Mental Health in the Vietnamese American Community

    Overview

    Mental Health in the Vietnamese American Community 

    Mental health symbols and labels

    Author: Pauline Đồng
    Grades: 11-12

    Suggested Amount of Time: 75 - 90 Minutes
    Area of Study: Vietnamese Resettlement and Community Building

    Compelling Question
    • What is Vietnamese America?

    Lesson Questions
    • How has wartime trauma impacted Vietnamese refugees and the Vietnamese American community?  
    • What struggles are shared with the immigrant experience in trying to achieve the American dream?
    Lesson Objective

    Students will be able to identify and describe the effects of the Vietnam War on the mental health of first-generation Vietnamese Americans by engaging in a gallery walk activity to analyze various excerpts of “House of Sticks: A Memoir.”

    Lesson Background

    After the Fall of Sài Gòn in 1975, an estimated one million Vietnamese former soldiers of the Army of the Republic of Vietnam (ARVN) were imprisoned without formal charges or trials, another million took part in a mass exodus seeking asylum from the international community, and in the following decades hundreds of thousands resettled in countries around the world. Both soldiers and civilians endured numerous political, socioeconomic, and psychological hardships from the after effect of the war and change in regime. Despite resettling in other parts of the world, the psychological effects remain. Consequently, intergenerational trauma is still prevalent within the Vietnamese American community. Before engaging in this lesson, it would be ideal for students to have a general understanding of the Vietnam War and its effects on Vietnamese refugees. This lesson is similar to "Mental Health in Vietnamese American Resettlement", however includes alternatives for interacting with the content using Vietnamese language.

    This lesson contains content that may be sensitive for some students. Teachers should exercise discretion in evaluating whether the resources are suitable for their class and provide a content warning to their students at the beginning of the lesson. This lesson is to bring awareness to mental health and should not be used to diagnose mental health conditions. Trauma can be a tough topic to talk about. It can bring up memories of bad things that have happened to us, and it can make us feel sad, angry, or scared. If you are talking about trauma, it is important to set ground rules. These rules will help to make sure that everyone feels safe and respected. Please provide the appropriate content warning to students.

    Image Citation: Iona_Admin. (2019, May 16). 7 Questions & 7 Ways to Better Your Mental Health - Iona. Iona. https://www.iona.org/7-questions-7-ways-to-better-your-mental-health/ 

    Ethnic Studies Theme

    This lesson connects to the ethnic studies theme of power and oppression from the Asian American Studies Curriculum Framework (Asian American Research Initiative, 2022). Students will consider war, migration and imperialism as contexts shaping citizenship and racialization. Students discuss US foreign policy and impact of war on migration and resettlement to the United States and the intergenerational trauma within the Vietnamese community and successive generations.

    For additional guidance around ethnic studies implementation, refer to the Ethnic Studies Model Curriculum (2021) https://www.cde.ca.gov/ci/cr/cf/esmc.asp.

    Historical Thinking Skills

    This lesson will facilitate student proficiency in cause and consequence one of Seixas’ historical thinking skills (Seixas & Morton, 2013). To help students to understand that there are short-term and long-term consequences of events. Students consider how change is driven by multiple causes, and results in multiple consequences. These create a complex web of interrelated short-term and long-term causes and consequences.

