Professor Joan Bicknell, Professor of Psychiatry at St George's Hospital Medical School, has in recent years given invaluable support and advice in the assessment of cases.
Cultural Taboos and Traditional Medicines
It is clear that one main cause of stress is the application of Western alipathic medicinal remedies to people who are traditionally concerned to have Oriental or, to us; alternative medicine and treatment.
The Research Council for Complementary Medicine has expressed interest in developing a research project in this area but the immediate need of so many of these people is of considerable urgency.
Special Residential facilities
Experience is already proving that to place a Vietnamese, who is suffering from stress, depression or, indeed, manifesting any type of psychiatric disorder into a normal Western psychiatric unit more often than not exacerbates the problem.
Some problem cases have, after a period in a psychiatric unit, been felt by the doctors and nurses concerned to be inappropriately placed in a situation where they find themselves totally isolated from their own people and have difficulty in communicating. Ockenden has already received two such cases and placed them, with appropriate support, in a reception centre situation, where it was possible for them to interact with their own country folk. In each case the patient has ceased to be withdrawn or to react with violence to personal approaches and become a normal supportive member of the permanent community.
This experience has led to the concept of developing one of Ockenden's centres as a supportive community to which such cases could be referred.
To do this adequately requires the appointment and appropriate training of staff who already have experience of psychiatric nursing and of psycho- therapy. Such staff need the support and assistance of Vietnamese who, while acting as interpreters, have the right empathy and understanding of the problems involved. These, too, need training.
Ockenden has from its own resources been employing for some time a medical social worker and has recently appointed an SRN with a qualification in psychiatric nursing. The latter is to go to Asia for three months for experiential training with an American team of psychiatrists and psychiatric
nurses.
Proposals
1)
Short-term Ockenden proposes initially to make available one of its centres in Surrey as the base for a short-stay centre for such cases, where there would be the possibility for them to interact with other Vietnamese and to have supportive care.
2) Long-term We feel that careful consideration should be given to the precedent created by the establishment of the Mapledon Hospital at Dartford in the forties as a national specialist resource centre for Polish refugees who were suffering from trauma as a result not only of their refugee experience but of mal-treatment in concentration camps. The development of one or two similar specialist centres in different parts of the country, even if these are in a wing of an existing psychiatric hospital, could be considered. 3)
Local Area Local community counselling centres for the Vietnamese could be established in areas where the refugees are most concentrated. These could be placed where the refugees can gather together, exchange ideas and problems, meet others sympathetic to their needs, read a Vietnamese news-sheet and gain advice about health or social problems.
Loneliness is the greater cause of depression and this, combined with cultural shock and the normal refuges experience, can prove too traumatic for an individual to bear.