Depression Among Hmong Shamans: A Qualitative Exploration of Beliefs and Experiences

Summary

Hmong shamans understand and respond to depression through cultural beliefs and spiritual practices rather than biomedical frameworks. Nine of twelve shamans interviewed struggled to name depression, while eight attributed it to soul loss or spiritual imbalance. Displacement, war trauma, and poverty were identified as contributing factors by all participants. Coping strategies included family time, gardening, and healing from other shamans. Female shamans more openly shared struggles, while male shamans concealed emotions due to their household role. Only younger shamans had sought therapy; older shamans associated depression with stigma, mistrust, and fear of medication. This suggests a generational shift toward openness to mental health services.

Study at a glance

Abstract

BACKGROUND: Hmong people experience a disproportionate burden of mental health challenges. While prior studies have examined mental health within Hmong communities, no study has focused on Hmong shamans’ experiences with depression. This study explores how Hmong shamans understand, experience, and respond to depression. METHODS: We conducted semi-structured, in-depth interviews with 12 Hmong shamans in the United States and Thailand from 2018 to 2020. RESULTS: The thematic analysis resulted in five key themes: struggling to name depression, making sense of depression through cosmology and lived experiences, coping with depression through culturally-rooted practices, concealment and internal conflict, and uncertainty toward allopathic health services. Nine participants struggled to describe depression. All participants identified displacement, war trauma, and poverty as contributing factors to depression. Eight participants attributed depression to soul loss or spiritual imbalance. Their coping strategies were culturally rooted, including spending time with family, gardening, and receiving healing from other shamans. While most female shamans openly shared their struggles, male shamans concealed their emotions due to their role as household figures. Only the younger shamans have sought therapy, while older shamans associated depression with stigma, mistrust, and fear of medication. CONCLUSION: Our findings show that Hmong shamans understand and cope with depression through cultural beliefs and spiritual practices. Younger shamans’ openness to utilizing mental health services suggests a promising shift that may influence future community understandings of depression. Future research should explore how shamans can be integrated into culturally sensitive care models to improve mental health care for Hmong communities.