    Readings
    • “Wartime Trauma among Vietnamese refugees subject of new study”
    • Six Excerpts from “House of Sticks: A Memoir”
    Handouts
    1. Mindfulness Activity (5 minutes)
    • Start the class with a breathing exercise or mindfulness meditation.
    • Introduce students to the learning objectives for today’s lesson. Inform them that they should practice self-care and mindfulness as they proceed in the lesson activities.
    1. Anticipatory Set (15–20 minutes): 
    • Present students with a list of vocabulary words associated with mental health in the Vietnamese American community. The instructor can have students complete a KWL (KWL Chart: The KWL Chart starts student’s thinking about what they know about a topic, what they Want to know, and what they have Learned in the end) chart individually so students can reflect on words they do or do not know. Then, the teacher can model the pronunciation of the words for students. Subsequently, students can share their charts in pairs or in small groups. Words may include but are not limited to the following: 
      • sức khoẻ tâm lý - mental health 
      • gia đình- family 
      • cộng đồng- community 
      • người Mỹ gốc Châu Á - Asian American 
      • người Mỹ gốc Việt - Vietnamese American 
      • Châu Á / Á Châu - Asia 
      • thể diện - reputation / face 
      • hậu chấn tâm lý - PTSD 
      • văn hóa - culture 
      • tập quán - custom 
      • dịch vụ y tế - health services 
      • khám bệnh - examination 
    1. Review and Discuss: Have students engage in a paired or small-group discussion about the following questions (available in Vietnamese). Then, ask several students to share their responses aloud to the class. Student representatives from each small group can share. Students can share their own responses to the questions or highlight common points in their group members’ responses, overall. 
    • Discussion (Thảo Luận) (15–20 minutes):
      • Summarize your understanding of the causes and effects of the Vietnam War on Vietnamese refugees. (Vietnamese translation: Tóm tắt sự hiểu biết của em về nguyên nhân và hậu quả của Chiến Tranh Việt Nam Đối với người Việt tị nạn.) 
      • What is “mental health” to you? (Vietnamese translation: Theo em, sức khỏe tâm lý ý nghĩa là gì?) 
        • Teacher note: It may be beneficial to define mental health as our emotional, psychological, and social well-being. The concept of mental health may be foreign to some students, as this phrase may not exist in some languages.
      • Do your family or friends talk about mental health? (Vietnamese translation: Gia đình hay bạn bè của em có bàn bạc về sức khỏe tâm lý không?) 
      • In your opinion, is mental health seen as something important in the community? Explain. (Vietnamese translation: Theo em, cộng đồng người Mỹ gốc Việt có coi trọng sức khỏe tâm lý không? Hãy giải thích câu trả lời của em.) 
    • Transition: Wrap up the preliminary discussion and move onto the next portion of the lesson. 
    1. Interaction with first source
    • Model responses for today’s activity using an excerpt from “Wartime trauma among Vietnamese refugees subject of new study” that covers mental health issues caused by the Vietnam War. https://www.nbcnews.com/news/asian-america/wartime-trauma-vietnamese-refugees-subject-new-study-rcna12759# (15–20 minutes)
    • Read the source aloud with the class. The instructor may read aloud to the class or have students take turns reading aloud to the class. 
    • Model responses (in Vietnamese) to these questions on the graphic organizer that students will use for class today. Questions for Discussion: 
    • What do you think? (Vietnamese translation: Em Nghĩ Sao? Câu Hỏi để Thảo Luận Tóm tắt ý chính của trích đoạn này.)
      • Summarize the key idea(s) from this excerpt: “The key idea(s) from this excerpt is ___.” (Vietnamese translation: Ý chính của trích đoạn này là ___.)
      • Have you ever seen this situation happen in your family or in your community? When? Where? (Vietnamese translation: Bạn có bao giờ thấy trường hợp này xảy ra trong gia đình hay cộng đồng của bạn chưa? Khi nào? Ở đâu?)
        • Response Starters: “I have/have not seen this situation occur.” (Vietnamese translation: Mình đã/chưa thấy trường hợp này xảy ra.) 
      • “How do you feel after reading this excerpt?” (Vietnamese translation: Bạn cảm giác/thấy như thế nào sau khi đọc trích đoạn này? Tại sao?) 
        • “I feel ___ after reading this excerpt because ___.” (Vietnamese translation: Mình cảm giác/thấy ___ sau khi đọc khi đọc trích đoạn này vì __.)
    1. Gallery Walk Setup
    • By this point, teachers should have the following excerpts set up as a digital gallery walk or as a physical gallery walk in the classroom. With six different excerpts, there should be six different stations in the classroom. The teacher can have the questions from “Em Nghi Sao? Câu Hỏi để Thảo Luận / What Do You Think? Questions for Discussion” by the stations for students to respond to, or teachers embed these questions and frames in the graphic organizers.
    • Source 1
      In the chapter “Betrayed by Our Tongues,” Lý references the American dream after facing racism and harassment. She wants to promise her family will achieve it but is disheartened. Yet, in what ways is this experience, the immigrant experience, a quintessentially American story? How is the trauma that Vietnamese Americans have experienced through war, suffering, and persecution passed down to Vietnamese American youth? What impact might it have on the mental health and behaviors of youth?

