Mental Illness Across Cultures Research Paper Examples
Type of paper: Research Paper
Topic: Psychology, Health, Medicine, Culture, European Union, Illness, Disease, Mental Illness
Palm Beach State College
This paper welcomes the cultural understanding of mental illness as it evidenced the vast differences in the conceptualizations of mental illnesses across cultures. It relates the varied perception, understanding and treatment of different mental illnesses from among the peoples and societies in western and non western world. The demarcation lies in the applications of the pervading concepts of western psychology and how it discredits the other acceptable and (might prove to be) more effective diagnosis and treatment of mental diseases. This paper emphasizes the need for a comprehensive mental health care or global health care perspective as it underlines the significance of acknowledging the cultural factors as significant determinants of mental well being. This study is very relevant to the increasing mental health problems all over the world. It also presupposes an encompassing approach to mental health and wellness, with a stress in acknowledgement the value of cultural beliefs and values and the equal treatment of both western and non western ways in mental illness diagnosis and treatment.
Mental Illness across Cultures
While mental health care has vastly improved through the past decades, many people are still beset by different mental illnesses. The latter is defined as “a mental or behavioral pattern or anomaly which causes suffering or a disability to function as normal individuals (Hiday & Wales, 2013). Mental illnesses are usually defined by a mix of how an individual acts, thinks, perceives, or feels. This may be related to specific parts or functions of the brain or the whole nervous system (Hiday & Wales, 2013). Mental illness is also a function of social and cultural conceptions of human behaviors and general psychology (Lakeman, 2013).
The disability and mortality brought by mental illnesses worldwide is remarkable. As various health institutions try to establish psychiatric services on a global scale, it is also important to reflect on the socio-cultural aspects of mental illnesses. There is a lack of emphasis on the cultural factors involved in treating mentally ill patients. Hence, the goal of globalizing psychiatric services may be detrimental (Lakeman, 2011). When people discuss mental illness as pinned to various cultures, often, there is a very large gap in commonalities and perceptions (Lakeman, 2011).
Alarmingly, instead of trying to close the gap, people try to view things in the western psychology contexts. However, this is not always the most effective solution. For instance, the two major mental illnesses in the United States, which are anxiety and depression, are hardly seen as a priority mental disease in a Tanzanian culture. They strongly focus on schizophrenia and other visible forms of psychosis (Sibitz, et. al., 2011).
The World Health Organization (WHO) (2010) affirmed that there is really a great divide in the accessibility of resources to aid mental health globally. It was noted that more than 90 per cent of global mental health resources are placed in highly developed nations (WHO, 2010). It is very alarming since more than 80 percent of the world’s population live in poor and middle income nations (WHO, 2010). Sadly, in African, Latin American, and South/Southeast Asian countries, mental health expenditures only accounted to less than 2 percent of total expenditures. In the United States, this accounted for more than 10 per cent (WHO, 2010). As depression is projected to be the second biggest cause of mental illness in 2030 globally, it is very significant to discuss mental illness across different cultures (Who, 2010).
Another major reason to study cultural factors in mental illness is the extent to which certain results are really culturally-sensitive and inclusive (Corrigan, 2011). As shown by various psychiatric studies, there are marked differences between ethnic minority groups and white people in results, service usage and service satisfaction (Corrigan, 2011). The lack of culturally inclusive understandings of positive results in mental illness is complicated by the fact that Blacks and other minorities are underrepresented in mental health related research (Corrigan, 2011). Hence, with these two important reasons, it is best to proceed with an all inclusive consideration of culture in mental illnesses across the world.
Mental Illness According to Different Cultures
As per Lakeman (2011), it is high time to acknowledge that psychiatric diagnoses are not universal. There are culture-specific illnesses and this is best exemplified by an Asian mental illness called “koro” (Crozier, 2011). “Koro” is a form of genital retraction anxiety which is seen in some Asian countries. Prior to recognizing its cultural dimension, “koro” had been categorized under delusional disorder (Crozier, 2011). However, it only perpetuated a skewed perspective on the cultural dimensions in mental illness. “Koro” seemed to be reserved as an exemption for its “cultural” meaning that is exclusively reserved for non-Western patients or populations exhibiting its symptoms. This was excluded as a true medical illness for the western countries (Crozier, 2011).
