By: Cheryl Lu, Social Media Coordinator
A few days ago, I came across a YouTube comedy video by Dawn Wong, a Chinese comedian. This video humorously contrasted how white and Asian people react and behave when receiving a traditional Western-style mental health therapy with an English-speaking therapist. The video, taking an exaggerated style, portrayed the white patient as being outspoken and sensitive with their childhood traumas, and the Asian patient with bland facial expressions and numbness to various types of abuse she was not aware of.
I burst into laughter. The portrayal of Asian family dynamic, though exaggerative, was somewhat accurate, hilarious and definitely something I could resonate with. While amusing, it touched on some real and relatable cultural nuances. Then I saw the comment section. One of the top comments read “I was laughing, but suddenly I just burst into tears.” I realized that comedy aside, the issue this video exposed might be more serious than it appears.
Comments under Dawn Wong’s video
Comments under Dawn Wong’s video
Comments under Dawn Wong’s video
After some digging, I found that the video, originally posted on the comedian’s Chinese social media account, generated even more empathy from her viewers in China. The audience resonated with it so much that the video received over 230,000 shares and 180,000 likes.
This got me thinking: how does culture impact our mental health? Or, if we were to rephrase the question and delve deeper, how exactly does culture impact our behaviour during mental health therapy and the result of the mental health care that we receive?
When addressing mental health and overall well-being, there has been considerable discussion about the accessibility of mental health therapies and services for ethnic minorities who speak a language other than English and French. Even when accessible, the care these individuals receive often differs in quality and effectiveness from those from traditional Western backgrounds.
The failure of therapies
I then did some simple online search. Astonishingly, I found countless articles, news pieces and academic papers on how mental health therapies often fail patients from Asian, Black, Hispanic, Arabic and Indigenous backgrounds. Even when accessibility is ruled out, these failures can still be caused by various reasons, including cultural bias, distrust, reluctance to approach, not feeling understood, cultural concepts clashing with mainstream values inherent to traditional psychotherapies, and many more. Most of these issues, directly or indirectly, are attributed to a lack of cultural competence.
Why cultural competence matters
How, exactly, can cultural competence impact the quality of a therapy session? First of all, as the comedy video has shown, the same questions and tactics that doctors use to provoke patients’ thinking can lead to very different reactions. Without understanding cultural differences, this might lead to misjudgment of a patient’s true condition. Patients from different backgrounds would also interpret a question, or the keywords in a question, differently. A personality trait that’s considered undesirable in North America might be considered the norm or even ideal elsewhere. Identifying an emotion, and the words that are used to name the emotion can also vary in different cultures. For example, in a simple question “When was the last time your father disappointed you,” the word “disappoint” can be interpreted as letting down, causing sadness, causing anger or causing embarrassment, which are entirely different emotions and would need to be treated differently. In some cultures, it is even forbidden for a parent to be deemed disappointing to a child, and this may be the patient’s first encounter with such an expression that folks from Western cultures are so familiar with. Furthermore, talking, the process of therapy itself, which is considered a solution and a means to let out in North American cultures, might be deemed worthless in others because it does not result in “things getting done.” These differences, with no doubt, will lead to very different results.
Ways to tackle
One way to combat this issue is to advocate for cultural competence in mental health care. More often than not, these failures weren’t caused because the doctors are less knowledgeable in their professional field, but because of their lack of understanding of cultural differences, and the trauma and mindset that they lead to. Incorporating professional language services can also help to an extent. Though interpreters are not expected to act as culture experts, they do help the conversations to run smoother, especially when patients experience difficulties finding an equivalent word to describe their feelings in English or French. Some expressions and idioms that are used to describe a serious issue in one language can sound lightweight or even ridiculous in another; and some that are used for less important matters, if translated word-for-word, can sound lethal. Medical interpreters are professionally trained to deal with these situations, and they also are experts in identifying regional metaphoric expressions, ambiguously gendered pronouns and adjectives that carry gender, age or other connotations, which patients with trauma often gravitate towards.
In conclusion, advocating for cultural competence in mental health care emerges as a pivotal solution to bridge the existing gaps. It goes beyond linguistic considerations, encompassing a deeper understanding of cultural values, norms, and expressions. Additionally, the integration of professional language services, while not replacing cultural expertise, can serve as a valuable tool in facilitating smoother communication. By acknowledging and addressing these cultural intricacies, mental health professionals can work towards providing more equitable and effective care and take a significant stride towards creating a mental health landscape that is truly inclusive and responsive to the diverse needs of individuals from all cultural backgrounds.
To learn about MCIS’ interpretation services: https://www.mcislanguages.com/interpretation/
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