      Begin excerpt: My father was one of almost two and a half million South Vietnamese soldiers who were captured and sent to the reeducation camps, where they were forced into backbreaking and often dangerous labor, sweeping minefields, digging wells and latrines, cutting down trees. They called the camps trại học tập cải tạo, meaning a place where you could be purified of your sins, offering a chance to recreate yourself through labor that benefited the community.

      They told us we only had to attend for about a week and a half, just until they sorted out the paperwork. Then they whipped and electrocuted us. They fed us once every few days, sometimes weeks, part of a potato. My father served a ten-year sentence.

      [Word Count: 121]

    • Source 2:
      In the chapter “Betrayed by Our Tongues,” Lý references the American dream after facing racism and harassment. She wants to promise her family will achieve it but is disheartened. Yet, in what ways is this experience, the immigrant experience, a quintessentially American story? How is the trauma that Vietnamese Americans have experienced through war, suffering, and persecution passed down to Vietnamese American youth? What impact might it have on the mental health and behaviors of youth?

      Begin excerpt: I could barely speak, I was so touched by her gesture. As I held the turtle in my hands, I thought about why it was that I liked turtles so much. It had become such a part of my identity that I’d forgotten its origin. I revisited those nights, years ago, sitting on tattered couch cushions on the door and listening to my father tell us about his time in prison. He was trying to make us understand what war was then, and what it meant to be a prisoner.

      After my father rescued the turtle and the warden saved my father from being shot and ordered his release from prison, relatives found him not far from the camp area. All seventy-two pounds of him. He had collapsed from exhaustion, dehydration, hunger, and pain before he could make his way home. It was over seven years of re-education. But it was not really over. He’d been sentenced to ten years, and the remaining three years of his sentence would be served as the government saw it. His sisters brought him home with them. They fed him. They clothed him. They nurtured and consoled him. Many of his friends were dead. You are lucky, his sisters told him.

      [Word Count: 206]

    • Source 3:
      In the chapter “A Lazy, No-Good Daughter,” Lý’s teacher Ms. Walsh calls the Administration for Children’s Services (ACS) to report Lý’s parents for child neglect since her father refuses to allow Lý to get glasses. This triggers Lý’s father’s PTSD, widens the rift between her and her parents, and worsens her own mental health. Still, Ms. Walsh says, “If I had to do it again, I would.” Discuss the source of the conflict here and if there could have been a better outcome. What would you have done in Ms. Walsh’s position? In Lý’s? How do you think many Vietnamese American youth grapple with the traumas of their parents? How do they deal with the acculturation gap? What strategies do Vietnamese American youth take to navigate family and societal pressures?

      Begin excerpt: Dr. Hayes diagnosed me with dysthymia, or high-functioning depression. It’s a depressive disorder that can sometimes accompany high achievers who are able to mask their depression well, he explained to me.

      ‘Based on what you’re telling me, I think it’s safe to assume that you’ve suffered from this for many years now,’ he said. ‘You’ve been able to do well, relatively speaking, making it to such a prestigious high school despite your circumstances, and getting decent grades up until recently, but I have a hunch that there’s a lot going on beneath the surface. Making sense of your feelings, naming them, will help you tremendously.’

      [Word Count: 105]

    • Source 4:
      In the chapter “A Lazy, No-Good Daughter,” Lý’s teacher Ms. Walsh calls the Administration for Children’s Services (ACS) to report Lý’s parents for child neglect since her father refuses to allow Lý to get glasses. This triggers Lý’s father’s PTSD, widens the rift between her and her parents, and worsens her own mental health. Still, Ms. Walsh says, “If I had to do it again, I would.” Discuss the source of the conflict here and if there could have been a better outcome. What would you have done in Ms. Walsh’s position? In Lý’s? How do you think many Vietnamese American youth grapple with the traumas of their parents? How do they deal with the acculturation gap? What strategies do Vietnamese American youth take to navigate family and societal pressures?

