2014. Vol.5, No.2, 109-115
Published Online February 2014 in SciRes (
Mental Health Needs in Vietnamese American Communities
Affected by the Gulf Oil Spill
Dung Ngo1*, Judith L. Gibbons2, Grace Scire3, Daniel Le4
1Department of Psychology, The University of Texas at Tyler, Tyler, USA
2Department of Psychology, Saint Louis University, St. Louis, USA
3Boat People SOS, Gulf Coast Region, Bayou La Batre, USA
4Boat People SOS, Gulf Coast Region, Biloxi, USA
Email: *
Received November 23rd, 2013; revised December 22nd, 2013; accepted January 18th, 2014
Copyright © 2014 Dung Ngo et al. This is an open access article distributed under the Creative Co mmons At-
tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
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Background: The Vietnamese American Gulf Coast communities have experienced recent disasters, in-
cluding both hurricane Katrina and the Deepwater Horizon (BP) Oil Spill. The objectives of this study
were to examine the impact of the 2010 Deepwater Horizon Oil Spill on the Vietnamese American Gulf
Coast communities and to offer recommendations on how to effectively work with this underserved
population. Method: Focus groups were held with Vietnamese coastal residents of three affected Gulf
Coast US States (Alabama, Louisiana, and Mississippi) to assess the impact of the oil spill disaster in the
areas of economic hardship, family functioning, and behavioral and mental health issues. Sixty Vietnam-
ese-speaking individuals (65% females) with an age range from 28 - 65 years who had an average of eight
years of education participated in the study. Approximately 77% had worked in the seafood industry and
about 92% indicated that they spoke English not very well”. Audio recordings of the focus group discus-
sions were transcribed, recorded on a spread sheet, and categorized into themes by two independent Viet-
namese-speaking individuals. A third researcher, also fluent in Vietnamese, checked and compared the
spread sheets for accuracy and reliability. Results: Nearly all participants reported being negatively af-
fected by the oil spill disaster. They described loss of income (59%), loss of employment (27%), and in-
ability to pay bills (12%). High levels of stress, anxiety and depression, as well as an increase in behav-
ioral problems were reported. None of the participants claimed to know where or how to seek help for
mental health problems. Conclusions: The oil spill disaster has had significant negative consequences for the
economic well-being, family functioning, and behavioral and mental health status of the Vietnamese American
gulf coast com munit ies. Impli catio ns a nd st rat egies for worki ng wit h this po pulation are off ered.
Keywords: Mental Health; Cultural Competency; Vietnamese-Americans; BP Oil Spill; Effective
In recent years, the Vietnamese Gulf Coast communities
have endured multiple natural, as well as man-made disasters.
The largest and third strongest hurricane ever recorded to make
landfall on US soil was hurricane Katrina, which occurred in
2005. Hurricane Katrina impacted about 90,000 square miles
across the Gulf Coast States; the death toll mounted to more
than 1500 in Louisiana and 238 in Mississippi alone. The hur-
ricane affected over 15 million coastal residents in a variety of
ways, such as economic loss, loss of employment, property
damage, unprepared forced evacuation, scarcity of fuel, and
food and water contamination (Wikipedia, 2013), with resulting
high rates of symptoms of post-traumatic stress disorder and
depression among Vietnamese Americans (Norris, Van Lan-
dingham, & Vu, 2009). Approximately 250,000 people were
forced to evacuate; although many returned to their ruined or
demolished homes and communities, others decided to rebuild
their lives elsewhere.
A more recent devastating disaster was the Deepwater Hori-
zon Oil Spill (aka the Gulf or BP Oil Spill) that occurred in the
Gulf of Mexico on April 20, 2010. The initial oil rig explosion
killed 11 people and injured 17 others; more than 200 million
gallons of crude oil were released into the Gulf of Mexico;
16,000 miles of coastline were affected, including the coasts of
Alabama, Florida, Louisiana, Mississipp i, and Texas; of the
400 miles of Louisiana coast, approximately 125 miles were
polluted by the oil spill (News-Basics, 2010). Given such
widespread damage, President Barrack Obama announced, “this
oil spill is the worst environmental disaster America has ever
faced(Oval Office, 2010). Oil spills differ from natural disas-
ters in a number of ways (Palinkas, 2012). First there is a long-
er period of acute stress; in addition there are devastating ef-
fects on the social fabric, disrupting community networks of
support, and thirdly, persons experience greater anxiety because
*Corresponding author.
such events are less common than natural disasters (Palinkas,
2012). Although it has been more than three years since the gulf
oil spill, the long-term damage to the economic and psycholog-
ical well-being of the people who are dependent on the fisheries
and seafood industry in this region remains unknown.
