04/07/2026
This is how we build a bridge and make mental health culturally relevant 👏👏
Mental Health through healing lens
When a ceremony is being performed, it's important not to underestimate how many benefits come from the mental, emotional, and collective healing involved. In Western spaces, it can be very challenging to describe how Hmong people have dealt with mental health and how we define it. In conversations between multigenerational participants with different perspectives on how mental health shows up in our community, we often conclude that mental health has not existed in the community until now, or that our community has never had tools for processing and healing these battles.
It is often the elders who have the hardest time perceiving what mental health is through the Western lens, leading them to dismiss these issues and causing a rift with our younger generation. And yes, although our language and community lack the terminology and research of mental health through Western healthcare, it does not mean we do not know how to describe it. Mental health has always existed, and we as a community have always been fighting the battle of healing it.
First, you have to remember that mental health is not new for our Hmong American community, but the privilege of being able to process these issues is. Our diaspora of displacement, war, and persecution stretches over 3,000 years. This may well be the first couple of decades where we as a community get the privilege of not worrying about death and running. We finally get to sit with our own personal struggles and the issues that we have learned and inherited from our predecessors. They did not have the luxury of having conversations to understand mental well-being, but we do. So when working with elders, I draw from culturally relevant healing to help them understand mental health. We meet them where they are at with knowledge they understand to learn knowledge crucial for growth.
An important example I use is the soul. Yes, we perceive the soul as a spiritual part of us, but our community has used the ntsuj to not only embody our soul, but also our consciousness and mental state. So when working with elders, I use soul loss and its symptoms to help them understand mental health symptoms. Elders understand that a soul that is unaligned can manifest symptoms that closely align with depression. But they also understand that there is no cure and that we must be proactive in healing. A cure is instantaneous, and healing is a journey that takes time and is forever ongoing.
They understand that to heal the soul and ensure it continues to grow, we must make changes in our lives, whether that is facing our demons, communicating with family, reaching out to resources, and being mindful. We often see shamans being asked (nug neeb) to report in detail about a ceremony after they perform it. The shaman may go into detail on that person’s soul’s well-being and give advice to the family: “Be more patient, show them love, learn to communicate, take time to rest.” I personally have found myself using this time to advocate for the individual or people going through a difficult time. Collectively, as a family and community, we take that person’s soul loss seriously, causing us to shift into a healing mentality to support them. But it is important that in no way do we use soul loss to replace mental health. For me, soul loss and culturally relevant healing are crucial in helping elders and community members learn and understand mental health.
Affirmations and words of assurance are crucial to this. I have seen someone getting their wrists tied with blessing strings from family and friends cry tears because they finally feel seen and loved. Or when a hu plig is complete and the whole family calls out “los tsev os” and reminds them they are home and loved, I’ve seen eyes tear up. Many times, for someone dealing with mental health, their mind can be so crowded that they do not have the capacity to process their pain. So when a shaman performs a ceremony and speaks to their soul, and their soul communicates all that they are going through and carrying, it often leads to that person finally being able to release their grief. I see it as third-person perspective healing. I’ve seen this lead to families having serious conversations of support after hearing these confessions from the soul.
In Hmong shamanism, it is believed a soul can ntxee nyeej 3 to 4 times in their lives. Spiritually, ntxee nyeej is described as a person’s soul transitioning into a new part of their life. But physically and mentally it is a coming of age. Symptoms include sadness, anger, drawing away from loved ones, reckless behavior, and illness. If a person’s soul ntxee nyeej, we perform an ua neeb to align the soul. But neeb ntxee nyeej isn’t just about the spiritual aspects, but the communal one as well. For a teenager, puberty can be challenging and lonely. The ceremony involves family reassuring them they are not alone and are supported.
This is especially crucial for elders. At this point in life, most of their kids are grown and out of the nest. They are aging, facing declining health, and many are coming to terms with their own mortality. It can be a lonely chapter in life. Ua neeb ntxee nyeej for an elder is called neeb fab laj. This ua neeb requires many roles beyond the shaman to complete it, along with the whole family. For many elders, this is the first time in a while all their children and family members are home. A part of the ceremony involves reenacting the elders being lost and then found by their family. The parents are called back into the home and are showered with love by their children and family, given positive affirmations, and reminded they are loved. I’ve seen elders cry with their children, and I’ve seen broken families reconnect.
There are so many other forms of spiritual healing that our community has used to heal and understand mental health. So much that I use, and so much more I am continuously learning about and incorporating. Healing for Hmong people has always been holistic and done collectively. We must meet each other halfway.
