By: Cheryl Lu, Social Media Coordinator
On July 14, we celebrate Mad Pride Day, an observance and social movement established for self-determination and dignity of people who receive or have received psychiatric services.
Originally called Psychiatric Survivor Pride Day, the day and its movement were formed in the 1990s in recognition of the prejudice against patients and ex-patients, as well as the psychiatric abuse they experienced. The movement aims to raise awareness of mental health concerns, reclaim terms from misuse, inform and educate the public about mental illnesses, and discuss patients’ own experiences with the health care system.
Contradictory to physical health, a person’s mental well-being can often be affected by languages and cultural aspects, hence a proper response to these cultural and social contexts is sometimes the key to a patient’s treatment and recovery.
“It is all too easy to lose sight of the importance of culture until one leaves the country,” says the book Mental Health: Culture, Race, and Ethnicity published by the U.S. Public Health Service. In the book, the authors looked into the diverse effects of culture and society on mental health, mental illness, and mental health services provided in the U.S.
How culture affects mental health
Though the symptoms of mental disorders can be found worldwide, there are a few ways culture can impact the mental well-being of each cultural group differently. One of the most prominent differences is how patients selectively describe their symptoms in ways that they consider culturally acceptable. For example, studies show that patients from an Asian background tend to talk more about what they physically feel, such as dizziness, while not reporting emotional symptoms at all, despite acknowledging their existence.
Culture also affects how people perceive mental illnesses. According to the book, this includes the traditionally believed causation and cure, whether an illness is factual or imagined, the stigma around it, whether it can generate sympathy and the types or characters of people who might fall ill. These mental illness reasonings and their interpretation bring consequences and different reactions and help determine whether and how patients will seek help, as well as if they can receive support from people in their communities.
Sometimes, culture and social factors contribute to the cause of mental illnesses too, though their weight varies from one disorder to another. Take depression for an example, studies found that exposure to violence and poverty play “a greater role in the onset of major depression” compare to schizophrenia, which is heritable and distributed globally with a similar consistency. For illnesses like post-traumatic stress disorder (PTSD), cultural and social factors such as war, genocide, death and torture are almost direct causes; which explains why PTSD is particularly common among veterans, Indigenous people and immigrants from “countries in turmoil.”
While the overall rates of mental disorder for most minority groups in the U.S. are similar to Caucasians, the book also examined cultural influences on mental health within each of those minority demographics and have come up with some interesting findings. For example, when coping with personal mental health issues, Asian Americans prefer avoidance over outward expression, while African Americans are exactly the opposite with a tendency to take an active approach. Compare to Caucasians, African Americans are also more likely to handle distress on their own. When compared internationally, children in Thailand are two times more likely than American children to rely on “covert coping methods” such as “not talking back” than “overt coping methods” like “screaming,” due to the local Buddhist culture that encourages emotional restraint.
Apart from the presentation, interpretation, causation and coping styles of mental illnesses, culture also plays a part in a patient’s treatment, where a lot of miscommunications can take place. According to the book, minorities in the U.S. are less likely than Caucasians to seek mental health treatment. This under-representation in mental health services can in turn contribute to the lack of understanding and research. Some cultures see what is believed to be a problem in North America in a positive way (e.g. a spiritual experience), and some cultures tend to avoid adverse effects of drug usage and only take trust counselling. If these signals are ignored, a person might be misdiagnosed.
Another cultural aspect that hindered minorities from receiving proper treatment is mistrust of clinicians and health care providers. As cited in the book, this is often caused by historical persecution, racism, documented abuses, and stereotyping (African American patients have a high rate of being misdiagnosed with schizophrenia, while Asian Americans, commonly believed “problem-free,” are often overlooked). Immigrants and refugees from regions where people lost faith in the government are generally skeptical of public hospitals.
Culture, as a social factor, plays a critical role in a person’s mental wellbeing, attitude and treatment. The communication between patients and mental health service practitioners is a delicate matter that must be handled with care. As a social enterprise with professional language services specialized in the field of health care settings, we realise the importance of language and culture, and train our healthcare interpreters to handle these sensitive situations to provide a comfortable environment for patients in need.
Learn more about our Interpreter Training Program in Mental Health and Autism Settings
Learn more about our interpretation services
References:
https://www.ncbi.nlm.nih.gov/books/NBK44249/
http://www.torontomadpride.com/history/
https://www.vice.com/en/article/7bxqxa/mad-pride-remembering-the-uks-mental-health-pride-movement
https://www.uniteforsight.org/mental-health/module7
https://cmha.bc.ca/documents/cross-cultural-mental-health-and-substance-use-2/