Abstract Background: Responding to the IASP Conference theme of “Conflicts, Culture and Social Wellness,” the author proposes Social Psychiatry’s role in promoting belonging and unity (Di Nicola 2013, 2018). Drawing on the history of Social Psychiatry (SP) and Cultural Psychiatry (CP), the author offers a schema of the distinguishing features and identity of each branch of psychiatry (Antić, 2021; Di Nicola, 2019). Issues: Are the histories and current practices of CP and SP mutually compatible and enriching or are they hiving off into separate domains? Proposition: A schema will be presented for differentiating underlying assumptions and core features of these two allied but increasingly differentiated fields of psychiatry. Key domains include: core arguments/dynamics (CP’s critiques of Western psychiatry lead to negation of its claim to universality; SP’s documentation of social determinants of health (SDH/MH) affords the affirmation of SDH/MH across societies and over time); categories (CP addresses race and ethnicity; SP investigates class and social structure); allied fields (CP – medical anthropology; SP – medical sociology, epidemiology & public health); metaphors (CP – “prism”/refracting; horizontal approach, “across cultures”; SP – “creolization”/blending; vertical approach, layers of “social strata”); values (CP - diversity/equity; SP – unity/solidarity); research (CP - ethnographies, CFI; SP - epidemiology, SDH/MH); allied professional movements/outgrowths (CP - Global Mental Health; SP - community psychiatry); allied populist movements (CP – “Black Lives Matter” in the USA; SP – “Gilets jaunes” in France); and, critiques (CP/GMH - eg, China Mills; SP – “southern epistemologies,” the Global South; Di Nicola, 2020). Outcomes: Cumulative results of the two allied traditions, sometimes practiced by the same/overlapping clinical and research teams, are discussed under the rubric “centripetal” (unifying, integrating) versus “centrifugal” (separating, dispersing) impacts. Implications: The disparate methods and results of CP vs. SP reflect the diverse foundational discourses of these increasingly differentiated fields. CP has morphed into a study of Dostoyevski’s “the insulted and the injured” imbued with a liberal, progressive ideology, culminating in identity politics. Meanwhile, social class, the signal critical tool of everything social, from sociology to socialism and SP, is being supplanted by a focus on culture. The author solicits a debate on what this means for the future of CP & SP and whether a synthesis is still possible. As for SP, the author proposes that with its centripetal unifying and integrating practices, SP promotes belonging and unity in mental health care and in social theory ( Di Nicola, 2019). DOI: 10.13140/RG.2.2.12373.96483

1. Conflicts, Culture and Social Wellness:
Social Psychiatry’s Role in
Promoting Belonging and Unity
Prof. Vincenzo Di Nicola
28th National Conference
Indian Association for
Social Psychiatry (IASP)
Imphal, Manipur, India
Friday, 26 November 2021

2. Prof. Vincenzo Di Nicola
MPhil, MD, PhD, FRCPC, DFAPA, FCPA, FCAHS
Professor of Psychiatry
University of Montreal & The George Washington University
Global Mental Health Teaching Faculty
Harvard Medical School
Honorary Chair & Professor of Social Psychiatry
Ambrosiana University

3. Conflicts of Interest
The presenter has no financial conflicts of
interest to declare

4. Learning Objectives
1. Participants will be able to distinguish the underlying
assumptions, core features, and the identity of Cultural
Psychiatry (CP) versus Social Psychiatry (SP), both
historically and in contemporary theory and practice.
2. Participants will be able to see how the assumptions
and features of Social Psychiatry (SP) and Cultural
Psychiatry (CP) translate into two increasingly
differentiated identities and paradigms for the social
sciences and medicine, highlighting centripetal versus
centrifugal trends.

5. Key Questions
1. What are the identities and core missions of
Cultural Psychiatry (CP) and Social Psychiatry (SP)?
Are they distinct or do they still overlap?
2. What are the impacts of each approach (CP, SP) in the domains
of theory, practice, education, and policy-making?
3. Are the differences in assumptions, theory, and practice
between CP and SP still convergent enough to make a synthesis
possible or have they diverged so far as to create two clearly
demarcated and differentiated fields of practice?
4. How can SP promote belonging and unity in a time of conflicts
and polarization?

6. Introduction
Responding to the IASP Conference theme of
“Conflicts, Culture and Social Wellness,” the
author proposes Social Psychiatry’s role in
promoting belonging and unity (Di Nicola 2013, 2018)
References:
Di Nicola, V. “Belonging without Boundaries: Settlers, Sojourners and Travelers
in the 21st Century.” S 03 – “Belonging Symposium,” Co-chairpersons: V Di
Nicola (Canada) Rachid Bennegadi (France), Romanian Journal of Psychiatry,
XV, Supplement 1, April 2013, 12-15.
Di Nicola, V. Borders and Belonging, Culture and Community: From Adversity to
Diversity in Transcultural Child and Family Psychiatry. Journal of the American
Academy of Child & Adolescent Psychiatry, 2018, 57(10): S116.

7. Introduction
Drawing on the history of Social Psychiatry and
Cultural Psychiatry, the author offers a schema of
the distinguishing features and identity of each
branch of psychiatry (Antić, 2021; Di Nicola, 2019).
References:
Antić, A. Transcultural Psychiatry: Cultural Difference, Universalism and Social
Psychiatry in the Age of Decolonisation. Culture, Medicine, and Psychiatry 45,
359–384 (2021).
Di Nicola, V. “A person is a person through other persons”: A social psychiatry
manifesto for the 21st century. World Social Psychiatry, 2019, 1: 8-21.

