distress at T2 and less education at arrival (T1) were significant predictors for more acculturative hassles at T3. These data suggest that addressing psychological distress during the early phase in a resettlement country may promote long-term refugee adjustment and, in particular, reduce exposure to acculturative hassles.

Multiple cultural variables have effects on the psychobiology and behavioral manifestations of illness, as do patient and physician perceptions of illness. The interaction among these variables is at the heart of clinical psychiatry. This case of a Vietnamese man with selective mutism under-scores the relevance of the `cultures' of medicine, psychiatry, and war and trauma on the manifestations of illness and illness perceptions by patient and physician. The discussion focuses on how these cultures interact and play a crucial role in formulating diagnosis and treatment planning. Sugges-tions are given for shifts in medical education that will encourage relevant cultural paradigms to make their way into educational and clinical systems, which in turn should improve cultural competence in clinical psychiatry.

Surveying 60 Vietnamese patients with either current or past post-traumatic stress disorder, this article aims to phenomenologically characterize the syndrome of `hit by the wind' in a multidimensional manner. This includes determining the patient conceptualization of the disorder, profiling `hit by the wind' episodes suffered by patients in the previous month, and presenting case vignettes. Eighteen of the 60 patients (30%) suffered at least one episode of `hit by the wind' in the last month; all 18 patients had at least one episode of `hit by the wind' in the last month that met panic attack criteria. For the 18 patients, 33 episodes of `hit by the wind' that met panic attack criteria were experienced in the previous month. For these 33 episodes, the most frequently reported DSM-IV panic attack symptoms were chills (100%; 33/33) and dizziness (88%; 29/33). Flashbacks played a role in the `hit by the wind' episodes for 5 of the 18 patients (28%). In the discussion, a model of how the syndrome of `hit by the wind' generates panic is adduced; also, possible Chinese origins of the disorder are discussed.

A wide range of expressions describing feelings and emotions is identifiable in the indigenous Vietnamese literature. The majority of Vietnamese expressions for common emotional states appear to have semantic equivalents in western psychology. The present overview draws on the lay and medical literature to provide examples of such expressions and descriptions. There does not appear to be evidence of a comprehensive psychiatric typology in the Vietnamese medical literature, although it is unclear to what extent the framework of Chinese medicine has influenced Vietnamese practitioners. Traditional Vietnamese health-care services, including those for mental-health problems, are eclectic, deriving their principles from cosmology, metaphysics and supernatural belief systems inter alia. The holistic notion of physical and mental health based on the state of harmony of the individual within the cosmos may be incompatible with the reductionistic principles underlying western taxonomies. Thus, the extent to which indigenous concepts of mental-ill-health influence Vietnamese immigrants’ choices about the utilization of either traditional or mainstream mental-health services in western countries needs further investigation.

This article examined the causes underlying low utilization of mental health services by Vietnamese immigrants in Australia. Study 1 examined cases of Vietnamese patients who had attended an anxiety disorders clinic, while Study 2 surveyed Vietnamese people in the community on their knowledge and attitudes towards common mental problems. Results from Study 1 showed that Vietnamese patients had significantly higher attrition rates, and presented with a larger number of nonanxiety disorders than their Australian-born counterparts. Study 2 results indicated that many Vietnamese people did not differentiate clearly between the terms ‘stress’, ‘anxiety’ and ‘depression’. Additionally, many participants felt that there was a generally negative cultural attitude towards people suffering from these problems and the mental health system itself. These outcomes suggest the importance of education for ethnic communities regarding available mental health facilities and treatments offered, as well as specific information on mental illness to help remove stigma.

This article describes the development and validation of the Phan Vietnamese Psychiatric Scale (PVPS). The PVPS was derived from Vietnamese idioms and cultural understandings of psychiatric and emotional distress identified from the Vietnamese literature and using ethnographic methods. The PVPS consists of a 26-item depression subscale, a 13-item anxiety subscale and a 14-item somatization subscale. Estimates of internal consistency for the three subscales ranged from .87 to .95, with 4-day interval test–retest reliability ranging from .81 to .89. Confirmatory factor analysis supported the subscale structure, with the depression subscale comprising two components ‘general mood disturbance’ and ‘psychovegetative symptoms.’ Multitrait–multimeasure analysis supported the construct validity of the scale. The PVPS demonstrated good criterion validity against case assignments by psychiatrists, naturalist healers, and structured diagnostic measures. The PVPS was rated as superior in clinical sensitivity and acceptability in comparison to other related measures.