A podcast seeks to make it easier for Hmong Americans to get mental health treatment

The topic for the day was trauma, but the mood was convivial as the four therapists sat down to record the latest episode of "The Hmong Mental Health Podcast."

The group was meeting in the offices of Vanguard Mental Health and Wellness Clinic in Woodbury for the third episode of the podcast, which began in March and is already garnering attention in the mental health treatment community.

Psychologist Alyssa Kaying Vang, who opened Vanguard 15 years ago, hopes the podcast will reduce barriers to therapy for Hmong Americans.

"While we've seen an increasing openness to mental health services, it's still a stigma in the Hmong community," she said.

Traditional Hmong culture emphasizes the physical and spiritual; the concept of mental health doesn't have a place in that model, Vang said. Hmong therapists who have trained in the United States practice with Western methods.

The explosion in social media has been both a boon and challenge to mental health practitioners, Vang said. People have more access to information, but also a greater likelihood of finding misinformation.

"It compelled us to say, 'Hey, if we want to meet the needs of mental health struggles today, we must do something differently to reach those communities and make an impact,' " she said.

The podcast can't take the place of professional therapists, Vang said. But for people who don't have a referral for therapy, or who are more comfortable listening to a podcast than seeking out a therapist, the show can give them access to quality information on mental health. For others, it could be a bridge to treatment.

A podcast also has the potential to reach more people than any single clinic, Vang said. About 475 people had downloaded the show as of mid-June, without any major advertising. And therapists on the podcast can reach Hmong communities across the country, from Minnesota to California and North Carolina.

Most of the Hmong community until recently has operated in survival mode, said Sheng Elizabeth Lor, executive producer of the Social X Change Project, a Hmong activist platform.

"My parents went through a war," Lor said. "They don't have time to think about mental health; they're surviving. Now that we're in this place where we're not in pure survival mode ... things like activism and mental health and self-development come in."

The line between physical and mental health in the Hmong community has traditionally been blurred, emphasizing instead the physical and spiritual, Vang said. Apparent symptoms of mental health problems in the United States, such as a loss of appetite or poor concentration, often are attributed to spiritual or physical suffering in Hmong culture.

"Mental health is often affiliated with weakness and shame and vulnerabilities we don't want to show to the community," Lor said. "So there are a lot of layers we need to explore."

A 2020 report by Wilder Research confirmed the lack of resources for culturally competent mental health care for the Hmong community. At the time, Vang was one of just a handful of Hmong therapists in Minnesota. Since then, the field has grown; now there are at least 30 mental health providers who speak Hmong in Minnesota.

But it's still far from enough to fill the need. Vang hired four new therapists in 2020, she said, but the clinic continues to get new referrals every day and maintains a waiting list for patients.

Even among Hmong people born in the U.S., there's a desire for culturally specific care, she said. "There's such a need for providers who look like you and sound like you," therapist and podcaster Mosi Thao said.

With so much hurt in the community, Vang decided that the first season of the podcast should focus on healing the self. Episodes so far have focused on attachment and trauma, with a closer look at how Hmong people experience them.

"Because the Hmong story is filled with an oppressive history and displaced experiences, we have internalized this narrative, historically speaking, that says that we're a people without a country," Vang says in her introduction to the third episode.

Although the podcasters speak mostly in English, they dip in and out of Hmong "when the concept is better understood within that language," Vang said. Some concepts work better in English, such as the understanding of certain disorders like schizophrenia.

Listeners have said they love the shift between languages, even when it's just a phrase or a few words in Hmong. "People from the younger generation say, 'Oh, I'm really going to learn Hmong through these podcasts,'" Thao said.

The podcast delivers the type of information that Lor feels the community needs. "It's nice to have four professionals having a conversation in a way that's lighthearted, conversational, not super clinical, but still has a lot of educational components," she said.

For the latest episode, Vang decided to replace scripts with a simple list of questions to let the therapists engage more casually. "I like it," Thao said. "It seems like there's a narrative and a flow. It's like we're color-commentating."

Each question on the list for Episode 3 could be its own podcast, therapist and podcaster Houa Vang said. "Let's get into it!" Vang said.

The podcasters checked their mics, and Vang pressed record: "Welcome back to 'The Hmong Mental Health Podcast.'"