“…mental health and culture have a complex relationship, and as such, it is necessary to remain mindful of the implications that come with this reality…”
Author: Arpana Wadhwani
Mental health is a subject that has become increasingly prevalent in the lives of the general populace. With the unprecedented challenges that have risen due to the ongoing COVID-19 pandemic, it is of utmost importance to ensure that children, teens, adults and seniors alike take the time to care for not only their physical wellbeing, but their psychological and emotional wellbeing as well. However, as essential as this is, it is evident that this belief does not hold true across all households — cultural backgrounds may be a contributing reason as to why. For the purposes of this article, let’s define culture within an ethnic context wherein religion, race and traditions are grouped to form a specific, distinct identity [1].
People of certain cultural backgrounds tend to justify their emotional and psychological symptoms with the necessary somatic (physical) indicators, as it helps them to make their conditions and circumstances more relevant in their own eyes [2]. Studies show that Asian patients have a tendency to only report physical manifestations of illness, delving into the emotional facets only when inquired specifically [3]. The same persisted particularly across Indian health systems, as those seeking treatment primarily discussed somatic symptoms with their physicians. This presents a stark contrast to the United States, where cognitive symptoms were more often reported [1].
It is important to understand that culture plays an integral role in the perception of mental health and associated symptoms [2]. The existence of mental illnesses and their importance is tied to the cultural belief regarding the tangibility of the illness whether they hold the idea that the illness is primarily somatic, or if they view mental illnesses and emotional or psychological symptoms as imagined [1]. Moreover, culture has been identified as influential in the perception of problems, what issues may constitute a problem, and the potential resolutions [1]. Thus, this would in turn determine the level of treatment sought for their conditions, alongside the severity of their symptoms.
As the intersectionality between mental health and cultural backgrounds becomes apparent, it is crucial to consider the persisting differences across these cultures; varying beliefs about the origins and implications of emotional or psychological distress impact the method of resolution that people may adhere to [1]. In fact, this may influence whether individuals or families choose to seek medical treatment and healthcare practices, or if they choose other routes of treatment [1]. For instance, in certain cultures the cause of a disease may be perceived as involving outworldly spirits, and thus the individuals or groups may turn to traditional healing processes and healers instead of allopathic medicine [1]. In these cases, religion and spirituality play a key role in the diagnosis of the mental illness and the adopted solution, as seen through the implementation of Indian Healing Temples, astrologers, and the like [1]. Mental health may also be seen as the consequence of karma and the totality of one’s actions, as depicted in India’s traditional healing system [1].
It is evident that in varying cultures, mental health and psychological conditions are associated with external and sometimes intangible factors. With this in mind, culture plays a significant influence on the perception of mental health within a group of people, and consequently determines the course of action taken. This further renders it important for healthcare professionals utilizing ‘Western medicine’ to identify and consider the cultural backgrounds of their patients, in order to understand the reasoning behind their presented symptoms. This also implies that outside of physical and cognitive indicators, it is of utmost significance for physicians to account for external influences when monitoring the behaviours of their patients. As such, physicians and other healthcare workers may benefit from cultural sensitivity workshops and education.
Inherently, mental health and culture have a complex relationship, and as such, it is necessary to remain mindful of the implications that come with this reality. One must understand that psychological and emotional wellbeing, along with the awareness of one’s condition is reliant on their cultural background and practices. With this in mind, it is essential for healthcare systems to consider the differing beliefs that perpetuate certain mental health treatment. It is imperative to make healthcare truly universal, by taking diverse backgrounds into account.
Editors
Alison McPhee, Rhea Verma, Rushil Dua, Mouayad Masalkhi
Designers
Majd Al-Aarg
Additional Credits
Header Image by José Martín Ramírez Carrasco on Unsplash
References
Gopalkrishnan N. Cultural diversity and mental health; considerations for policy and practice. Frontiers in Public Health. [Internet]. 2018 Jul 19 [cited 2020 Aug 28];6(179):1-7. Available from: doi:10.3389/fpubh.2018.00179
Office of the Surgeon General, Center for Mental Health Services, National Institute of Mental Health. Mental health: culture, race, and ethnicity: a supplement to mental health: a report of the surgeon general [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration; 2001. Chapter 2, Culture counts: the influence of culture and society on mental health [cited 2020 Aug 28]. p. 23-42. Available from: https://www.ncbi.nlm.nih.gov/books/NBK44249/
Andrade S [Internet]. Berkeley (CA): Berkeley Public Health; 2019. Cultural influences on mental health. 2017 Apr 16 [cited 2020 Aug 28]. Available: https://pha.berkeley.edu/2017/04/16/cultural-influences-on-mental-health/