8. Issues
Are the histories and current practices of Cultural
Psychiatry (CP) and Social Psychiatry (SP)
mutually compatible and enriching or are they
hiving off into separate domains?

9. Proposition – Schema
A schema will be presented for differentiating
underlying assumptions and core features of
these two allied but increasingly differentiated
fields of psychiatry

10. Schema – Key Domains
Core arguments
Categories
Allied fields
Metaphors
Values
Research
Allied professional movements
Allied populist movements
Critiques

11. Key Domains
Core arguments
CP’s critiques of Western psychiatry lead to a
negation of its claim to universality
SP’s documentation of Social Determinants of
Health/Mental Health (SDH/MH) affords the
affirmation of social factors across societies
and over time
Categories
CP addresses race and ethnicity
SP investigates class and social structure

12. Key Domains
Allied fields
CP – medical anthropology
SP – medical sociology, epidemiology & public health
Metaphors
CP – “prism”/refracting;
horizontal – “across cultures”
SP – “creolization”/blending;
vertical – layers of “social strata”

13. Key Domains
Values
CP – diversity/differentiation
SP – unity/solidarity/belonging
Research
CP – ethnographies, Cultural Formulation Interview
SP – epidemiology, Social Determinants of Health/
Mental Health (SDH/MH)

14. Key Domains
Allied professional movements/outgrowths
CP – Ethnopsychoanalysis (France),
Cultural Family Therapy (Canada)
SP – Community Psychiatry,
Global Mental Health (GMH)
Allied populist movements
CP – “Black Lives Matter” in the USA
SP – “Gilets jaunes” in France

15. Key Domains
Critiques
CP/GMH – eg, Ethan Watters, Crazy Like Us;
China Mills re: GMH
SP – “Southern epistemologies”;
the Global South (Di Nicola, 2020)
Reference:
Di Nicola, V. Review article—The Global South: An emergent epistemology for
social psychiatry. World Social Psychiatry, 2020, 2(1): 20-26.

16. Outcomes
Cumulative results of the two allied traditions,
sometimes practiced by the same/overlapping
clinical and research teams, are discussed under
the rubric centripetal (unifying, integrating)
versus centrifugal (separating, dispersing)
impacts

17. Centripetal Impacts
Under the rubric centripetal (unifying,
integrating) impacts
SDH/MH affords the affirmation of social factors
across societies and over time
Class
Unity/solidarity/belonging
Metaphor: “Creolization”/blending

18. Centrifugal Impacts
Under the rubric centrifugal (separating,
dispersing) impacts
Negation of the universality of the Western academic
model of psychiatry
Culture
Diversity/differentiation
Metaphor: Refracting “prism”

19. Implications
The disparate methods and results of Cultural
Psychiatry vs. Social Psychiatry reflect the diverse
foundational discourses of these increasingly
differentiated fields
CP: Diversity & differentiation
Reflected in general & medical anthropology
SP: Unity/solidarity
Reflected in sociology, epidemiology

20. Implications
Cultural Psychiatry has morphed into the study of
Dostoyevski’s “the insulted and the injured”
imbued with a liberal ideology, culminating in
today’s “identity politics”
Meanwhile, social class, the signal critical tool of
everything social – from sociology to socialism
and Social Psychiatry – is being supplanted by a
focus on culture

21. Implications
The author solicits a debate on what this means
for the future of Cultural Psychiatry & Social
Psychiatry and whether a synthesis is still
possible
Does the current focus on intersectionality
address these concerns? Is that the way to a
synthesis of the vertical (SP) and the horizontal
(CP)?

22. Implications
As for Social Psychiatry, the author proposes that
with its centripetal, unifying and integrating
practices, Social Psychiatry promotes belonging
and unity in mental health care and in social
theory (Di Nicola, 2019)
Reference:
Di Nicola, V. “A person is a person through other persons”: A social psychiatry
manifesto for the 21st century. World Social Psychiatry, 2019, 1: 8-21.

23. Acknowledgments
Prof. Pratap Sharan, President,
Indian Association of Social Psychiatry
Session Co-chairs:
Prof. Indira Sharma
Prof. Varghese P. Punnoose
Prof. Rakesh Chadda, Secretary-General,
WASP
Turku, Finland

24. References
Antić, A. Transcultural Psychiatry: Cultural Difference,
Universalism and Social Psychiatry in the Age of Decolonisation.
Culture, Medicine, and Psychiatry 45, 359–384 (2021). Available
from: https://doi.org/10.1007/s11013-021-09719-4
Di Nicola, V. “Belonging without Boundaries: Settlers, Sojourners
and Travelers in the 21st Century.” S 03 – “Belonging
Symposium,” Co-chairpersons: V Di Nicola (Canada) Rachid
Bennegadi (France), Romanian Journal of Psychiatry, XV,
Supplement 1, April 2013, 12-15.

25. References
Di Nicola, V. Borders and Belonging, Culture and Community:
From Adversity to Diversity in Transcultural Child and Family
Psychiatry. Journal of the American Academy of Child &
Adolescent Psychiatry, 2018, 57(10): S116. Available from:
https://www.jaacap.org/article/S0890-8567(18)31360-
1/fulltext#relatedArticles
Di Nicola, V. “A person is a person through other persons”: A
social psychiatry manifesto for the 21st century. World Social
Psychiatry, 2019, 1: 8-21. Available
from: https://www.worldsocpsychiatry.org/text.asp?2019/1/1/8/
267958

26. References
Di Nicola, V. Review article—The Global South: An emergent
epistemology for social psychiatry. World Social Psychiatry, 2020,
2(1): 20-26. Available from:
https://www.worldsocpsychiatry.org/text.asp?2020/2/1/20/2811
30

27. Questions
&
Comments