Culturally Responsive Psychiatric Case Management with Southeast Asians
The Asian-American population has grown dramatically in the past 20 years. From 1980 to 1989 alone, the growth was from 1.7 percent to 2.8 percent of the total U.S. population (O'Hare, 1990). Many of the more recent Asian arrivals are displaced individuals from countries disrupted by war, poverty, or political persecutions. These immigrants and refugees bring with them not only rich and diverse cultures, but also unique problems associated with the transition and their experiences with past traumas. In addition, they encounter new difficulties during their adjustment to the host country. It is a serious mistake to assume that due to phenotypic similarities, all Asians share the same heritage, values, and mannerisms. Such generalizations make therapeutic interventions ineffective and are often alienating to the client. More helpful is an attempt to understand and study the historical backgrounds and immigration patterns of Asians in the United States. Past circumstances under which they came to this country affect their current attempts to adjust, and also explain why difficulties frequently arise in the transculturation process. Casting all Asians as immigrants is misleading. The term implies a voluntary and planned act of moving from one country to another. The term refugee, however, implies that a person is fleeing involuntarily to escape an undesirable situation such as
war or political oppression (Szule, 1980, p. 139). The method of leaving one's homeland directly affects the mental status of the individual. Williams (1985) discussed the psychological effects of refugee flight, and the increased risk for emotional problems that result from the disruption. Key questions are: Was the flight associated with fear and disorganization? Did they lose much in the process? Were they able to leave with relatives and some token pieces or reminders of their country? Or were they forced to flee immediately with nothing but what they could carry through forests and war zones?