The Vietnamese population in the coastal region has been
somewhat neglected, due, in part, to their lack of political voice
and absence of advocacy for resources. While the needs for
mental health intervention are high, there are no culturally and
linguistically sensitive services available. Additionally, due to
the lack of understanding of the Vietnamese culture, main-
stream professionals are unable to effectively reach out to this
underserved population. The objective of this paper was to pro-
vide the readers a better understanding of the Vietnamese
coastal residents, reveal their mental health needs in the face of
the oil spill, and to offer recommendations on culturally-sensi-
tive strategies for working with this underserved population.
The qualitative data were collected during focus groups
conducted by the first author, following methods and proce-
dures successfully used by other researchers (e.g., Bloor, Frank-
land, Thomas, & Robson, 2001; Legerski, Vernberg, & Noland,
The background of Vietnamese American communities in
the gulf coastal states provides a context for the study. Viet-
namese Americans only began to resettle in the United States in
1975, when Saigon (South Vietnam) fell to the Communist
regime. With the current population of more than 1.5 million
(Nguyen, 2011), Vietnamese individuals live in virtually every
state. However, the vast majority of the population has chosen
to resettle in mild-weathered states, with California and Texas
being the top two states comprising the highest concentration of
Vietnamese American populations, respectively. Several rea-
sons have been identified for their choice of resettlement. First,
many chose to live in the coastal region due to its subtropical
climate, which is similar to the weather they grew up with in
Vietnam. Second, the Vietnamese communities of the West and
Gulf Coast regions (except for Alabama (AL), Mississippi
(MS), and Louisiana (LA)) are better established with regard to
infrastructure for economic, legal, and social services, and
health care support for Vietnamese-speaking individuals. Also,
many chose the Coastal region to continue the fishing and
shrimping traditions they brought from their native country. For
thousands of individuals whose language literacy is limited, the
seafood industry has allowed them job opportunities to start a
new life and to take care of their families. When asked directly
why they chose this profession, the response was usually, “you
dont need to speak English to catch fish or shrimp; besides this
is the only thing that I know all my life.Yet, a large number of
Vietnamese individuals moved to New Orleans due to the at-
traction of the Catholic tradition. In the early 1980s, the New
Orleans Archdiocese was particularly supportive of Vietnamese
Roman Catholics. Thus, many Vietnamese relocated to this area
to build a tight knit Catholic community or village. As a result,
New Orleans is the home of many Vietnamese Catholic parish-
es, with Mary Queen of Vietnam being the largest.
From the seafood industry standpoint, the Coastal states that
were impacted most severely by the aforementioned disasters
included Alabama, Mississippi, and Louisiana. According to
the US Census (2010), there are approximately 42,775 Viet-
namese Americans resettled throughout these Coastal states
(28,352 in Louisiana; 7025 in Mississippi; and 7398 in Alaba-
ma). Approximately, 30% - 50% of all seafood-industry
workers in the Gulf region are Vietnamese ethnic in origin.
Boat People SOS has estimated that approximately 70% - 80%
of Vietna mese workers across the Gulf Coast of Alabama, Mis-
sissippi, and Louisiana, are associated with the seafood industry.
Many of these individuals have worked as fishermen, shrimpers,
deck hands, shrimp packers, oyster shuckers and crab pickers
since resettling in the US. For many, the traditions of fishing
and shrimping were handed down to them from previous gen-
erations. The hurricanes and BP Oil Spill disaster in the recent
years have turned their livelihoods upside down and put them
in a limbo situation. Many lost their hard-earned boat vessels,
either due to damage from the hurricanes or to foreclosure from
being unemployed after the BP Oil Spill. Furthermore, chang-
ing jobs or acquiring new technical skills is not an option for
many individuals, due to their cultural and language barriers.
