Refugees who do and do not seek psychiatric care an analysis of premigratory and postmigratory characteristics

Social psychiatric research can provide information about the role of interpersonal and societal factors in the genesis of psychiatric disorder. This discipline relies heavily on “experiments in nature” which expose a large number of people to a potentially pathological social stimulus. It also depends in large part upon the study of nonpatients to serve as a comparative group for patients. Both conditions are met in this study of Hmong refugees from Indochina. While the population and the event are esoteric to some extent, their experiences of sudden sociocultural change, geographic migration, role discontinuity, identity crisis, and massive loss are common experiences among many psychiatric patients, regardless of their origin. Thus this study contributes to our understanding regarding the social genesis of psychiatric disorder. This prospective study of refugees to the United States was undertaken among the Hmong population in Minnesota (N = 97) during 1977. Subsequently 17 of this group became psychiatric patients over a 12-month period. Premigration and postmigration factors associated with patient status are described. Hypotheses are offered regarding those postmigration experiences or social strategies which favored or prevented psychiatric status.