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Culture and Mental Health
- 1. Culture matters: Influence of Society and Culture on Mental Health
- 2. Why does culture matter? 2 Client / service user Mental health services Professional, i.e. social workers
- 3. 1. Client / service user • Symptoms – culture-bound syndromes? • Presentation – how do the clients describe the symptoms? • ”Making sense of the illness” the meanings they impart to their subjective experiences. • Family factors • Coping styles • Treatment seeking • Mistrust • Stigma • Immigration • Overall health 3
- 4. 2. Professionals • Training, practice and institutions • Communication • Lack of resources in the primary care sector • Bias and stereotyping 4
- 5. 3. Mental Health services • Every society influences mental health treatment by how it organizes, delivers, and pays for mental health services. • Structural racism and discrimination • Poverty • Marginalization 5
- 6. Break 6
- 8. 1. People should work out their own mental health problems. 8
- 9. 2. Once you have a mental illness, you have it for life. 9
- 10. 3. Females are more likely to have a mental illness than are males. 10
- 11. 4. Medication is the best treatment for mental illness. 11
- 12. 5. People with a mental illness are generally violent and dangerous. 12
- 13. 6. Adults are more likely than teenagers to have a mental illness. 13
- 14. 7. You can tell by looking at people whether they have a mental illness. 14
- 15. 8. People with a mental illness are generally shy and quiet. 15
- 16. 9. Mental illness only happens to certain kinds of people. 16
- 17. 10. Most people will never be afected by mental illness. 17
- 18. STIGMA 18
Editor's Notes
- With a seemingly endless range of subgroups and individual variations, culture is important because it bears upon what all people bring to the clinical setting. It can account for minor variations in how people communicate their symptoms and which ones they report. Culture-bound syndromes - sets of symptoms much more common in some societies than in others. The meaning of an illness refers to deep-seated attitudes and beliefs a culture holds about whether an illness is "real" or "imagined," whether it is of the body or the mind (or both), whether it warrants sympathy, how much stigma surrounds it, what might cause it, and what type of person might succumb to it. Cultural meanings of illness have real consequences in terms of whether people are motivated to seek treatment, how they cope with their symptoms, how supportive their families and communities are, where they seek help (mental health specialist, primary care provider, clergy, and/or traditional healer), the pathways they take to get services, and how well they fare in treatment. The consequences can be grave - extreme distress, disability, and possibly, suicide - when people with severe mental illness do not receive appropriate treatment.
- the institutions in which they train and practice, are rooted in Western medicine. Professionals view symptoms, diagnoses, and treatments in a manner that sometimes diverges from their patients. "[Clinicians'] conceptions of disease and [their] responses to it unquestionably show the imprint of [a] particular culture, especially its individualist and activist therapeutic mentality,” some degree of distance between clinician and patient always exists, regardless of the ethnicity of each (Burkett, 1991). Clinicians also bring to the therapeutic setting their own personal cultures Hunt, 1995; Porter, 1997. Thus, when clinician and patient do not come from the same ethnic or cultural background, there is greater potential for cultural differences to emerge. Clinicians may be more likely to ignore symptoms that the patient deems important, or less likely to understand the patient's fears, concerns, and needs. The clinician and the patient also may harbor different assumptions about what a clinician is supposed to do, how a patient should act, what causes the illness, and what treatments are available. For these reasons, DSM-IV exhorts clinicians to understand how their relationship with the patient is affected by cultural differences
- the institutions in which they train and practice, are rooted in Western medicine. Professionals view symptoms, diagnoses, and treatments in a manner that sometimes diverges from their patients. "[Clinicians'] conceptions of disease and [their] responses to it unquestionably show the imprint of [a] particular culture, especially its individualist and activist therapeutic mentality,” some degree of distance between clinician and patient always exists, regardless of the ethnicity of each (Burkett, 1991). Clinicians also bring to the therapeutic setting their own personal cultures Hunt, 1995; Porter, 1997. Thus, when clinician and patient do not come from the same ethnic or cultural background, there is greater potential for cultural differences to emerge. Clinicians may be more likely to ignore symptoms that the patient deems important, or less likely to understand the patient's fears, concerns, and needs. The clinician and the patient also may harbor different assumptions about what a clinician is supposed to do, how a patient should act, what causes the illness, and what treatments are available. For these reasons, DSM-IV exhorts clinicians to understand how their relationship with the patient is affected by cultural differences
- Not true. When people have a physical health concern, they generally take some action and often go to the doctor or seek some other kind of help for their problem. Mental illness is associated with changes in brain functioning and usually requires professional assistance. Because of the stigma surrounding mental illness, many people are reluctant to seek help.
- While it’s true that most mental illnesses are lifelong, they are often episodic, which means that the symptoms are not always present. Just like people who live with chronic physical illnesses like arthritis and asthma, people with mental illnesses can, when the illness is managed, live positive and productive lives.
- Men and women are equally afected by mental illness in general, but women may experience higher rates of specifc illnesses such as eating disorders and depression. Men have higher rates for some disorders such as alcoholism and ADHD. Some illnesses are relatively equally shared by men and women, like bipolar disorder. It may seem that women are more likely to have a mental illness than men, but this may be because women are more likely to seek help for mental and emotional difculties and to share their concerns with friends than are men. Rates for women are significantly higher as compared to those for men, except for substance use disorders (men: 5.6%, women 1.3%), and psychotic disorders (almost identical estimates). Overall rates are 33.2 versus 21.7.
- Medication can be a very efective part of managing a mental illness, but it is by no means the only type of treatment or support that helps people recover. A wide range of appropriate interventions, including medication, counselling, social and recreational groups, self-help, holistic health, religious support, hospital care, exercise and nutrition are options for helping people recover and stay well. The best approach is to have a combination of strategies that have been proven to be efective.
- People with mental illness are generally not more violent than the rest of the population. Mental illness plays no part in the majority of violent crimes committed in our society. In fact, a person with a mental illness is more likely to be a victim of violence than the perpetrator. The assumption that any and every mental illness carries with it an almost certain potential for violence has been proven wrong in many studies. Often, it is the misrepresentation by the media that leads to this false belief.
- Some illnesses are frst diagnosed in childhood but many more begin to appear during the late teenage years and into early adulthood.
- Sometimes if a person is experiencing symptoms of their mental illness, how they are feeling, thinking and behaving may be diferent from what is normal for them, but generally, you cannot tell if a person has a mental illness based on his or her appearance
- There is no strong causal relationship between personality characteristics and a tendency to develop mental illness. Some mental disorders, however, such as depression, anxiety and schizophrenia can lead people to avoid or limit social contact.
- This is incorrect; mental illness can happen to anyone.
- According to a systematic review of data and statistics from community studies in European Union (EU) countries, Iceland, Norway and Switzerland: 27% of the adult population (here defined as aged 18–65) had experienced at least one of a series of mental disorders in the past year (this included problems arising from substance use, psychoses, depression, anxiety, and eating disorders). These figures represent an enormous human toll of ill health, with an estimated 83 million people being affected. Yet even these figures are likely to underestimate the scale of the problem, as only a limited number of disorders were included and it did not collect data on those aged over 65, a group that is at particular risk. These figures also fail to capture the complexity of the problems many people face. 32% of those affected had one additional mental disorder, while 18% had two and 14% three or more.