As the last days of summer give way to fall in the northern hemisphere, cultures worldwide look forward to religious and cultural observances that ask them to reflect on and celebrate community. These observances often carry profound emotional weight, particularly for individuals from refugee, immigrant, and migrant backgrounds. For many, these are joyous occasions; for others, they can stir up more complex emotions.
As healthcare providers, it is not news to us that the holidays may often bring with them troubling increases in mental illness, especially for aging populations, youth, and those struggling with prolonged health problems. However, it is essential to note that “the holidays” do not necessarily occur at a single time of year for everyone. Upcoming celebrations are often the perfect excuse to connect, reach out, and check in on our friends, colleagues, and patients. When those people come from different backgrounds to our own, however, it is worth considering whether or not that outreach is coming too late.
Understanding the intersection of cultural practice and effective care is one of EthnoMed’s driving missions. So, as we all try to enjoy the final days of summer, let’s connect with our patients and coworkers by looking at some celebrations happening soon in thousands of households across King County.
Mooncake Festival (September 17th)
Also known as the Mid-Autumn Festival, it is celebrated in East Asian cultures with filled cakes in an array of sweet and savory flavors reflecting different regions and family traditions. Brightly colored lanterns and large family gatherings round out this festival, symbolizing the harvest and reunion with loved ones. It has significance for many, similar to Thanksgiving in the US, and for that reason, it can underscore feelings of isolation and homesickness for individuals living far from their countries of origin.
Pchum Ben (October 1st – 3rd)
The most significant and widely celebrated Cambodian Buddhist festival focuses on honoring ancestors. Culminating in a substantial final day, the celebration involves ceremonies at pagodas, food offerings, and prayers for the spirits of the deceased. For many, the holiday becomes a time to address unresolved grief and loss, which, for members of this community in particular, often means reckoning with unimaginable loss and trauma.
For context, look for our upcoming EthnoMed feature on Caseworker Cultural Mediator Jeniffer Huong, read through the EthnoMed Cambodian Cultural profile, or check out the Inheriting podcast on NPR to learn how traumatic lived experiences can echo through generations.
Dashain (October 3rd – 12th)
Dashain, the most significant Hindu festival in Nepal and parts of India, spans several days and features elaborate rituals, family reunions, and feasting. Dashain represents the triumph of good over evil and is a time for children to receive blessings from their elders and for families to travel from all over to join in dancing, storytelling, making music, flying colorful kites, performing rituals, and giving gifts.
Día de los Muertos (October 31st – November 2nd)
Día de los Muertos is a vibrant and meaningful celebration rooted in Mexican culture. Observed from October 31st to November 2nd, the unmistakable sea of vibrant orange marigolds smelling of spice and fruit honors deceased loved ones through colorful altars, offerings of food, and communal gatherings. It serves as a way for families to remember and celebrate the lives of those who have passed and a vital opportunity to connect with their family’s history and heritage.
Conclusion
According to the American Psychiatric Association, refugees have a prevalence of PTSD and depression between 15% and 30%, which is ten times more than that experienced by non-refugee populations1. Aside from the acute traumatic experiences that may exist, being separated from family and one’s community during significant times can add to the linguistic and cultural isolation already felt2. Additionally, the stigma around seeking care for mental health issues in many cultures can add a tremendous load to people already struggling through insecure immigration status and financial stressors3.
As healthcare providers and colleagues, we all seek to provide cultural sensitivity and emotional support. Still, we often feel less comfortable taking that first step when it comes to people whose traditions we do not fully understand. So, we invite you to be curious and ask your colleagues what they look forward to this fall. Also, providers should be aware of the complex emotions and memories that arise during significant times of celebration or reflection and encourage patients to share what they have on their horizon. This simple practice can drive connection and provide invaluable insight into their care and follow-up. Some may need encouragement to seek out celebrations by local community centers or resettlement agencies, a reminder to reach out to loved ones, and, in some cases, seek out more targeted care.
Incorporating cultural sensitivity into our practice and everyday lives enhances our care and fosters a more inclusive and supportive environment. As we honor and celebrate our own cultural traditions this fall, let us remain mindful of the incredible variety of experiences had by patients and staff at Harborview Medical Center this and every “holiday” season. Check out the EthnoMed Event Calendar for holidays and educational webinars
References
- American Psychiatric Association. (2017). The Mental Health Needs of Refugees: What Psychiatrists Need to Know.
- Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., … & Pottie, K. (2011). “Common mental health problems in immigrants and refugees: general approach in primary care.” Canadian Medical Association Journal, 183(12), E959-E967. doi:10.1503/cmaj.090292.
- Miller, K. E., & Rasmussen, A. (2010). “War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks.” Social Science & Medicine, 70(1), 7-16. doi:10.1016/j.socscimed.2009.09.029.