Culture, relativism and the expression of mental distress: South Asian women in Britain (original) (raw)
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Cultural experience of depression among white Britons in London
Anthropology & Medicine, 2001
Cultural pluralism that characterises many major urban centres, especially London, underscores needs for research in cultural psychiatry to identify distinctive needs for mental health services and clinical treatment. Such questions motivated development of this study of the cultural experience and meaning of depression amongst white Britons in London, involving development of a British EMIC interview for depression by adapting an earlier version of the EMIC used in Bangalore, India. Steps in the process involved historical and ethnographic study of depression, and extensive pilot testing. This report focuses on the experience of depression with reference to patterns of distress and its meaning with reference to perceived causes. A wide range of contradictory, overlapping and linked explanations, consistent with reports from previous studies of Indian and other non-Western cultures, were notable among white Britons, whose illness concepts are likely to appear as diverse and inconsistent to an outside observer as ndings from research in South Asia may be for a Western medical anthropologist. Furthermore, somatic idioms of depression, although not spontaneously reported, were frequently reported when speci cally probed, raising questions about the distinctiveness of depressive and somatoform disorders as discrete diagnostic headings. The range of perceived causes are reviewed, considering the relationship between coded categories and narrative accounts that specify the interrelationship of categories in a causal web. The discussion considers the utility of the EMIC for cultural study and re ections on methodological issues arising in its adaptation and use that may help other researchers wishing to apply the framework and use the tools of cultural epidemiology.
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Benson and Thistlethwaite are general practitioners who have written an introductory yet thorough practical guide on mental health to assist all health professionals working in multicultural contexts. While some book introductions (Chapter 1) can be quite tedious, theirs is quite fascinating as it provides some examples of their personal and professional cross cultural experience with refugees at a South Australian migrant service, Aboriginals at the Yalata community, Nepalese people in Dharan Eastern Napal and patients in Yorkshire England. The reason for, and their concern about, writing the book is implicit but clear: 'The World Health Organization has predicted that by the year 2020 depression will be the second leading cause of disability-adjusted life years (DALYS) for all ages and sexes. It (depression) is already one of the most common causes of disability in the world' (World Health Organization 2008, p. 11).
Culture and mental health of women in South-East Asia
World psychiatry : official journal of the World Psychiatric Association (WPA), 2006
This article reviews the impact of cultural factors on mental health of South Asian women. Marked gender discrimination in South Asia has led to second class status of women in society. Their mobility, work, self-esteem and self-image, in fact their worth and identity, seem to depend upon the male members of a patriarchal society. Women's lack of empowerment and both financial and emotional dependence have restricted their self-expression and choices in life. This, along with family, social and work pressures, has a definite impact on women's mental health.
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The term ‘‘cultural concepts of distress’’ (CCD) was introduced in DSM-5 to better characterize the broad set of constructs identified in clinical and ethnographic research on cultural variations in distress. The contributions to this issue of Transcultural Psychiatry on cultural concepts of distress show how much work on this topic has evolved and equally what remains to be done. In this Commentary, we take stock of the current state of the field and outline some future directions for research and clinical application.
Culture and Mental Health: Sociocultural Influences, Theory, and Practice
International Journal of Health Care Quality Assurance, 2009
Culture and Mental Health takes a critical look at the research pertaining to common psychological disorders, examining how mental health can be studied from and vary according to different cultural perspectives. Introduces students to the main topics and issues in the area of mental health q using culture as the focus Emphasizes issues that pertain to conceptualization, perception, health-seeking q behaviors, assessment, diagnosis, and treatment in the context of cultural variations Reviews and actively encourages the reader to consider issues related to q reliability, validity and standardization of commonly used psychological assessment instruments among different cultural groups Highlights the widely used DSM-IV-TR categorization of culture-bound q syndromes Download Culture and Mental Health: Sociocultural Influence ...pdf
A comparison of the illness perceptions of North Indian and white British women
Journal of Mental Health, 2013
Background: Treatment seeking by South Asians for depression has been shown to be lower than for white British people. Aims: This study compared illness perceptions about depression and the help-seeking behaviour of white British (n = 70) and North Indian women (n = 70) living in the UK. Previous studies have used interviews to elicit illness perceptions but have been time-consuming. The shorter Brief Illness Perception Questionnaire (BIPQ) was used instead. Method: A cross-sectional survey design was used. Participants were asked to evaluate problems of a vignette character using the BIPQ. Results: Compared with the British group, Indian participants believed treatment would be less beneficial; felt they had less of an understanding of the character's difficulties and that the character's difficulties had less of an effect on her emotionally. Significantly fewer of the Indian sample suggested the character should go to her general practitioner (GP). Consistent with previous findings, Indian women reported themselves to be feeling more distressed when compared with British women. No differences in perceived causes of the vignette character's difficulties were found between the groups which is slightly discrepant with previous studies. Conclusions: Ethnic differences were found in illness perceptions which could help explain the lower rate of GP consultation amongst Indian women.
Mental health in primary care: ways of working the impact of culture
This article reviews the literature to bring together aspects of culture and its impact on ways of working in mental health in primary care. It describes a case from primary care that demonstrates the complexity of developing cross-cultural formulations. It argues that if comprehensive and effective management of cross-cultural patients is to take place in general practice, primary care clinicians should take into account the cultural experience of the patient they are managing, including their social situation. Such patients often present with multiple somatic complaints. In order to provide holistic care it recommends the use of a tetra-axial diagnostic classification and culturally sensitive questioning through professional interpreters as necessary.
Culture and mental health: Towards cultural competence in mental health delivery
2019
The purpose of this paper is to highlight the role of culture in the conceptualization of mental illness and the phenomenology of mental illness across cultures. Mental health professionals are increasingly dealing with a multicultural patient population and there is an urgent need for awareness of the influence of culture in understanding patient’s expression of distress, assigning symptoms to a diagnostic category and planning treatment in culturally appropriate ways. Cultural bias can lead to misdiagnosis and have devastating consequences on patients. This paper highlights the need for cultural competency in mental health service delivery and outlines ways mental health professionals can think about the issue of culture in their practice. Journal of Health and Social Sciences 2020; 5,1:023-034 The Italian Journal for Interdisciplinary Health and Social Development