In working with Vietnamese American refugees the mental health worker needs to be knowledgable of and sensitive to several areas: (1) the cultural history and history of the migration experience of the group; (2) the group's mental health dispositions; (3) cultural and systemic biases affecting counseling; and (4) the role of paraprofessionals. Some of the cultural factors affecting the utilization of mental health services are 'saving face', stoicism, respect for authority and discrimination which may cause them to seek help only at advanced stages of illness. Mental health counseling in the United States has run into some difficulty in serving the refugees as it has been mainly a white middle class profession that has focused on the individual which can be considered culturally biased when dealing with family centered Vietnamese Americans. For the reasons previously stated, in addition to language difficulties and cultural differences, many agencies employ indigenous paraprofessionals. While it is beneficial there are also problems to be considered. Recommendations for addressing these problems include: (1) the development of a community education and prevention program by actively involving ethnic community leaders in the planning process; (2) supporting ethnic community leaders; (3) training indigenous paraprofessionals about the mental health care system; (4) providing mental health services through medical care facilities; and (5) focusing on family therapy as oppossed to individual therapy. © 1987 Martinus Nijhoff Publishers (Kluwer).

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