Refugee Experiences of Mental Health and Trauma

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    Refugee Experiences of Mental Health and Trauma

    Photograph or the security check-in or sign-in check point in Vinai Refugee Camp, 1983.

    Author: Liz Ramos
    Grades: 11-12

    Suggested Amount of Time: 60 Minutes
    Area of Study: Hmong Refugee Experiences

    Compelling Question
    • How do Hmong communities experience displacement, refugee camps, and resettlement?

    Lesson Questions
    • What are Hmong Refugee Experiences?
    • What are the ways in which trauma manifests in refugee experiences? 
    Lesson Objective

    Students will learn about Hmong refugee experiences and the ongoing impacts on community formation, family relations, and individual identity formation in connection to mental health.

    Lesson Background

    This lesson is meant to follow the “Contextualizing the Hmong Refugee Experience” lesson. After learning about the displacement of Hmong people, students will explore the impact of their refugee experiences in connection to mental health. Much of the existing mental health concerns and signs of trauma in the Hmong community today stem from past events related to persecution, forced migration, and adapting to new homes. 

    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.

    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

    Image Citation: Hagen, E. (1983). [Photograph or the security check-in or sign-in check point in Vinai Refugee Camp, 1983.]. Erica Hagen Collection / Hmongstory Legacy, Fresno, CA.

    Historical Thinking Skill

    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 will 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. Educators may enhance this lesson by discussing mental health but also focusing on healing practices as a response to coping with the trauma and making connections with present-day society.

    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 impact on Southeast Asian migration to the United States and the intergenerational trauma within the Hmong 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.

     

    Supplies
    • Access to laptop device
    • Note-taking supplies (paper/pencil or GoogleDoc) for “Thoughts, Questions, Epiphany” activities
    • CER (Claim, Evidence, Reasoning) final assessment activity
    • Project Zero Resources (templates)
      • Reporter’s Notebook
      • Feelings and Options
      • Values, Identities, Actions 
    Readings
    • New generation pushes Hmong mental health concerns into the light from MPR News
    • Building Partnerships: Conversations with the Hmong About Mental Health Needs and Community Strengths from UC Davis Center for Reducing Health Disparities

    This lesson is recommended to be taught after “Contextualizing the Hmong Refugee Experience” but can also serve as a stand-alone lesson as well. 

     

    Step 1: Teacher introduces the topic: Refugee Experiences of Mental Health and Trauma. Have students brainstorm their definition of the terms: Mental Health and Trauma. 

    • Display the quotes below from the Building Partnerships: Conversations with the Hmong About Mental Health Needs and Community Strengths report. 
    • Have students read the quotes to themselves and share with a partner the following: What quote stood out to you, and why? What conclusions can you draw about Hmong mental health after reading these quotes? What questions do you have?
      • “As many had mentioned earlier, in our country, we have no medical doctor who would give us all kinds of diagnosis or say that you have this kind of illness that kind of illness. When we are ill then we are ill, and when we die we die. There were no such illness as cancer, stroke, liver disease, heart disease, etc. When we got here everything had changed.”  -Hmong Community Leader
      • “In Laos, we didn’t ever talk about mental health problems. We just talk about pain here, pain there. But here when we try to explain, there’s two types of doctors. One’s to cure your physical. The other one’s to cure your mind… They need more education to let them know what is mental health and what’s not.”  -Hmong Community Leader
      • “I’d like to see someone that is a Hmong person that can talk to these people and make sure what they have is what they have, whether medical problem or mental health problems. So that person would know where to go for services… There’s a lack of Hmong mental health providers.”   -Hmong Community Leader
      • “The Communists killed my husband dead, right in front of me… and I’m very depressed but tried not to think about it, if I think about it, then my heart will stop.”  -Hmong Refugee Woman
      • “I believe that the most important thing in this country is the living situation and the daily living conditions. Things such as rent and bills create massive and major depression. They cause many anxiety and depressive feelings.” - Hmong Community Leader

     

    Step 2: Students will examine the impacts of the Hmong refugee experiences on their mental health. Have students read the article “New generation pushes Hmong mental health concerns into the light” (https://www.mprnews.org/story/2020/01/22/new-generation-pushes-hmong-mental-health-concerns-into-the-light).  

    • Before reading, have the students skim the article and share unknown words. Go over and define the unfamiliar words as a class. 
    • During their read, have students note: challenges, community strengths and assets, and prevention. 

     

    Step 3: Next, read the UC Davis report: Building Partnerships: Conversations with the Hmong About Mental Health Needs and Community Strengths (https://ucdavis.box.com/s/agfynbzvluhtiubr1xqy8o2de0ehzaoq). Have the students discuss key points with a partner or table group. Debrief as a class. 

    • Before reading, have the students skim the article and share unknown words. Go over and define the unfamiliar words as a class. 
    • During their read, have students note: challenges, community strengths and assets, and prevention.

     

    Step 4: Discuss the quotes in relation to the report's key findings about challenges, community strengths and assets, and prevention. 