      Begin excerpt: I watched him one afternoon, sitting by the living room window and staring out at the setting sun. I could hardly see the features on his face, let alone his expression, but I could feel his pain. I wanted badly to tell him that I was sorry. That if I could I would take away all the horror and trauma from the war and his time in prison. I would make him whole again. But how could I tell him that? I had never once told my father I loved him. I had never once apologized to him. I wouldn’t even know how to begin.

      As he slipped into an abyss of fear and anxiety, I slipped further into my depression. I began to skip days at the nail salon, where I’d been working most weekends, which only exacerbated my parents’ feeling of betrayal. Unable to contain his rage, my father kicked me in the head one morning as I slept. I was too lost within myself to even react. I was shattered. I was ashamed.

      [Word Count: 176]

    • Source 5
      Though Lý is initially excited about going to college and finding new experiences, her mental health starts to decline because of her feelings of guilt for leaving her parents behind. Why do you think Lý struggles in particular with these feelings? How might Lý’s immigrant or Vietnamese American identity shape her feelings toward school and family?

      Lý experiences a second traumatic event at the hands of a well-meaning authority figure when she is taken to a psychiatric hospital without notice or explanation. There, she meets several people she makes a connection with, but is rattled all the while. Discuss Lý’s experiences and if anything surprised you. How might mental health patients be better served? How might mental health services better serve immigrant and Vietnamese American patients in a culturally responsive way?

      Begin Excerpt: ‘This is completely understandable,’ he told me. ‘You’ve probably been depressed for a long time, but you’re a highly functioning depressed person, which is how you’ve managed to do so well despite your condition. But it makes sense that the symptoms would show eventually. I suspect you may have a bit of ADD as well, so the Dexedrine may help with that. We’ll start with a low dosage and see how it feels. If we need to increase it, we’ll increase it.’

      [Word Count: 82]

    • Source 6:
      Though Lý is initially excited about going to college and finding new experiences, her mental health starts to decline because of her feelings of guilt for leaving her parents behind. Why do you think Lý struggles in particular with these feelings? How might Lý’s immigrant or Vietnamese American identity shape her feelings toward school and family?

      Lý experiences a second traumatic event at the hands of a well-meaning authority figure when she is taken to a psychiatric hospital without notice or explanation. There, she meets several people she makes a connection with, but is rattled all the while. Discuss Lý’s experiences and if anything surprised you. How might mental health patients be better served? How might mental health services better serve immigrant and Vietnamese American patients in a culturally responsive way?

      Begin excerpt: And then there were moments when time suddenly didn’t seem to work the same way anymore. It expanded and contracted, leaving me disoriented. What seemed to me to be only seconds were hours in real life. I drifted into my inner world and stayed there for longer and longer periods. I stopped answering my mother’s calls. I began to sleep for twelve hours at a time, even more some days. Holed up in the confines of my room, I didn’t want to leave because I was afraid of what I might end up on the other side of the door and afraid of what others might and within. I was paranoid that friends would finally figure out who I really was, someone who didn’t belong anywhere, not in the prestigious Macaulay Honors College, not among her smart accomplished friends, and not even in her own home.

      [Word Count: 146]

    1. Gallery Walk Facilitation (20–30 minutes)
    • Place students in groups of two to four and instruct them to rotate to each station to answer and discuss the questions from ”Em Nghi Sao? Câu Hỏi để Thảo Luận / What Do You Think? Questions for Discussion”. Responses are to be written on the graphic organizers and used to help students discuss the questions. Teachers can allow students to move through the excerpts and discussions at their own pace. Or, teachers can structure the reading, writing, and discussions with time.
    1. Closing (15 minutes)
    • To close the activity, the teacher can select a student representative from each group to share aloud to the class. Students can share thoughts about the excerpts and their takeaways as it pertains to the lesson questions and objectives.

    As students engage in a gallery walk of 6 sources, they will complete a graphic organizer that tracks their understanding and takeaways of mental health impacts, conversations and views in the Vietnamese American community.

