How Mental Health is Perceived Across Cultures 

Culture is beautiful, it is also diverse within family levels, friends, communities, and a whole societal level. Culture plays an important role in mental health; practitioners must understand how culture can influence one’s understanding of the psychological state.

This study is on cultural manifestations of stigma and how they influence one’s view about mental health. A stigma is a blemish, a mark, or a feeling of strong disapproval an individual or society can have about something.

Stigma towards individuals with mental health issues can be a debilitating influence that prevents them from seeking the appropriate help needed. Each culture has its own view on how it sees mental health.

Mental Health Stigma in Different Cultures

Asia:
In most pan-Asian countries, mental health issues are seen as a weakness and lack of self-control. Self-control is a value many Asian cultures uphold highly and the lack of it to them will bring shame to the family. A study conducted on mental health help-seeking attitudes from more than 19 Asian ethnicities living in the U.S. has shown that
having greater adherence to emotional self-control resulted in less positive attitudes. However, greater ethnic identity affirmation (how one feels either positive or negative about their ethnic background) was correlated with a more positive attitude towards seeking mental help. It seems that shamefulness can be a stigma against seeking help, but having a strong sense of belonging can aid in seeking help.

Africa:                                                                                                                                                                                                                                                                 Many African cultures connect mental illness with spiritual causes. African spirituality emphasises the development of one’s physical, psychological, social, economic, and spiritual well-being to become fully human. For instance, in Nigeria, any mental health issues are regarded as divine punishments. Individuals with mental health issues are stigmatised and treated unfavourably by the community. The stigma discourages these individuals from seeking the correct support.

Middle East:
Most countries of Middle Eastern cultures view mental health issues as a form of physical illness or divine punishment. Shame, gender role expectations, and the lack of knowledge about mental health are all contributing factors to stigmatisation in these communities, and some families are pushed to the side if any of them have mental health issues. A study on Jordanian adolescents has shown that mental health treatments did not worsen stigmatisation by the public or families. Rather, strong support and education on mental illnesses can be a major factor that drives out the fear of seeking mental help

Western:
Stigma in Western cultures stems from fear and misconception about mental health issues. For instance, a survey conducted in Australia in 2011 showed that the general population believed that some mental health issues were a problem of personal weakness and some other issues, especially phobias, were ‘not a real medical illness’ While mental health issue is recognised as a health issue in many Western societies, discrimination such as gender role expectations, workplace stigma, and self-stigmatisation continue.

Integrating Cross-Cultural Approaches for Practitioners
As shown, stigma can manifest at various levels, from individual levels, family, society, religious groups, and even from healthcare providers. If stigma may seem so rampant at multiple levels, how can we as practitioners begin to improve mental health for individuals or societies?

One way is to elevate cultural competency and educate yourself further with evidence-based approaches. Competency refers to having the awareness, knowledge, and skills to function effectively and appropriately. Cultural competency hence refers to functioning effectively and appropriately in culturally diverse situations. Training can be held for practitioners to be more educated on diverse cultures.

However, practitioners may need to move beyond cultural competency and seek partnerships with community-based mental health services. Cultural competency can be quite static or may require training when facing the constantly fluctuating nature of culture. Partnerships with local cultural communities may create a synergetic environment and a more effective mental health system that can be welcoming and stigma-reducing for individuals with mental health illnesses.

Takeaway
A cross-cultural perspective on mental health can be an ever-challenging endeavour in attempting to understand and provide better mental health care for those in need. In current times of growth, it is becoming easier to see the similarities and differences between cultures. Educating and speaking about mental health issues will help others see mental health not as some weakness, curse, or anything. By reading this blog you are taking the steps of curiosity to start paving the way for providing a culturally diverse practice within the mental health service.

Written by Matthew Jung

Sources:

Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care.

Elshamy, F., Hamadeh, A., Billings, J., & Alyafei, A. (2023). Mental illness and help-seeking behaviours among Middle Eastern cultures: A systematic review and meta-synthesis of qualitative data. 

Eyllon, M., Vallas, S. P., Dennerlein, J. T., Garverich, S., Weinstein, D., Owens, K., & Lincoln, A. K. (2020). Mental Health Stigma and Wellbeing.

Gearing, R. E., Brewer, K. B., Schwalbe, C. S. J., MacKenzie, M. J., & Ibrahim, R. W. (2013). Stigma and Adolescents With Psychosis in the Middle East: Implications for Engaging in Mental Health Treatment. The Journal of Nervous and Mental Disease.

Gureje, O., Lasebikan, V. O., Ephraim-Oluwanuga, O., Olley, B. O., & Kola, L. (2005). Community study of knowledge of and attitude to mental illness in Nigeria. British journal of psychiatry.

Hwang, W.-c. (2016). Chapter 3 – Understanding Cultural Influences on Mental Health. In W.-c. Hwang (Ed.), Culturally Adapting Psychotherapy for Asian Heritage Populations (pp. 41-66)

Leiderman, E. A., Vazquez, G., Berizzo, C., Bonifacio, A., Bruscoli, N., Capria, J. I., Ehrenhaus, B., Guerrero, M., Guerrero, M., Lolich, M., & Milev, R. (2011). Public knowledge, beliefs and attitudes towards patients with schizophrenia