    • Optional: Students can complete another Thoughts & Feelings and My Best Judgment from the Reporter’s Notebook (https://ucdavis.box.com/s/k8rttjg24nlrvvvyqusxwubwn4ygy1zc).  
    • Challenges:
      • Scarcity and difficulty accessing services
      • Too few Hmong providers - culturally appropriate services
      • Stigma and lack of awareness of mental health problems
    • Community Strength and Assets:
      • Family and community bonds- interdependence
      • Hmong community-based organizations
    • Prevention:
      • Education and awareness campaigns
      • Cultural connection and empowerment programs
      • Group therapy
      • Parenting programs to overcome intergenerational cultural Conflict

     

    Step 5: Debrief as a class and clarify any misunderstandings.

     

    Assessment/Closure

     

    Step 6: Students will choose either Option A or Option B for their assessment product:

    • Assignment Option A: Have students complete a well-developed CER (Claim, Evidence, Reasoning) response to the questions: What are Hmong Refugee experiences? How have these experiences impacted Hmong mental health? 

      CER will utilize the following criteria: 

      • Student product contains a central thesis addressing the question, What are Hmong Refugee experiences? 
      • Student product includes a minimum of three details.
      • Student product includes reasoning explaining how the evidence supports their claim.
      • Student product includes reference to how the refugee experience has impacted Hmong mental health.

     

    Students will choose from one of the following options:

    • Option A: Have students complete a well-developed CER (Claim, Evidence, Reasoning) response to the questions: What are Hmong Refugee experiences? How have refugee experiences impacted Hmong mental health? 
    • Option B: Students have the option of completing the Strategy Values, Identities, Actions reflection. 
    • Engagement: Consider the following method to support with lesson engagement:
      • Engage learners in assessment discussions of what constitutes excellence and generate relevant examples that connect to their cultural background and interests
      • Provide prompts that guide learners in when and how to ask peers and/or teachers for help

     

    • Representation: Consider the following method to support with multiple means of representation:
      • Provide descriptions (text or spoken) for all images, graphics, video, or animations
      • Chunk information into smaller elements

     

    • Action and Expression: Consider the following method to support in presenting their learning in multiple ways:
      • Provide sentence starters or sentence strips

     

    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:
      • Writing: Teach note taking on a graphic organizer 
        • Students use a Frayer graphic organizer to support understanding of a key word or concept. Place the target word in the center amid four surrounding quadrants to support different facets of word meaning. 

     

    • Expanding: Consider the following method to support with expanding students:
      • Writing: Require learning logs for summaries of learning
        • In a shared or interactive writing format, chart out characters, setting, problem, and events (including orientation, complication, and resolution). Add theme, as appropriate.

     

    • Bridging: Consider the following method to support with bridging students:
      • Writing: Require academic writing and the use of target academic vocabulary 
        • Apply domain­-specific vocabulary and general Academic vocabulary in open sentence frames to perform functions, like describing or explaining, that target specific grammatical structures.

     

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

    1. Teachers may wish to provide students with a choice board of three options or select one of the enrichment options as follows to provide further exploration and call-to-action opportunities for their students. 
      1. Begin by playing the YouTube video titled “Time” Video (3:03 minutes) https://www.youtube.com/watch?v=r8EZeEYTv3o. After viewing, discuss takeaways from the video as a class. 
      2. Draw students to the Hmong working hard to resettle and build a life, not to forget the Hmong story and sacrifice of those to give their children and descendants opportunities in the US, reflect- remember- record, and what is the identity of the Hmong people. Connect the theme of identity to the California Ethnic Studies theme. 

     

    1. Healing Board - Students can tap into their creativity and create a healing board, which is a play on a vision board or mood board. On that healing board (digital or physical), students can include a collage of images, quotes, ideas that illustrate ways the students themselves deal with healing or socioemotional/mental health wellness. If time permits, students can share their healing board with their peers. 

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

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

    Bui, T. 2020, January 22. New generation pushes Hmong mental health concerns into the light. MPR Newshttps://www.mprnews.org/story/2020/01/22/new-generation-pushes-hmong-mental-health-concerns-into-the-light 

    California Department of Education. 2021. Ethnic studies model curriculumhttps://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

    Elliott, K., Sribney, W. M., Giordano, C., Deeb-Sossa, N., Sala, M., & Aguilar-Gaxiola, S. 2009. Building partnerships: Conversations with the Hmong about mental health needs and community strengths. UC Davis Health System.  https://health.ucdavis.edu/media-resources/crhd/documents/pdfs/building-partnerships-06-hmong.pdf 

    Gonzalez, J. 2023, March 17. Deeper class discussions with the TQE method. Cult of Pedagogy.  https://www.cultofpedagogy.com/tqe-method/ 

    Project Zero, Harvard Graduate School of Education. (n.d.). Feelings and optionshttps://pz.harvard.edu/resources/feelings-and-options 

    Project Zero, Harvard Graduate School of Education. 2015. Reporter’s notebookhttps://pz.harvard.edu/resources/reporters-notebook

    Project Zero, Harvard Graduate School of Education. 2020. Values, identities, actionshttps://pz.harvard.edu/resources/values-identities-actions

    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. TEDx Talks. (2019, December 16). The impossible happens every day in the life of the refugee | Kao Kalia Yang | TEDxMinneapolis [Video]. YouTube.  https://www.youtube.com/watch?v=cuYepsQ0fwM 

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

    Supplementary Source

    Hmongstory40 Project. 2015, January 10. “Time” Video [Video]. YouTube. https://www.youtube.com/watch?v=r8EZeEYTv3o 

    Model Curriculum

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