    • Engagement: Consider the following method to support with lesson engagement:
      • Invite personal response, evaluation and self-reflection to content and activities
      • Create an accepting and supportive classroom climate
    • Representation: Consider the following method to support with multiple means of representation:
      • Provide electronic translation tools or links to multilingual glossaries on the web
      • At each Gallery Walk station, Vietnamese words that pertain to more complex ways of expressing emotions and thoughts can be provided as visual or textual aids. A preliminary list of words to express emotions and thoughts is included below. 
        • phân vân - mixed feelings 
        • buồn - sad 
        • tức - angry
        • bực mình - frustrated
        • ngạc nhiên - surprise 
        • thông cảm - sympathize
    • Action and Expression: Consider the following method to support in presenting their learning in multiple ways:
      • Provide graphic organizers and templates for data collection and organizing information
      • Embed prompts for categorizing and systematizing

    For additional ideas to support your students, check out the UDL Guidelines at CAST, 2018 http://udlguidelines.cast.org.

    • Emerging: Consider the following method to support with emerging students:
      • Reading: Preview the text content with pictures, videos, demos, charts, or experiences
      • Reading: Preview text with a picture walk 
    • Expanding: Consider the following method to support with expanding students:
      • Reading: Provide a content vocabulary word bank with non-linguistic representations 
        • Students use a Frayer graphic organizer to support understanding of a keyword or concept. Place the target word in the center amid four surrounding quadrants to support different facets of word meaning.
    • Bridging: Consider the following method to support with bridging students:
      • Reading: Use focused questions to guide reading
        • Students use inquiry posing their own questions and wonderings to guide shared research experiences. 

    For additional guidance around scaffolding for multilingual learners, please consult the following resources:

    1. Social Media Post - Students create a social media post to share what they learned about mental health in the Vietnamese American community. 
    2. Video Interview - Students can use a video recording device to interview a family member, friend, or community member to share what they learned about mental health in the Vietnamese American community, and ask the interviewee how they take care of their mental health and why.
    3. Photovoice - Students create a photovoice collage to document their thoughts, feelings, and emotions about mental health in the Vietnamese American community. 
    4. Generational Trauma - Teachers can extend the lesson to explore the effects of war on second and third-generation Vietnamese Americans by way of generational trauma. 

    American Initiative. 2022. Asian American Studies K-12 Frameworkhttps://asianamericanresearchinitiative.org/asian-american-studies-curriculum-framework/ 

    Britt, K. 2020, May 11. English learner toolkit of strategies. California County Superintendents. https://cacountysupts.org/english-learner-toolkit-of-strategies/

    California Department of Education. 2021. Ethnic studies model curriculum. https://www.cde.ca.gov/ci/cr/cf/esmc.asp 

    California Department of Education & English Learner Support Division. 2012. California English Language Development standards (Electronic Edition) kindergarten through grade 12 (F. Ong & J. McLean, Eds.). California Department of Education. https://www.cde.ca.gov/sp/el/er/documents/eldstndspublication14.pdf

    California Educators Together. (n.d.). ELA / ELD framework. https://www.caeducatorstogether.org/resources/6537/ela-eld-framework

    CAST. 2018. The UDL guidelines. http://udlguidelines.cast.org

    Orange County Register. 2001, April 29. Camp z30-d: The survivors, 1975-2001. Orange County Register. In the Online Archive of California. https://oac.cdlib.org/ark:/13030/hb729006wn/?order=5&brand=oac4  

    San Diego County Office of Education. (n.d.). Providing appropriate scaffoldinghttps://www.sdcoe.net/educators/multilingual-education-and-global-achievement/oracy-toolkit/providing-appropriate-scaffolding#scaffolding

    Sexias, P. & Morton, T. 2013. The big six: Historical thinking concepts. Nelson Education.

    Trần , L. 2022. House of sticks: A memoir. SCRIBNER. 

    Tulare County Office of Education. (n.d.). Strategies for ELD. https://commoncore.tcoe.org/Content/Public/doc/Alpha-CollectionofELDStrategies.pdf 

    Wang, C. 2022, January 24. Wartime trauma among Vietnamese refugees subject of new study. NBC News. https://www.nbcnews.com/news/asian-america/wartime-trauma-vietnamese-refugees-subject-new-study-rcna12759# 

    Model Curriculum

    Standard(s)

    Grade(s)