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Sociological and Cultural Issues in Mental Illness
suggestion is that a person has certain ways of relating to their environment because of how successful these things have been on reproductive capacity and survival in general.
The humanistic perspective was developed by Abraham Maslow and Carl Rogers in the 1950s. It looks at issues like motivation in how people think and behave. One concept is self-actualization or the ability to grow and change to reach one’s maximal potential. The idea is that people are naturally driven to do this. Out of humanism came positive psychology, which emphasizes achieving happiness and better health through making positive changes in one’s life.
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SOCIOLOGICAL AND CULTURAL ISSUES IN MENTAL ILLNESS
Culture and society have a strong influence on a person’s mental health, the onset of mental illness, and access to mental health services. Culture is what underlies certain culture-bound syndromes, which are mental disorders seen more commonly in some cultures than in others. Culture determines whether or not a person decides to seek help for their mental symptoms. Coping strategies vary from culture to culture and even the meaning of one’s symptoms varies with cultural biases. The clinician’s culture also plays a role in the delivery of mental health services.
A culture is a group of people with shared belief systems, norms of behavior, and values. A culture can be based on religious beliefs, common backgrounds, race, or the occupation of the group. Language also determines what culture a person belongs to. Culture shapes mental health in general so you will see patterns of health and disease in certain cultures but not in others.
Let’s look first at the patient’s culture. There is a strong influence of culture on the mental health consumer, with influences on mental illness definitions and how healthcare is utilized when it comes to mental illnesses. There are symptoms of mental illness in all parts of the world. Certain disorders are universal, such as schizophrenia, bipolar disorder, depression, panic disorder, and obsessive compulsive disorder. There are many culture-bound diseases that may simply be variations on existing mental disorders. Somatization varies greatly from culture to culture.
Not all cultures are the same when it comes to the meaning of mental illnesses and make sense of them in different ways. There are differences in how cultures see the origin and prevalence of mental illness. Some feel a more biological approach is causative of mental illness, while others look at psychodynamic causation. Some disorders have a similar prevalence across cultures, while others do not. Depression is particularly seen as having different causes, depending on one’s cultural background. PTSD is common in the world as well but its causes are different, depending on one’s culture. The rates of suicide are very different depending on the cultural environment. Different ethnic backgrounds within the US Have differences in their suicide rates.
Family issues and the way a family influences mental health vary across cultures. The family can be protective against or causative of mental illness. If the family is supportive, this will be protective against mental illness. Families with abuse, neglect, poverty, or marital discord tend to promote a higher rate of mental disorders later in life and can contribute to a higher rate of suicide. The importance of family on the raising of children differs among cultures, which can influence the range and type of mental diseases seen in the culture.
Culture determines one’s coping styles. Certain Asian cultures, as an example, will avoid negative thoughts rather than dwelling on them and do not express negative thinking as much as other cultures. African Americans, on the other hand, are more active in handling emotional issues rather than just avoiding them. They tend to handle distress by themselves compared to Caucasians and have a greater emphasis on spirituality as a coping strategy.
Certain races and ethnic backgrounds in the US will be less likely to seek help for their mental symptoms and do not trust mental health providers as much. There is often a delay in seeking treatment until the symptoms are very severe. There is less of an emphasis in some cultures to use psychologists or psychiatrists, instead preferring primary care providers, traditional healers, or spiritual guidance as ways of receiving mental health services. There is often a preference toward seeing a therapist of the same ethnic background or race.
Mistrust is a big barrier to seeking help for mental disorders in certain ethnic groups. Some fear hospitalization or stigmatization so they will not seek care voluntarily unless they are very sick. Some of the issues of trust are generational and others are based on discrimination and racism in general. Lack of trust in institutions also plays a role. Stigma is not necessarily purely a cultural issue but it is influenced by culture. Immigration to a new country is stressful and related to the onset of many stress-related mental disorders. Immigration-related mental diseases are worse in the first three years of the time of moving to a new culture.
Other issues that result in cultural influences on mental illness is the effect on overall physical health on mental health. Minorities in the US have more common diseases, shorter lifespans, and greater stress placed on them because of their physical infirmities. Somatic symptoms are more difficult to interpret when a person has a higher risk for physical diseases in the first place.
The culture of the clinician is also important in mental illness treatment. Most providers in the US have a Western approach to mental disorders just as they have in relation to physical disorders. Even as there is an emphasis on biology, social issues have crept into the western understanding of mental disorders. Lifestyle and its effect on wellness is well understood. Talk therapy is a big part of western-based psychological diseases as is biological treatment with medications. If a clinician’s culture is very different from the patients, this will impact the care the person receives. Clinicians who stereotype will have difficulty accurately seeing the origins of their patient’s symptoms and good ways of treating them.