Past reports have documented that many Vietnamese refu-
gees had experienced a multitude of traumatic experiences be-
fore arriving in the United States. These traumas may include
war atrocities, family disintegration, communist “reeducation”
(i.e., imprisonment), being lost at sea, being attacked by pirates,
being starved, being ill without medical care, being sexually
assaulted by pirates, and witnessing death of friends or loved
ones (US Committee for Refugees, 1984; Mo llica, Wyshak, &
Lavelle, 1990). While man-made and natural disasters can be
traumatic for anyone, individuals with histories of past trauma
are particularly vulnerable to mental health and adjustment
problems (Teodorescu, Heir, Hauff, Went zel-Larsen, & Lien,
2012). Repeated or retraumatization has been identified as a
serious mental health risk and treatment tends to be highly
complex and difficult (Courtois & Ford, 2009). Given that
many Vietnamese individuals came to the US with a history of
a multitude of past traumatic experiences (Ngo, Tran, Gibbons,
& Oliver, 2001) the re-traumatization experiences through these
disasters may put them at an increased risk for a host of beha-
vioral and mental health problems.
The Vietnamese communities in the Coastal States (AL, MS,
and LA) have demographic characteristics that are quite differ-
ent from t he well-established Vietnamese communities in other
States such as California, Massachusetts, or Texas. First, the
Vietnamese community in the Gulf Coast region lacks the so-
cial support and culturally sensitive health care infrastructure.
For example, there are limited Vietnamese speaking advocacy
or social service organizations to assist victims of disasters. Al-
though, faith-based organizations have been the main front-
runners in extending helping hands, they are not equipped with
the specialty knowledge and skills to effectively deliver mental
health support. Additionally, during the times of crises, there
are virtually no Vietnamese-speaking mental health profession-
als to provide crises intervention to the victims of disasters.
Furthermore, Vietnamese-speaking general practitioners are
also scarce for residents in the cities of Biloxi, MS and Bayou
La Batre, AL. Despite the great needs for social and mental
health services among the Vietnamese community in the Gulf
region, mainstream agencies are not equipped with the cultural
sensitivity and language skills to reach out to this underserved
Parti c i pants
Sixty Vietnamese adults across the three States participated in
the focus group study. Of this number, 39 (65%) were females,
with an age range from 28 - 65 years. Participants were eligible
for inclusion if they were at least 18 years of age or older, we re
a resident of the state where the focus group was held, and
spoke fluent Vietnamese. On average, participants had had
about 8 years of education in Vietnam, with the number of
years ranging from 3 - 12 years. With regard to marital status,
86% were married, 10% were single, and 4% were divorced/
separated. Approximately 77% reported working in the seafood
industry. The type of work related to Seafood Industry included
shrimpers, deck hands, shrimp packers, and oyster shuckers.
About 92% (55/60) reported that they spoke English not very
well”. See Table 1.
Four primary questions framed the focus group discussion.
Those questions and the resulting discussions were in the Viet-
namese language. 1) What impact did the Oil Spill have on you
and your family? 2) Did you notice any c hanges in your health
(or members of your family’s health; including mental health)
or behavior within the past month? 3) What are the health/
mental health resources that are availab le in y our area? 4) What
are some of the major barriers you faced in dealing with the
Participants who had received advocacy or other social ser-
vices from a Vietnamese non-profit organization (Boat People
SOS) were recruited from AL (Bayou La Batre), MS (Biloxi),
and LA (New Orleans). A supporting staff from each city ran-
domly called up the clients and invited them to participate in
the focus group meetings. One focus group was conducted in
each city by the first author. The number of participants in each
group ranged from 17 - 22 persons. The group meetings were
Table 1.
Demographics of focus group parti cipants (N = 60).
Number of
Participants % Mean (SD)
Total Sample
Bayou La Batre (AL) 22
Biloxi (MS) 17
New Orleans (LA) 21
65% (female)
37 years (SD = 6)
8 years (SD = 3)
Marital Status
Married 86%
Single (never married) 10%
Divorced/separated 4%
Employment Type
Seafood 77%
Casino/Hotel 10%
Restaurant 5%
Nails 5%
Other 3%
English Proficiency
92% (not very well)
held at a neutral place (i.e., at the BPSOS office) and lasted
about two hours. Prior to the focus group discussion, each par-
ticipant completed a short demographic form and signed a con-
sent form to be audio recorded. Participation was completely
voluntary. Participants had the option to decline or to withdraw
from the discussion at any time. The audiotapes were tran-
scribed verbatim by two independent coders fluent in Vietnam-
The responses from each participant were typed into a
spreadsheet for content analysis and comparison across partici-
pants. The responses were then grouped together under the
heading of each of the four questions discussed. Once the
process of categorizing responses was completed, a third person,
also fluent in Vietnamese, reviewed the spreadsheet for similar-
ities and consistency across the two coders. Results indicated
that the t wo coders were in agreement at a rate of nearly 100%.