As other examples, Indians and Pakistanis are reluctant to receive diagnosis such as severe emotional distress or mental retardation since they believe that this disorder strongly impacts on their other family members to be able to get married (Morales & Norcross, 2010). In Vietnam, mental illnesses are explained according to mystical beliefs. Mental health is considered as a by-product of harmony between the “hot” and “cold” aspects of the human body (Morales & Norcross, 2010). Hence, they do not instantly take the western prognosis of going to a psychiatrist or undergoing counseling and other psychological interventions, more especially if they have to personally disclose themselves to a medical practitioner (Morales & Norcross, 2010). It is important that trust is first gained between the patient and the medical doctor or psychiatrist.
Just like the Vietnamese, trust is also an issue with the Russians (Sibitz, et. al., 2011). Hence, they view the patient and professional interaction as an authoritarian relationship in which they cannot fully divulge sensitive information about themselves. Hence, many Russian mental patients find it a challenge to confide in a medical doctor, particularly of another race. Russian patients expect a patriarchal or authoritarian dynamics based on trust. Inherently, this reduces their motivation for self care and preventive health behaviors (Sibitz, et. al., 2011).
The same paternalistic tendencies are present in the Hispanic culture (Lakeman, 2011). They usually consult their older families and relatives on health matters, including mental illnesses. Usually, they hold a fatalistic view on illness and they believe that God wills it if a person has to experience mental disorders and other psychological conditions (Lakeman, 2011). They believe that God is disciplining or punishing someone when he/she is beset by a mental disorder. They often consult a folk healer called “curandero” (Lakeman, 2011).
At the same time, other mental conditions like anorexia nervosa, chronic fatigue syndrome, etc. are also often identified as greatly culture-pinpointed to European and American populations (Koenig, 2012). Since it has always been practiced that western countries lead in mental diagnoses and psychiatric conceptualizations of mental illnesses, the whole world has been blinded by the distinct cultural dimensions of mental illnesses.
The need for inter-disciplinary paradigm in promoting comprehensive understanding about the dynamics of culture and mental illness has been shown by the growing literatures and medical research evidencing that subscribing mental illnesses according to western psychology to low income countries is ineffective. It is shown to have damaging effects to many peoples. Ethan Watters’ book Crazy Like Us showed examples from various parts of the world (like China, Japan, Peru, Sri Lanka and Tanzania) where the orientation to psychiatric conceptualizations of mental illness has potentially altered the symptoms and syndromes or how it is diagnosed or limited the treatment (Koenig, 2012). Watters (2010) exemplified the work of Gaithri Fernando who expanded the mental disorder related to the aftermath of the tsunami which hit Sri Lanka in 2006. The author claimed that western notions of trauma and the medical criteria for post-traumatic stress disorder (PTSD) were not fit for a Sri Lankan context.
Watters (2010) also studied how depression has altered Japan through the last two decades. This illustration enabled the author to show the dynamics between mental illness and cultural factors were commercially interpreted. During the 1960s, there was a notion of a personality type called “Typus Melancholicus” which was introduced by Hubert Tellenbach (Watters, 2010). This psychiatric condition has strongly influenced the country’s psychiatric thinking. Typus melancholicus had important alignment with a respected Japanese personality type. It associated with the Japanese who were “diligent, serious, thoughtful and had altruism” (Watters, 2010). They felt a significant negative emotion when a cultural or natural disaster hit their nation and their negative feeling have detrimental impact on others as well (Watters, 2010).
While at the end of the 20th century, the term for depression (utsubyô) emerged in Japan (Kitanaka, 2011). However, it has been related to a very debilitating and rare mental condition. Before 2000, there had been no true market for antidepressant medications in the country but the developing public understanding of Typus melancholicus was commercially related to the entry of antidepressant medicines in Japan (Kitanaka, 2011). It had a commercial agenda since a large pharmaceutical company called GlaxoSmithKline took advantage of the development of this disorder to introduce a new antidepressant medication in Japan (Kitanaka, 2011). They subsume the depression under a flagship program called “international consensus group” of medical experts on cultural psychiatry. The pharmaceutical company hinted on the notion of cross-cultural variations in depression and impressed that in fact depression is a serious yet underrated problem in Japan (Kitanaka, 2011). Presently, depression is now accepted in Japan as influencing Japanese, mostly males, who are very hard-working and have over-internalized the national ethos of company loyalty and usefulness (Kitanaka, 2011). This has led to the vast growth of the markets for anti depressants in Japan. However, it brought a negative impact on how psychological and social treatments for depression should go about (Kitanaka, 2011).
