Cultural Issues in Psychopathology
By: Kimberly Swanson, M.S. - Psychology, CNA
In todays’ society,
there is stigma or negative connotation when it comes to seeking and receiving
mental or psychological services. Often
times, these negative point of views towards mental health stems from cultural
beliefs. It is apparent that cultural
issues are attributed to depression and cultural issues and is also a major
factor to the treatment of depression.
Understanding Culture and Mental Illness
The beginning
stages of incorporating culture into clinical psychological research started with
Kleinman (1977). Kleinman (1977) believed that culture is the basis of human
behavior especially when it comes to “mood disorders”. Fields (2010) states that, clinicians need to
be understanding and mindful of patients’ culture while treating them. There are two points of views, when it comes
to culture and depression (Fields, 2010).
The two points of views are: 1.
“universal views” – It applies to all cultural lines and can be measured with
proven evidence; 2. “cultural-bound”
views - is based on a specific culture and cannot be measure (Field, 2010).
In Field’s (2010)
research, it shows the current views on “multicultural competence, the American
Psychological Association (APA) Multicultural Guidelines” which points out the different
cultural views on mental health and the “cross-cultural validation of
depression”. According to Fields (2010),
cultural definition and “interaction” is constantly changing and evolving.
Identifying
culture as an intricate part of in the care of mental patients is a new phenomenon
that is taking place within psychological research (Fields, 2010). The purpose of incorporating culture into
psychological research is to address the complex issues that are often found
when working with a diverse population (Fields, 2010).
Examples of Culture
Issues & Depression
Asian Pacific Views on Depression
In the MyPsychLab
(2013), “Martha: Major Depressive Disorder” video, it discusses how depression
is viewed from an Asian Pacific patient name Martha. Martha suffered from depression due to a
failed marriage. At first, Martha did
not seek treatment because of her cultural issues. Nira
Singh (Director of children youth and family outpatient services of RAMS Mental
Health Agency) mentions that, “there is a stigma for most Asian Pacific clients
who utilize the services”. Getting
medical help is seen as more important than getting psychological assistance (MyPsychLab,
2013). Traditional families of Asian
Pacific Islanders may see treatments as shameful depending on their view on
mental health (MyPsychLab, 2013).
Nira Singh
mentions that, “often times that patients do not know that these services are
available to them and is available in their native language” (MyPsychLab, 2013). In the video, Singh also states that: “as
model minorities, you are not suppose to have mental problems…There is a feeling
of shame when acknowledging a weakness” (MyPsychLab, 2013). More outreach is needed in educating the
public on depression and how it affects people’s lives.
Bosnian Views on Depression
In Fields’ (2010)
research, there were many examples on how different cultures view
depression. One example is a case, “The
Case of G,” about a Bosnian refugee who suffered from the posttraumatic stress
disorder (PTSD). The patients’ PTSD was
triggered by war and “the tragic losses” that he had to face in “his home
country”. G did not have to a psychologist or therapist in Bosnia because of
negative cultural views. The patient
views himself as a “traditional man” and in his country, seeing a therapist
often times means that you are “crazy” (Fields, 2010). He was concerned about being viewed as crazy
by others. For the Bosnian refugee, not
being able to speak English was also a perceived barrier. Having this perceived language barrier makes
the patient of a different culture feel “inadequate” (Fields, 2010).
In G’s case, there
was a need for social interactions.
According to Fields (2010), the patient’s plan of care was mostly geared
for “cultural dynamics” instead of starting an initial “treatment plan”. Once G received the support of getting more
social interactions with peers with similar cultures and backgrounds, G’s
condition greatly improved (Fields, 2010).
How Cultural Issues Affects Treatments for
Depression
The American
health care system is fragmented. These
fragmentations makes is extremely difficult for patients to receive the proper
treatment for depression. Doctors,
mental “health professionals”, “patients”, and “families” face the dilemma
of a divisive system that separates the “medical
and mental health” in its treatment options and line of care (Heinrich, 2000). By bridging and incorporating the medical with
the psychological, there would be a more balanced and improved system of care
for mental health patients, especially those who are suffering from depression
(Heinrich, 2000).
Overcoming
perceived cultural differences in patients when it comes to their line of care
is also extremely important. Clinicians
must be able to understand their client’s culture in order to provide the
patients with the best treatment options for depression. Each case for depression is different and
must be treated as so. Getting into the
mind of the patient and seeing from their point of view enables the mental
health professional to better serve their clients. Clinical research and case studies like
Fielding, (2010) and Heinrich (2000) has shown that understanding a patient’s culture means
getting to the root of the problem. This ideology of culture is paving the way for a more positive solution for patient care and for improving their
overall mental health.
References
Fields, A.J. (2010). Multicultural research and practice: Theoretical issues and maximizing cultural
Exchange. Professional
Psychology: Research and Practice, 41(3). 196-201.
Doi:10.1037/a0017938.
Heinrich, R.L. (2000). Improving depression care: Disseminating skills or changing
organizational
structure and
culture? Families, Systems, & Health.
18(4).
Kleinman, A.M. (1977). Depression, somatization and the “new
cross-cultural psychiatry.”
MyPsychLab, Pearson Video Series . (2013).
Speaking Out: The DSM in Context:
Martha:
Major Depressive Disorder [on-line video]. Available from
www.pearsonmylabandmastering.com.
Copyright in 2015 by ©Messenger Publishing, Inc.
Copyright in 2015 by ©Messenger Publishing, Inc.
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