Question 1: Wha t Impact Did the Oil Spill Have on
You and You r Fa m ily?
To this question, the following themes were reported: reduc-
tion in work hours/income 58.33% (35/60); loss of employment
26.66% (16/60); unable to pay bills 11.66% (7/60), and family
separation 3.33% (2/60). Ov erall, every participant in the focus
group across the three States reported that their household in-
come was impacted to some degree. Individuals who own
smaller boat vessels were no longer able to shrimp due to the
disappearance of these species after the Oil Spill. Additionally,
they indicated that the fuel cost is significantly higher than the
net profit. One man stated, “I have been shrimping in this water
for more than 25 years; on a bad trip, I could still make about
$1500 - $2000/week in net profit. On the last three trips, we
came home with a negative income, not making enough to cov-
er the fuel cost. Furthermore, the prices of the shrimp had fal-
len drastically during this period. I have bills that must be paid.
I might lose my boat soon. The participants across the three
States concurred that they, too, are short or late on paying their
bills. The effects on household income not only affected boat
owners but also trickled down to hired captains, deck hands,
oyster shuckers, and seafood processing workers. Family unity
was also affected. Two participants, one from Biloxi and one
from New Orleans, indicated that they had to relocate their
children to live with relatives in another state so their children
could continue to go to school.
Question 2: Have You Noticed Any Ch a nges in Your
Health (Including Mental Health) or Behavior within
the Past Month?
To this question, the following themes were reported: in-
crease in anxiety and depression—common symptoms included
worrying all the time, having poor appetite, difficulty falling
or staying asleep, feeling tense and irritable, feeling weak and
fatigue, losing interest in daily activities, and feelings of body
aches and indigestion.These are soma tic symptoms common -
ly associated with Anxiety and Major Depressive Disorders
documented among Asian individuals (e.g., Kalibatseva &
Leong, 2011).
All participants across the three States raised their hands to
indicate that they had experienced several of these symptoms
regularly over the past two weeks. Two participants reported
that, “I have not been able to sleep in two days.” Thoughts
about the unknown future of the seafood business were daunt-
ing for many Vietnamese. The vast majority of the Vietnamese
Coastal residents is dependent on the seafood industry for its
livelihood and feared that the seafood will disappear indefi-
nitely. One lady in Bayou La Batre stated, “I have been shuck-
ing oysters for 13 years. Although this is a hard job, I do not
know English well enough to learn any other trades. I had been
dependent on this job to raise my three children. My husband is
a deckhand and is currently out of job. My work hours had
been cut from 9 hours/day to just 4 hours/day and on some days
they dont even call me in to work. I dont know how long this
will continue.This sentiment resonated among all participants
in all three states. The stress associated with losing their em-
ployment and income also led to behavioral problems and ma-
ladaptive coping. A female participant in Biloxi indicated that
her husband has been drinking and smoking more than usual.
Another woman reported that with more idle time at home, her
husband had been visiting the Casinos more often. She added,
I just hope that he doesnt gamble away the little money we
have left.Marital conflict was also an important topic that the
group members brought up for discussion. Several women from
Bayou La Batre stated that they knew of someone in the com-
munity who was battered after the husband lost his job as a
Question 3: Wha t Are the Health/Mental Health
Resources That Are Available in Your Area?
The mental health question was rephrased as What re-
sources are available to help you deal with the stress symp-
toms?The decision to rephrase this question was to make it
sound less stigmatizing and less threatening to the participants.
To this question, nearly all participants indicated that they did
not know of any available resources for Vietnamese-speaking
individuals in their local area. To deal with these psychosocial
stressors, participants indicated that they get together for sup-
port. However, informal support from friends and neighbors
could lead to more problems. Because the Vietnamese com-
munities in the Gulf region are fairly small, confidential infor-
mation about personal problems could leak out into the com-
munity and become the topic for rumor. One lady in Biloxi
stated, “People in this area know each other. Therefore, we
dont really talk about personal family matters. Other people
may use that information in a negative way. So we just keep
Of the 60 participants, only two people reported that they had
health insurance because they could afford it as boat owners. At
the focus group in Biloxi, when asked, “What do you do if you
became very sick?A moment of silence filled the room. Sud-
denly, a voice in the back of the room said loudly, “We just
endure it until the sickness go away and hope that we dont die.
