Mental illness stigma ppt slides - cultural info

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Mental illness stigma ppt slides - cultural info

  1. 1. Mental Illness Stigma Joe Tinkham
  2. 2. General Information● Cognitive Tolerance -- embracing both traditional health methods and modern medical practices● Somatization -- express emotional distress somatically ○ well documented in some Arabian Gulf countries as well as Eastern Asian countries ○ excessive somatization used as metaphor to convey state of mind ■ e.g. "sinking of the heart" or "broken heart" ■ reflect cultural conceptualization and understanding of mental process, not deficit in emotional expression ■ may relate to using spirit possession as metaphor/conceptualization in other cultures ■ e.g. spirit catches you● Idiom of Distress -- most commonly accepted way of communicating stress/distress in various cultural settings, which may not be common in other cultural settings ○ "playing the sick person" ○ helps remove stigma of being diagnosed with mental illness
  3. 3. Arabic Countries● Arabic denotes common language, geography, history, and shared values/characteristics● Treatment for Arab patients primarily includes pharmacotherapy ○ using psychiatrist/psychologist viewed as personal weakness and disgrace of family ○ prefer using general healer and refrain from disclosing family information ■ family hires companion to accompany family member to therapy ■ they grow close and in many cases the companion takes on traits of the client● Somatization found in Arabic countries● No distinctive boundaries between self and body● Certain Doctor/Patient role expectations ○ doctor seen as omnipotent, omniscient, mysterious
  4. 4. Egypt● Cairo is center of mental health research and teach in Arab world ○ 70% of professionals in Arab world are Egyptian ○ treatment in hospitals is free, but stigma associated with so most people prefer private practitioners● Cultural belief in "Zar Cult" or belief in evil spirits that possess a person, causing unhappiness, misfortune, and mental/physical illness ○ possess certain people who are vulnerable to envy and jealousy of others ○ can never remove, only appease spirits● family often have negative attitudes towards mental health professionals because they are resistant from making relationships outside family/cultural background and they feel guilty, frustrated, alienated, and helpless when communicating with them● "maalesh" or "never mind" attitude toward mental illness and bizarre behavior● varying beliefs in causation ranging from evil eye to heredity● fear of treatment, especially ECT, often family organizes and structures the persons life, which is thought to help
  5. 5. Ghana● often lack of agreement on how to understand mental illness in low-income, developing countries● greater reliance on culturally specific, traditional explanations of mental illness in rural areas● degree of stigma is influenced by how much blame is attributed to the person ○ traditional views remove blame from the person and places it on social and spiritual forces beyond their control● more acceptance and support of strong traditional belief systems in general● greater acceptance of biomedical model in urban centers● Conclusion: ○ develop more integrated mental health services to reflect different beliefs and include more traditional views
  6. 6. Southern India● Diversity in beliefs in causes of mental illness related to severity of stigma● Patients and relatives often hold multiple and contradictory beliefs about mental illnesses ○ not static, but dynamic and adaptive to situation● Patient beliefs tended to focus on biomedical and karma/evil spirits causes ○ family relatives tended to focus on karma/evil spirit beliefs● Almost all believe in treatment of doctor, while also holding faith in other treatments such as traditional healers and religious cures●
  7. 7. Japan● people are more reluctant to use psychiatric labels to describe mental disorders, unless they are the more extreme forms● Japan places greater emphasis on hospital care● less likely to discuss mental health issues outside of the family and close friend● more likely to endorse the helpfulness of private information sources ○ e.g. books, internet ○ Despite the stigma associated with seeking outside help, there is a general belief that professional help is beneficial, especially psychotropic medication ○ however, not optimistic about full recovery● The predominant view in Japan is that trait neuroticism is a major risk factor for depression ○ seen as a sign of weakness of character and highly stigmatized
  8. 8. Japan continued● The stigma attached to mental health may also be related to a stigma against expressing negative emotions● Collectivistic cultures tend to focus less on their internal state and cognitions ○ would affect Japans bias against expressing negative emotions because focusing on ones negative emotions is asserting themselves over the importance of the group● A large part of Japanese culture that may be strongly influencing the personal and perceived stigma is the "tatamae" and "honne" culture● Tatamae = things people say in order to maintain positive relationships, but may not actually believe● Honne = what the person is truthfully thinking and believing● While people still hold negative attitudes towards mental disorders (especially more mild cases), they overrate the attitudes of the community as being more negative they they actually
  9. 9. Fiji Islands● Urban areas associated with acceptance of Western model ○ positive views toward hospitals and medication (majority view)● Rural areas associated with acceptance of traditional etiology views ○ e.g. witchcraft and use of traditional healers● Majority do not view witchcraft or heredity as causes of mental illness ○ lack of belief in witchcraft causes likely due to increasing Western influence ○ lack of belief in heredity causes likely due to locus of control would shift from individual to family -> indicating "bad genes"● Health workers more positively disposed toward those with mental illness ○ contact with those with mental illness
  10. 10. Australia● Japan and Australia share a common belief that personal vulnerability factors contribute to each disorder, but different kinds● In Australia, there is an emphasis on genetic predisposition as a risk factor for developing mental illness● Greater emphasis on community care
  11. 11. General Findings● Factors associated with positive attitudes toward mental illness: ○ direct contact with persons with mental illness ○ younger age ○ higher education ○ more prestigious occupation● Urban areas tend to favor biomedical model and treatment methods ○ rural areas tend to favor traditional model and treatment methods● Several studies conclude that education/health education have the potential to help reduce stigma ○ several also indicate integrating traditional views into mental health services

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