ORIGINAL RESEARCH Resilience of Vietnamese Refugees: Resources to Cope with Natural Disasters in Their Resettled Country Huaibo Xin, DrPH, MD, Robert E. Aronson, DrPH, Kay A. Lovelace, PhD, Robert W. Strack, PhD, and Jose ´ A. Villalba, PhD ABSTRACT Objective: Study findings suggest that refugees are more vulnerable than the general population to mental disorders from disasters. This pilot study explored the nature of Vietnamese refugees’ resilience to a potential natural disaster as a first step toward improving their disaster mental health. Methods: Interviews were conducted with 20 ethnic Vietnamese and Montagnard adult refugees using a semistructured interview guide. Factors in resilience at both individual and family levels were examined. Results: Our results indicated that these refugees had positive personalities and strong family cohesion. However, although a majority of the participants had experienced natural disasters, they lacked knowledge and specific strategies to cope with these events. The individual participants and their families lacked sufficient information, financial resources, emergency supplies, or social support for a natural disaster. Conclusions: Enhancing refugees’ current strengths in responding to disasters, delivering them tailored emergency training, strengthening relationships between refugee service providers and refugee commu- nities, and advocating for refugees’ socioeconomic capacity building should be considered. (Disaster Med Public Health Preparedness. 2013;7:387-394) Key Words: disaster mental health, natural disaster, resilience, refugees, ethnographical approach, public health P ublic disasters, whether natural or manmade, take a tremendous toll not only on people’s lives and properties but also on the mental health of survivors. Numerous studies conducted with diverse population groups have demonstrated the impact of disasters on both the prevalence and incidence of disaster-related mental disorders such as major depression, anxiety, and posttraumatic stress disorder (PTSD). 1-3 A variety of factors affect a population’s vulnerability to mental disorders in the event of a public disaster. For instance, regardless of the type of trauma, cumulative traumatic or disaster experiences are asso- ciated with increased risk for mental illness. 4-6 A history of psychiatric disorders increases the likelihood of a recurrence or new development of mental illness during or after a public crisis. 2,7-10 Moreover, receiving a late psychological crisis intervention or no intervention can intensify a victim’s risk of developing a mental disorder. Refugee populations have often experienced multiple traumas (eg, famine, torture, deadly infectious dis- eases, witnessing family members or friends killed, forced isolation, and a feeling of being close to death) in their country of origin, in refugee camps, or during forced migration before arriving in a resettlement country. 11-14 Among refugees, the prevalence of psychiatric disorders is also high. Epidemiological data suggest that refugees in the United States are more susceptible to depression, anxiety, and PTSD than the general population. 15-17 In addition, refugees are underserved by the US mental health system because of a lack of accessibility to and utilization of mental health services. 11,18-20 Thus, refugees can be more vulnerable to mental disorders in public disasters than the general population. Individual Resilience In the past 20 to 30 years, resilience has been identi- fied as a factor in mitigating the effects of disasters on mental health. 21 Research efforts have been redirected from simply minimizing the consequences of adversities to strengthening each individual’s capacity to overcome difficulties by building up their resilience. 21 Individual resilience has been described Disaster Medicine and Public Health Preparedness 387 Copyright & 2013 Society for Disaster Medicine and Public Health, Inc. DOI: 10.1017/dmp.2013.44 https://doi.org/10.1017/dmp.2013.44 Published online by Cambridge University Press