The room was then filled with laughter again.
Question 4: Wha t Are Some of the Major Barriers
You Faced in Dealing with the Disaster?
Perhaps the most challenging barrier faced by the majority of
the participants was the lack of English proficiency. Among
this sample, 55 out of 60 (92%) individuals self-reported that
their English skills in the areas of Reading, Writing, and
Speaking/Understanding were not very well. Three individu-
als (5%) reported they neither write nor read Vietnamese very
well. Ninety seven percent of the sample reported they did not
receive the news directly from mainstream media outlets or
from the official website about the disasters. Nearly 100% re-
ported they were late in receiving the news about the financial
claim process published by the Gulf Coast Claims Facility. The
participants expressed that we are at a disadvantage due to
our inability to read or hear English. There was a general
consensus among the participants across the three states that
initially they did not know where or how to file the claims for
their financial loss as a result of the Oil Spill disaster. All of
them attributed this to a lack of English proficiency.
Due to their limited English proficiency, Vietnamese Coastal
residents tend to congregate into a tight knit community for
support. For this reason, the community is somewhat segre-
gated from the mainstream social support network. Furthermore,
with the lack of language and cultural knowledge, mainstream
agencies are struggling with delivering culturally sensitive ser-
vices to the Vietnamese population. In response to the hurri-
canes and the Oil Spill disaster, limited national and state re-
sources were allocated to assist victims of disasters. However,
due to cultural and language barriers, many Vietnamese did not
receive the benefits they rightfully deserved or needed. Addi-
tionally, the absence of a political voice within the community
and the lack of advocacy, al so p lac ed t he c ommun ity a t a d is ad -
vantage in fighting for these limited resources.
One objective of this paper was to present the qualitative data
on the perceived impact of the BP Oil Spill, the mental health
needs, and mental health resources among the Vietnamese
Coastal communities. A second objective was to offer practical
and culturally sensitive recommendations for mainstream health
care and service providers in order to effectively reach out and
work with the Vietnamese population.
The results revealed that the BP Oil Spill had a significant
negative impact on the participantshousehold income in vari-
ous ways. This negative impact affected not only family con-
nectedness but also placed the participants at an increased risk
for mental health and behavioral health problems. The reper-
cussions reported by participants fell into the three tiers of the
mental health impacts of oil spills of Palinkas’ conceptual
model (2012). We found economic impacts, consistent with
Tier I, increased social conflict and reduced social support of
Tier II, and signs of anxiety, depression, and somatic symptoms,
intrapersonal impacts of Tier III. The somatic symptoms are
consistent with past reports that Asian individuals may express
psychological symptoms in a somatic manner (Mumford, 1992;
Kalibatseva & Leong, 2011). It should be noted that man-made
or natural disasters may be stressful and traumatic for anyone;
but that the Vietnamese coastal population is particularly at risk
for mental health problems due to their past experiences of
repeated traumatization prior to coming to America, including
war, imprisonment, torture, and refugee experiences, their ex-
posure to hurricane Katrina, and now the oil spill disaster.
In addition to mental health symptoms, participants also ac-
knowledge signs of behavioral health issues. Although marital
discord and domestic violence was not fully examined in the
discussion, participants were concurred that the stress asso-
ciated with the oil spill does contribute to the strain of their
spousal relationship. One female participant from Biloxi ex-
plained that, “my husband and I argued more and more be-
cause he has so much free time doing nothing.While domestic
violence is an undeniable fact within the Vietnamese commu-
nity, it often occurs in private and hidden behind the public
view (personal conversation with Coi Nguyen, a Domestic Vi-
olence case worker in the Gulf Coast).
Another behavioral health problem that might be exacerbated
by the stress related to the Oil Spill is gambling. Pathological
gambling is a huge problem among the Asian communities and
has been widely documented (e.g., Blaszczynski, Huy nh,
Dumlao, & Farrell, 1998; Ethnic CommunitiesCouncil of
NSW, 1999; Petry, Armentano, Kuoch, Norinth, & Smith,
2003). The city of Biloxi, MS is home to at least nine first-class
casinos and resorts ( Every
participant in the focus group across the three States agreed that
gambling is a serious problem for many Vietnamese individuals
in the community. During an interview, Danny Le, Branch
Manager for BPSOS in Biloxi, “this [gambling issue] is a se-
rious problem that we dont know how to handle.Over the
past several years, a number of people have sought assistance
from his office after losing their life savings. During the initial
needs assessmen t survey, the first author came across a case in
which a Vietnamese woman lost her family after she gambled
away more t han $100,000 of her husband’s hard earned income.
