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Ruth
DeSouza » Mental Health » Culture
and mental health
Culture and Mental Health
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Emil Kraepelin (1904) had difficulty diagnosing some people as they didn’t express their illness in the same way as his clients in Northern Europe and suggested a new speciality called comparative psychiatry. Other terms have been developed such as transcultural, ethno-psychiatry and culture and mental health. Cultural factors are critically important in psychiatry/mental health because they are a major determinant of onset, expression, course, and outcome of mental disorders. Sloan (1996) talks about individualism and scientism arguing that one billion of the worlds population is North American and European out of six billion, but the former nations dominate politically, economically and culturally (on mental health theory and practises) and thus an individualistic persdpective has dominated, assuming that problems reside in individuals and everything can be quantified or empirically obtained. Increasingly, postmodern views are gaining recognition that recognise that importance of social context e.g. poverty in the expression and aetiology of psychopathology. Emphasis is growing on qualitative research, ecological perspectives (Individual and societal mental health are linked) and the view that the individual represents the struggles in the cultural environment.
Maori mental health
Migration and Mental Health links
Migration is not only a geographical transition, it is also a psycho-social transition and can result in a "cultural bereavement", grief not only for the country left behind, but also for the culture or subculture into which one is born. Being a migrant and a daughter, grand-daughter and great-grandadaughter of migrants, I have always had a great interest in migration. All too often migrants focus on the positive aspects of migration without realising the losses and changes that can occur. Sometimes migration can lead to wonderful new possibilities, a new and better life, but sometimes it can lead to huge stresses and mental, emotional and physical health difficulties. Psychological aspects of migration include the dual task of resolving grief over losses and of mastering resettlement conditions. Dislocation and displacement can also be a part of the experience. Immigration has been linked to increased psychosocial distress and physical ailments In addition subclinical adjustment problems have been noted related to language, employment and family issues. Immigration also causes disruption to cultural norms which can differ from those of the host country and can mean restructuring of lifestyle. Moving to a place where there is no community of ones own is especially stressful and is linked to an increased risk of illness which is heightened if you are visibly different. Looking at a New Zealand context, 16.8% of all New Zealanders were born elsewhere (Statistics New Zealand), to read more about migration and settlement in New Zealand as well as my own history of migration have a look at my culture page.
Culture
and Maternal Mental Health
Little is known of
the experiences of minority women in New Zealand in regard to mothering.
However, Mäori women consistently experience disproportionately greater
inequalities than non-Mäori women and men and Mäori men. Data for Pacific
women is not routinely available and
from my experience services and staff are unresourced for supporting refugee
and migrant women experiencing multiple transitions. Few
researchers in New Zealand have made migrant motherhood an area of investigation.
An exception is a study by Lealaiauloto and Bridgman (1997) of new mothers
of Pacific Island backgrounds. Forty-eight new mothers, their partners
and thirteen health workers were interviewed with a common theme emerging
that highlighted the high stress levels experienced by these mothers.
Other New Zealand studies have ignored cultural dimensions, under-represented
or, worse still, discarded data relating to them. Webster, Thompson, Mitchell
and Werry (1994) discarded the Edinburgh Postnatal Depression Scale (EPDS)
scores of five women of Asian and Pacific Island ethnicity because their
scores could not be validated in a clinical interview due to language
difficulties. This exclusion of ethnic minority groups can also seen in
a study by Kearns, Neuwelt, Hitchman and Lennan (1997). The researchers
explored the social context of well-being for women before and after childbirth,
but were only able to procure a sample of four per cent self-identified
Maori and Pacific Islanders whilst these groups at the time made up a
proportion of 18 per cent in the Auckland area. For this reason I decided
that research was needed into the experiences of migrant women and mothering.
I chose migrant women from Goa, India for this research because of my
insider status within that culture. Although Goans are a small minority
within the Indian community with the majority of Indians in New Zealand
originating from Gujarat in Western India.
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