Mental health stigma persists among Fresno’s Southeast Asians. How center upgrade will help

Chongge S. Vang hit rock bottom after losing his wife last November. He felt very lonely and didn’t understand why he was still alive.

That incident triggered a similar feeling the 79-year-old Sanger resident felt decades earlier. He had lost all of his friends, relatives and parents in Laos, when the Vietnam War spilled over to his country.

“I almost killed myself,” he recalled on a recent morning, speaking on thoughts he had after his wife died. “I’m very, very sad and I want to kill myself, and I was thinking about the bad things all the time. I don’t feel good.”

Vang had suicidal thoughts, yet he was able to better handle those emotions after seeking help at The Fresno Center’s Living Well Center.

The Living Well Center on Thursday will have a grand opening for an expansion that will help meet the huge need for mental health services in the Southeast Asian community.

The center will play an important role because Southeast Asians often don’t openly talk about their mental health issues, or instances of trauma they’ve experienced, said Ghia Xiong, director of the center.

Xiong said there’s a negative stigma that many Southeast Asians associate with mental health — and there’s no terminology to even describe a mental illness.

There is lack of understanding, and oftentimes nobody wants to associate with people affected by mental illness or even their family due to common myths that still persist. That leads to fear, which causes people to not seek help.

Many in the community also don’t understand how prevention and early intervention can make a big difference. “They wait until the level of severity is very severe,” he says.

The mental health needs of the Southeast Asian are great, Xiong says, and have needed to be addressed for a long time.

“We came to this country as refugees. We came to Fresno in the 80s. At that time, there wasn’t any mental health services, culturally, that would services this community.”

Chongge Vang, 79, a lieutenant in the CIA-backed Secret War, points to a photo with his friends during the Secret War. Photographed at Vang’s home Wednesday, July 24, 2019 near Sanger. ERIC PAUL ZAMORA ezamora@fresnobee.com

Expansion to help more people

Under the center’s expansion, it will be able to see adults and youth. It will provide outpatient and intensive case management, whereas before it only offered therapy for adults, Xiong said.

The center has added a Hmong psychiatrist, who will work a quarter of his time at the center. The mental health services are culturally and linguistically appropriate, and will be offered by about 20 staff.

Xiong said the center will increase its capacity to treat up to 250 patients annually. The funding from Fresno County to offer the services is about $2.1 million annually for the next three years.

War trauma plays a role

It took nearly 20 years to get a mental health services project started in Fresno after Southeast Asian refugees arrived in the area. In 2004, the center was able to start out in a much smaller scale.

That project on Thursday will take a leap and become a center.

Several years later, “we have a center that is really specific for this particular community, which is the Hmong, Lao, Cambodian, and Vietnamese, although Vietnamese is small,” Xiong said.

Susan L. Holt, deputy director overseeing clinical operations for the Fresno County Department of Behavioral Health, said after the three-year expansion, The Fresno Center will have the option to extend for two more years, for a maximum funding of $10.7 million for five years.

“It is Fresno County Department of Behavioral Health’s goal is to provide individuals we serve with choices and options for their treatment, including services which are designed in alignment with their culture,” she said.

The most common diagnosis seen at the center include depression, anxiety and post-traumatic stress disorder. Factors that play a role in those diagnoses include cultural and poverty issues.

“What they are experiencing here in this new country, you can say is a result of what they experienced in their home country, and what they experienced, is this war trauma,” Xiong says.

Chongge Vang, 79, right, stands alongside his wife My Her Vang, left, in traditional Hmong clothing, in a family photo Wednesday, July 24, 2019 near Sanger. Vang suffered ongoing depression after losing his friends over the years, which was made worse after his wife died in 2018. The Fresno Center is opening its Living Well Center to focus on mental health issues for its clients. ERIC PAUL ZAMORA ezamora@fresnobee.com

As a first lieutenant in Laos who was among those recruited by the CIA to fight against the communist in North Vietnam — in what became known as the Secret War — Vang carried out a mission every week.

He would descend into the Ho Chi Minh trail by parachute at night to see what the Vietnamese in the north were carrying in trucks traveling to South Vietnam to fight American soldiers.

Vang worked for the CIA’s special guerrilla force units from 1961 to 1975, while the Vietnam War was ongoing. During those years, he saw friends die violently.

Vang’s parents were killed when the Vietnamese in the north poisoned Hmong children, women and men in revenge after the U.S. forces pulled out, he said.

In 1975, Vang, his wife and his two older children escaped to Thailand, before coming to the U.S. as refugees.

In America, Vang was able to start over, but it wasn’t easy, he says. He missed his parents, relatives and friends who died during the conflict.

Still, in some ways that paled in comparison to losing his wife in November. He was struck with a serious case of depression.

“I wasn’t going along with my wife, but I don’t know what should I do to go with her... should I use gun to kill myself, or knife to kill myself, thinking about why am I so lonely.”

Chongge Vang’s wife My Her Vang, shown in two framed photos at his home Wednesday, July 24, 2019 near Sanger. My Her died last year, worsening Vang’s depression. ERIC PAUL ZAMORA ezamora@fresnobee.com

Younger generation also need services

The center is also starting to see a new need with Southeast Asian youth.

“We see the cross-cultural generation conflict — not being able to communicate with their parents or role expectations of what their parents want and what the children want,” Xiong says. “And also, we are beginning to see a little bit of issues with gender identity, with coming out of the closet.”

But a lot of the center’s treatments are very unique — tailored specifically to Southeast Asians, he said.

Vang says the center helped him a lot, and he now even helps others who might be in similar situations. One of his friends in Orange County, where he worked before relocating to Fresno, died at age 113 years.

“I was thinking about him, I’m 70 something, why I should die?” he asked. “I try to live as long as I can. I need to help people who need help like me.”