In a psychologically oriented country such as the United States, the experience of mental illness stigma is also a great problem, especially for their racial and ethnic minority groups (Vogel, Armstrong, et. al., 2013). A study of four different ethnic groups in the U.S. (Black Americans, American Indians and Native Alaskans, Asian Americans, and Spanish Americans) led to the concept of “double stigma,” which came from the prejudice and discrimination associated to one’s racial identity and mental illness (Vogel, Armstrong, et. al., 2013). It was shown that there is an intersection that defines the complex relationships between various identities (such as class, disability, gender, race, and sexual orientation) and expressions of oppression. Medical scholars emphasized that the impacts of interlocking identity boundaries should be seriously studied (Vogel, Armstrong, et. al., 2013). The oppression linked with one’s economic status, disability, race, and gender function as an intersecting system. These were not distinct instances of oppression (Vogel, Armstrong, et. al., 2013).
With regards to serious mental illnesses, it is noted that bipolar disorders showed universal symptoms of joylessness and sadness (Schomerus, Matschinger, & Angermeyer, 2013). However, the suicidal tendencies from this disorder range between cultures. Likewise, it is interesting to highlight that the symptoms and the rates of depression do not significantly differ among White population and Black and ethnic minority populations (Schomerus, Matschinger, & Angermeyer, 2013). However, among South Asians in the United Kingdom, various factors affect the rates of depressions such as overall stay in the U.K., ability to speak the English language, racial prejudice experiences, and presence of children at their residences (Schomerus, Matschinger, & Angermeyer, 2013).
Psychiatric disorders are becoming more prevalent in the Middle East (Parker, 2012). However, the approach in evaluating and treating patients in the Arab region followed a western tradition of mental health assessment and treatment. In general, the Arabs think that global statistics evidence the similarities of most mental illnesses from one country to another. They assume that serious mental disorders like schizophrenia, anxiety and depression are common to other nations. The few statistics generated from specific Arab countries such as Egypt and Lebanon hold this assumption (Parker, 2012). Hence, the stronger issue in the Arab world has got to do with the stigma and ignorance attached to the mental illnesses more than the mental illnesses itself.
All cultures possess their distinct systems of health and wellness beliefs to interpret their own diseases, how it can be treated or cured and the involved parties in the treatment or medical processes. The degree to which mental health patients perceive their conditions as related to their cultures can spell differences in the manner and time duration for recovery or further sickness. Western societies usually consider diseases as outcomes of natural and scientific phenomena. They intervene with medicines and advanced treatments. On the other hand, other societies believe that mental illness is an outcome of a super natural event and they usually consider spiritual and ritualistic practices to treat these illnesses. In another aspect, the treatment is also heavily influenced by how patients culturally comply with medical procedures.
It is a welcome note that there have been various moves to consider globalization of mental disorders from the perspective which included culture. As shown, cultural factors are significant in the understanding, diagnosis and treatment of mental illnesses. It is also a positive development that the inequalities between the western and non western notions of psychology are now being addressed. However, there is vast work to do in this respect. As shown in this study, the present condition is an enormous field for further action and more studies and experiments. Certain lessons are important, although, at this level.
Initially, this study has shown that people and institutions should be wary of their false assumptions and generalizations about indigenous and non western concepts of mental illnesses. Secondly, there should also be a balanced view of how different disorders are treated across cultures and locations. While there is an obvious advancement in the field of specializations by western psychiatry, it is detrimental to totally ignore the cultural practices relating to prognosis and treatment of mental illnesses in non-western societies.
There is no superiority with respect to the regulations, services and treatments for mental illness in rich, western countries. Their results might not be better than in non-western, poor countries. While the western notions on mental illnesses and their treatment are pervading, it does not preclude the understanding of why other cultures consider mental illnesses in a different way. Race and ethnicity should not also be a hindrance to the more comprehensive understanding of mental illnesses across cultures.
As a conclusion, this study intends to promote a more comprehensive view on mental health, including a cultural orientation and perspective in understanding mental illnesses, not just subsuming them under the western broad concepts of, let say, depression, schizophrenia, among psychosis, among others. Cultural information should be explored and studies on this factor must be seriously considered because evidence point to their more effective treatment. Cultural dimensions help mental patients get treated and western practitioners should recognize this. It is best for them to critically reflect on their own medical practices and inquire into the cultural boundaries which they often ignore.
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