Cultural Sensitivity or Colonialism?
It is scarcely enough to make a gesture towards mental patients and the mentally ill on one day of the year only. However, to mark World Mental Health Day (10 October 2007) I am posting an article which I wrote quite a few weeks ago to suggest to indymedia readers the extent of real globalisation in establishment efforts to overcome the problem of mental illness. However, as with globalisation in other areas, the question arises of how far we are on the right track?
The theme of World Mental Health Day is "Mental Health in a Changing World: The Impact of Culture and Diversity." World Mental Health Day takes place on 10 October 2007 and it is being organised by the "World Federation of Mental Health."
Cultural competence is the demonstrated awareness and integration of three population-specific issues: health-related beliefs and cultural values, disease incidence and prevalence, and treatment efficacy. But perhaps the most significant aspect of this concept is the inclusion and integration of the three areas that are usually considered separately when they are considered at all (Lavizzo-Mourey & Mackenzie, 1996)
Acculturation (noun): 1 The modification of the culture of a group or individual as a result of contact with a different culture. 2 The process by which the culture of a particular society is instilled in a human from infancy onward (American Heritage Dictionary).
Cross-cultural psychiatry is concerned with the cultural and ethnic context of mental disorders and psychiatric services. It emerged as a coherent field from several strands of work, including surveys of the prevalence and form of disorders in different cultures or countries; the study of migrant populations and ethnic diversity within countries; and analysis of psychiatry itself as a cultural product(Wikipediahttp://enwikipediaorg/wiki/Cross-cultural_psychiatry).
The definition of culture has long been a controversy and the term is used in a variety of ways. A few commonly-used definitions are:
[Culture] is that complex whole which includes knowledge, beliefs, arts, morals, laws, customs, and any other capabilities and habits acquired by [a human] as a member of society." The term sub-culture is used to refer to minority cultures within a larger dominant culture. (Taylor, Ein Seymour-Smith, C(1986), Macmillan Dictionary of Anthropology)
Culture is the collective programming of the human mind that distinguishes the members of one human group from those of another. Culture in this sense is a system of collectively-held values (Geert Hofstede)
Stereotyping: to classify or categorize people, and believing that all those belonging to the same group are alike. Stereotyping infers preconceived but often incorrect, negative notions (Foundations of Nursing, Transcultural Healthcare)
The literature, for the day, from the World Federation of Mental Health, from which the above definitions are taken, is based on the American way as a datum, it seems to me. In approaching divergent cultures the modus operandi recommended is to enlist the support of religious leaders, elders and head honchos in the target community. In a way it seems to me as if the methodology is based on colonialism rather than genuine cultural sensitivity.
Then too acculturation seems to be a one-way street. The psychiatrist and his allies must strive to understand the culture of the client - all the better to help them. It reads as if the client presents a difficult problem which must be solved by protocols and pious prescriptions.
There is no mention of what is an even greater difficulty - the difficulty the mental patient routinely has, often over a lifetime, with the unyielding culture of psychiatry itself.
Like "what I think of you is important but what you think of me carries no weight."
Perhaps on World Mental Health Day, on October 10, readers of indymedia.ie might consider how the supremacist element in the drive of the "World" Federation of Mental Health might be moderated, mollified.
Undoubtedly the stigma will be removed from mental illness only when the care of the mentally ill is understood transparently by everyone. Cultural sensitivity must apply to the client in the mental health system and to mental patients as a group. And not just cultural sensitivity but love and respect - which every human being needs and deserves.