The psychosocial stressors associated with the Oil Spill may
exacerbate the gambling behavior, which is already a problem
in this vulnerable population.
Despite the mental health needs that exist in the Vietnamese
community, the available resources (e.g., Vietname s e-speaking
mental health professionals) to meet these needs are nonexistent.
The lack of mental health resources may cause a delay in
treatme nt, which may exacerbate the severity of the condition
over time. Interview information obtained from faith-based and
social service organizations revealed a serious lack of culturally
and linguistically sensitive mental health services for the Viet-
namese population. Although mainstream agencies are trying to
reach out to the Vietnamese community, they, too, are not cul-
turally competent to work with Vietnamese-speaking clients.
One hallmark of the Vietnamese culture is a strong emphasis
on family unity and connectedness. Thus, when family mem-
bers are separated due to an uncontrollable event, it is a devas-
tating experience for the whole family as a unit. In our sample,
at least two families reported that they had to send their child-
ren to another state to live with relatives in order to continue
with schooling.
Past studies have documented that limited English profi-
ciency was associated with poor adaptation and health problems
among refugees and immigrants (Okafor, Carter-Pokras, Picot,
& Zhan, 2013; Nguy en & Benet -Martínez, 2013). Poor English
proficiency also limits Vietnamese individuals in their search
for jobs, as most require adequate command of the English
language. Many of those individuals have held only one type of
job (e.g., oyster shucking) since their resettlement in the US.
Thus, it would be quite difficult for them to adapt to new skills
training or a job change. English skills have been used effec-
tively as a good indicator of adaptive acculturation and have
been found to mediate the impact of trauma on depression and
PTSD (Ngo et al., 2001). Ninety two percent (92%) of the sam-
ple in this study indicated that their English skills were “not
very well.This is a much higher statistic than the national
average (54%) reported by the Vietnamese American popula-
tion (US Census, 2010). Poor English proficiency also exacer-
bated the stress level for many Vietnamese individuals in the
Gulf region since it blocked their ability to access accurate
news regarding the claims process in a timely manner.
The following recommendations are made to assist health
care providers to effectively work with the Vietnamese popula-
tion. For some additional cultural advice on working with Vi-
etnamese Americans after disasters, see al so Kapl an a nd Huy nh
(2008). It is important to be aware that the path toward becom-
ing a culturally competent practitioner is a developmental pro-
cess. Furthermore, to become a culturally competent practi-
tioner one must practice compassion, be open, have a positive
attitude, and develop new and effective skills, as well as keep
up with current information and knowledge about the popula-
tion one serves.
Seek to learn the history and immigration experiences of the
Vietnamese population. Vietnamese people are very proud
of their history as it relates to their longstanding struggle
and resilience against foreign colonization and civil wars.
Furthermore, their journey in search for freedom was often
marked by horrific traumatic experiences. Understanding
their history and exploring their immigration experiences
could be, in and of itself, very therapeutic and an excellent
way to build rapport.
Offer help and direct individuals and families to appropriate
resources. Vietnamese individuals are indeed a very proud
group of people. It is unlikely that they would outwardly
ask for help, even though they really need the assistance. It
is customary in the Vietnamese culture to offer support be-
fore the person has to voice her/his needs. Oftentimes, the
offer must be made several times and the person may de-
cline repeatedly before s/he accepts the offer.
Create a trusting and collaborative network with community
leaders, faith-based leaders, health care professionals (in-
cluding indigenous healers), and social service organiza-
tions that specifically serve the Vietnamese-speaking popu-
lation. In order to reach out to the Vietnamese community,
it is critical that an agency or service provider fully secure
the support of these individuals. When approaching these
community leaders, it is important to explain what services
you have to offer and solicit their help in delivering these
services to the people. The trusting relationship that you
seek to build with the people begins with the people in the
leadership positions within the community.
