Regardless of whether people are aware of it or not, cultural background plays a critical role within the world of mental health. In fact, nearly every classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a section detailing any factors of culture in the process of diagnosis or treatment. The risk of onset, clinical expression and overall severity of various illnesses may differ across cultural groups due to the traditions and other influences that are reinforced over generations. Doctors and mental health professionals alike should be aware of an individual’s background during evaluations, as certain aspects unique to one’s customs may mask a symptom. For example, panic attacks in the case of post-traumatic stress disorder (PTSD) may go overlooked among Cambodians and Latin Americans because there is a commonly assumed association of traumatic exposure with panic-like khyal attacks (Hinton, DE., June 2010) and ataque de nervios.
Culture, race and ethnicity are immeasurably tethered to the economic disparity, social tension and full-blown intolerance that are translated into inconsistent health care. In some cases, cultural, ethnic and racial associations can empower individuals and add a level of group support that makes them more resilient. On the other hand, they may also lead to mental and interpersonal conflict as well as difficulties in overall survival within contemporary society. For example, multiple studies have observed the health seeking behaviors of linguistically diverse groups and found that members of these cultures showed a significant avoidance or refusal of accepting hospital and other mental health services (Minas et. al. 1996, McDonald & Steel 1997). The reasons behind this general reluctance have been attributed to the barriers of communication and understanding in regards to treatment that may be offensive to certain traditions and what effective care consists of. Furthermore, a heightened value may be placed on spirituality in certain communities, which can directly conflict with a range of medicinal practices.
Although a controversial and heavily debated topic, the concept of culturally specific conditions also highlights the importance of a person’s background. Many cultures have given particular names to certain sets of symptomatic behaviors and displays. However, evidence over accumulative studies better supports the idea that these seemingly specific disorders are actually manifestations of universal human psychopathology. Cultures simply have a shaping and modifying relationship with these disorders and are not the root causes of them in any way (Simons 1996).
There is also the situation where someone’s cultural background can be overly emphasized as a contributor to a particular disorder. For instance, research has uncovered that African-American populations are disproportionately diagnosed with more severe mental conditions. These uneven findings range from disruptive behavior disorders, psychotic and mood disorders and even schizophrenia depending on what types of symptoms were compared (Feisthamel & Schwartz 2009, Baker & Bell 1999, Flaskerud & Hu 1992).
Overall, the compiled discoveries and results of these evaluations detail how intertwined culture is with mental health. More importantly, the research has large implications for future diagnostic and treatment practices. Clinicians and mental health professionals of all different disciplines need to employ cultural awareness while also making sure to view the person with a full and comprehensive perspective. Managing this imperative balance is one of the many needed factors in a competent and skilled practitioner.
Navigating through the distinctive contexts of multiple cultures requires an ample amount of awareness, knowledge and skills (Gabb 2000). The bond between the health care provider and the client is the cornerstone of a successful healing process. Through this supportive, interdependent connection, caregivers can allow their visitors to comprehend the wide range of incidents and experiences that impact their well-being, from torture and trauma to displacement and loss. For the demographics of diverse backgrounds, working with interpreters and being aware of verbal and nonverbal communication differences is at the utmost significance. As these experts and professionals are major guides in one’s path to recovery, they must also be educated and trained in the needs of anyone who might ask for help.
For further information about comprehensive diagnosis and other factors that contribute to an individual’s mental disorder, please contact the California Dual Diagnosis Helpline online to chat with one of our online representatives or call us at 855-980-1736.