Despite the high prevalence of depression and post-traumatic stress disorder among first-generation Vietnamese Americans, their underutilization of mental health services continues to persist. The question of how culturally sensitive mental health services can be delivered to engage this population effectively in treatment has been a key issue for disparities research for the past several decades. Ample literature has identified individual, sociocultural and structural factors that influence mental health service use among this population, but very few studies have explored the perceptions of the clients themselves about mental illness or their pathways to care.
Twenty-one individual, inductive, and qualitative one-on-one interviews were conducted to address three aims: 1) to explore the conceptualizations of health among first-generation Vietnamese Americans living with depression and/or PTSD, 2) to illustrate the pathways through which this population obtained outpatient mental health services, and 3) to describe their expectations and perceptions of outpatient mental health treatment. Constructivist grounded theory (GT) guided all aspects of this study.
The participants were mostly female and ranged in age from 42 to 74 years. Two major themes, "bounded within these four walls" and finding one's way to "a place where I am respected," emerged as overarching processes through which the participants described their experiences. Their rich stories portrayed journeys through losing, finding and reclaiming their self worth -- journeys marked with losses, sacrifices, disruptions, stigma, resilience, coming to terms with their conditions, and managing their illnesses. These men and women remained optimistic on the road to reclaiming their sense of self worth, despite being crippled by their legacies of war, trauma, and migration to the United States. Their stories offer a culturally nuanced understanding of how participants explained their emotional discomforts, how they found their various ways to agencies that could help ease these discomforts, and the unexpected resources and relationships they gained from outpatient mental health care. This study's findings provide strong implications for social work research, practice, and policy that can help empower these individuals to find purpose and hope in their lives.