Religious leaders' assessment and attribution of the causes of mental illness: an in-depth exploration of Vietnamese American Buddhist leaders

Among Asian Americans, particularly within immigrant communities, religious leaders are respected and sought out for support and guidance. There is a need to examine how religious leaders, especially within non-Christian faiths, identify persons and ascribe meaning and attributions to mental health concerns. The aim of this paper was to address this knowledge gap by exploring the perceptions of five Vietnamese American Buddhist leaders in regards to mental illness. Using qualitative analytic techniques we identified appearance, behaviours, and cognitive impairments that leaders interpreted as indicators of a mental health condition. Religious leaders cited messy and overly adorned outer appearance, aggressive and violent behaviours, and abnormal cognitive functioning as indicative of mental health problems. They attributed mental illness to a variety of causes: daily stressors, mind-body imbalance, karma, virtuous deeds, and spiritual possession. Findings inform strategies for faith-based initiatives and mental health service delivery to religiously affiliated Asian Americans.