Mental health articles

OF mental health care and mentally ill

Mental illness in different cultures

There are many ways in which culture can influence mental health issues.

• What is a mental illness? Concepts about what a mental illness is differ from one culture to another. The group of disorders most often associated with mental illness is the severe mentaldisorders, such as schizophrenia and mania. The commonest mental health problems in generalor community health care are the common mental disorders (depression and anxiety) and problems associated with alcohol and drug dependence. These disorders are rarely viewed as being mental illnesses. Although you should be aware of these mental illnesses, you need not add to the sufferer’s problems by using labels with a potential stigma attached to them. Instead,you can use locally appropriate words to describe stress or emotional upset as a way ofcommunicating the diagnosis.

• Words used to describe emotional distress. The descriptions of human emotions and illness are noteasy to translate into different languages. Consider the word ‘depression’. This word meanssadness and is used to describe both a feeling (‘I feel depressed’) and an illness (‘the patient is suffering from depression’). In many languages, however, while there are words to describe the feeling of sadness, there are no words that describe depression as an illness. Thus, it isimportant to try to understand the words in the local language that best describe depression as a feeling and as an illness. Sometimes, different words may be found for these two meanings.

Sometimes, a phrase or series of words will need to be used to convey the meaning of depression as an illness. The Glossary in this manual provides the words in English to describe various mental health problems and symptoms. Space is provided next to each word and its meaning for readers to write down the term in their local language.

• Beliefs about witchcraft and evil spirits. People in many societies feel that their illness has been caused by witchcraft or evil spirits or is the result of some supernatural cause. There is little to gain from challenging such views (which are often shared by the community). Such an approach will only make the person feel uncomfortable. Instead, it would be better to understand these beliefs and explain the medical theory in simple language.

• Priests, prophets and psychiatrists: what do people do when in distress? Sick people seek help from a variety of alternative, religious and traditional health care providers. Examples include:

homoeopathy, Ayurveda, traditional Chinese medicine, spiritual healers, shamans, priests,pastors and prophets. This is for several reasons. First, medical health care does not have the answers for all health problems, and this is especially true for mental illness. Second, many persons associate their emotional upset with spiritual or social factors and thus seek help from non-medical persons. Traditional treatment may help some people get better quicker than would medical treatments.

• Counselling people with mental health problems. In many Western societies, counselling to helppeople with emotional problems is based on psychological theories which have evolved fromwithin their cultures. These theories are foreign to the cultural beliefs in many non-Western cultures. This does not mean that counselling therapies will not be useful in these cultures.You will need to search for resources and methods that have evolved in your own culture because these are likely to prove more acceptable. Only a simple form of counselling that can be applied in most cultures is described in this manual.

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