Become familiar with Vietnamese health care customs and
attitudes toward mental health. For example, preventive
medicine is not a top priority for many Vietnamese indi-
viduals. Furthermore, many do not have health care insur-
ance coverage. Thus, they often delay seeking help for their
illness until the condition becomes unbearable. For mental
health problems, the matter is usually dealt with within the
family circle. The patient is usually shielded or hidden from
public view due to the fear of ruining the family’s name.
Vietnamese women are known for their self-sacrifice for
the sake of the family. Thus, a woma n may suffer i n sile nce
in order to maintain harmony for her family. For this reason,
depression may never be spoken of or even perceived as an
illness that needs professional intervention.
Become familiar with home health remedies. Almost every
Vietnamese family practices some form of home health re-
medy for common ailments such as flu, fever, allergies, in-
digestion, muscle aches, stomach aches, etc. One of the
most common home health practices is “coining” or “cao
gio”. Coining (cao gio) involves rubbing medicinal oil on
the body parts that are believed to be affected by the illness
(usually the neck, bac k, chest, arm, and the temples). Once
a light coating of the oil is applied, the affected or target
area would be lightly rubbed repeatedly with a coin or
spoon. This action causes the skin to change color and
leaves prominent dark reddish marks on the affected areas.
These marks last between three to seven days. Usually no
physical pain is associated with coining. After the proce-
dure, the person (client/patient) usually reports some kind
of immediate relief. To the naïve observer, these marks may
look like signs of physical abuse. Thus, it is important to
become familiar with the various forms of home health re-
medies practiced by the Vietnamese people to avoid making
false assumptions about a behavior or practice unfamiliar to
one’s culture.
Become familiar with indigenous health care practices and
pattern of medication usage. First, many Vietnamese adhere
to the belief that Western medicine is harmful to their liver
or stomach if taken for an extended time. For this reason,
many people change their treatment regimen to herbal me-
dicines without informing their primary doctor. Second,
many Vietnamese individuals, especially elderly individuals,
often share medicines that they believe work for them. Thus,
it is common for Mrs. A to share her headache medications
with Mr. B because she responded well to a particular type
of medication. Finally, many traditional Vietnamese indi-
viduals are more familiar and comfortable with alternative
treatment methods, such as acupuncture. For these reasons,
recommendations for treatment must consider incorporating
both Eastern and Western treatment methods to facilitate
cooperation by the client/patient.
Despite the fact that the Vietnamese-American population
has continued to grow into the 21st century (US Census, 2010),
research on the mental health issues among this population
remains scarce. The recent hurricane and the BP Oil Spill have
put the Vietnamese communities in the Gulf Coastal region at
an increased risk for behavioral and mental health problems. In
particular, the BP Oil Spill has caused a negative economic
impact among many Vietnamese families, produced high levels
of distress, and interrupted family functioning. While the men-
tal health needs are high, resources to address these needs are
nonexistent in the coastal region. Barriers that prevented early
intervention included poor English skills, cultural barriers, and
lack of resources. Additionally, mainstream health care provid-
ers are struggling to deliver culturally competent services to
this underserved population. The objective of this paper is to
present qualitative findings on the perceived impact of the BP
Oil Spill, identify the mental health needs, and document the
lack of mental health resources to meet the needs of the Viet-
namese Gulf Coastal communities. Finally, the recommenda-
tions presented in this paper may be helpful to mainstream ser-
vice providers who are passionate about delivering effective
services to this population.
Author Notes
Shortly after the BP Oil Spill, D. N. was hired as a mental
health consultant by the American Red Cross to work in the
Gulf Coast. During the three months he was there, he organized,
developed, and delivered Psychological First Aid workshops to
Vietnamese residents, as well as to community and faith-based
leaders. In the beginning of 2011, he partnered with Boat
People SOS—a Vietnamese-American non-profit advocacy or-
ganization—to work on various mental health projects funded
by the Department of Mental Health in the states of Mississippi,
Alabama, and Catholic Charities of New Orleans. Over the past
two and a half years, he has delivered numerous psycho-educa-
tional workshops addressing topics such as mental health, cop-
ing with stress, domestic violence, and addictive behaviors to
more than 500 Vietnamese participants across these three Coas-
tal states. He also conducted multiple Cultural Competency
Workshops and trained more than 200 mainstream public ser-
vants and health care workers throughout the states of AL, MS,
and LA. This paper draws from his initial needs assessment of
the community and from focus group studies he conducted in
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