Describes the psychological problems facing Southeast Asia refugees and the difficulties involved in providing mental health services to this population. Two case studies were examined, both involving refugees from Vietnam who resettled in Canada. These refugees not only experienced extreme trauma before migration, they also experienced a range of stressful situations upon resettlement, including the enormous tasks of learning a new language, absorbing new values, adjusting to a complex industrial society, and coping with continued loss of socioeconomic status. While these factors contributed over several years to psychological problems such as depression and posttraumatic stress disorder, refugees came to mental health facilities only as a last resort. In Vietnamese culture, mental illness is considered a weakness that brings shame to the entire extended family, and the attitude toward mental illness combines fear, denial, and rejection. Mental health practitioners who do not understand this attitude can cause distrust, anger, and suspicion in their refugee patients. Successful management of these patients includes taking a careful history of their previous life styles and the circumstances of leaving their country of origin and their arrival in the host country and then arranging a support system that includes people from their ethnic group.
