What are the debates in mental health relating to culture?
If mental disorders are universal conditions or locally (culture and context) specific
What would disorders being universal implicate?
Biological causes
What would disorders being culturally specific implicate?
mental disorders are ways of describing or understanding ‘abnormal’ or undesirable behaviours in specific cultural contexts
What are the key elements of culture?
- social and shared
- beliefs, values, practises transmitted from one to another
- we all participate in culture
- fluid and ever changing
*Disparities in power
How does power impact culture? and how does it impact mental illness?
- disparities in power
- some groups and viewpoints have more dominance
- impact on how we understand mental illness
How does culture impact mental health?
- culture can be a social determinant
- can be a protective factor (ex: some black women = tendency to avoid self blame = shield)
- Help determine how we understand and respond to the experience of psychological distress
- How we respond to these types of thoughts and feelings
- Expression of mental distress
How is culture a social determinant?
- When behaviour and personality don’t fit well with culture, more likely to be deemed as having a disorder
- experiencing racism and discrimination = risk factors
- ethnic minorities = higher chance experiencing and diagnosed
How does culture impact our response to mental distress?
- what we perceive as unusual or problematic
- whether we think consulting a medical professional
- beliefs of mental distress = products of cultural context
What is somatization?
experiencing psychological symptoms through bodily pain/discomfort - may be more common in cultures where outward expression of emotionality and pain is discouraged
- mental illness is a way of performing mental distress in a way understandable to other members of cultural group?
What is category fallacy?
- the reification of one culture’s diagnostic categories and their application to people in another culture, where these categories lack coherence and their validity had not be established
Why are singular/universal systems ineffective?
Conceptualization of mental distress depends on cultural context
What is transcultural psychiatry?
anthropology + psychiatry to incorporate cultural understandings of illness into clinical practise
What is ethnocentrism?
Tendency to imagine one’s own culture as correct
What are critiques of psychiatry and its view of culture
- generalizations of non white cultural groups
- not meaningfully considered culture
- treats culture as an afterthought
** psychiatry is a set of cultural beliefs
What are critiques of western psychiatry?
- form of imperialism
- displaces local understandings of suffering
- dismisses other perspectives
Critiques of culture bound syndromes
- pathologizing/exoticizing non western expressions of mental distress
- implying DSM diagnostic categories exist independently of culture
- now called cultural syndromes, cultural idioms of distress, and cultural explanations or perceived cases. culture related diagnostic issues
What are cultural syndromes
co-occuring symptoms or abnormal behaviours in a specific (non-western) cultural group - similar to culture bound syndrome
What are cultural idioms of distress
ways of talking about suffering within a given cultural group without involving specific symptoms or syndromes
What are cultural explanations or perceived causes?
Describe causal reasons for a person’s psychological distress and abnormal behaviour that are culturally bound or specific
What are culture related diagnostic issues
- list cultural factors that might affect how clinicians form a diagnosis
What are the three key approaches characterizing the debate on whether mental illness is universal or culturally specific?
Absolutist, Universalist, Relativist
What is Absolutist and evidence
- mental disorders as being globally shared phenomena
- psychotic phenomena seem to be known by virtually all cultures around the world
What is Universalist and evidence?
- Mental illness globally consistent even if the content is heavily shaped by culture
- cultural conditions play role in shaping experience of mental illness (content of psychosis)
What is Relativist and evidence?
- perceptions of distress unique to each culture and diagnosis = culturally bound
- whether psychotic phenomena are signs of illness depends on social context
