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World Mental Health Day, Week or Month: We Need to Acknowledge the ‘World’ in Mental Health
October is a busy month around the globe for mental health.
World Mental Health Day falls on the 10th of October. It’s National Depression & Mental Health Screening Month here in the States, and October 3-9th is Mental Illness Awareness Week. October, in general, is World Mental Health Month.
But what does mental health mean to different people across the world? And what cultural differences do we need to be aware of when assessing and treating mental health with clients?
Understanding Global Mental Health
We tend to think of mental health in blanket terms, but the truth is mental health is understood, acknowledged, spoken about, and even treated very differently across the world.
While there is a broad understanding of the importance of mental health, there are strong social and cultural divides that impact advocacy, support, and treatment.
A few statistics to highlight:
- Mental health problems are one of the leading causes of the overall disease burden worldwide.
- Mental health and behavioral problems (e.g., depression, anxiety, and drug use) are reported to be the primary drivers of disability worldwide.
- Major depression is the second leading cause of disability worldwide and a prominent contributor to suicide.
- It is estimated that 1 in 6 people in the past week experienced a common mental health problem.
There is an increasing understanding that mental health presents many concerns and community issues around the world. Research reports that the highest percentages of mental health statistics exist within more than two-thirds of low and middle-income countries. But the impact is disproportionately distributed across community groups.
This is concerning when the largest treatment gaps for mental health exist within developing countries.
Disparities in financial and human resources for mental health services also exist, both across and within countries and regions of the world.
Cultural Differences in Understanding Mental Health
When you reflect on different cultures in your community and around the world, what comes to mind? You likely think about the very obvious, perceptible things; clothing, language, and food. Perhaps you think about religious beliefs, rituals, and rites of passage.
Our culture impacts so much more than simply our language and the food we eat. It has a significant impact on our personal beliefs, norms, and values. It also informs how we understand and perceive others’ behavior, ideas, and reactions.
There’s the classic stereotype of Italians and how they speak loudly and use vigorous hand gestures. To anyone outside the culture, this could be perceived as aggressive or confrontational – but within the culture, it is normal. Most of the time, nothing aggressive or offensive is being said.
In the case of mental health, cultural backgrounds and ideas can have a huge impact on whether or not someone seeks help, the type of help they seek, and the support network they have around them to help them work through mental health challenges.
Research published by The Commonwealth Fund reported that minorities in the United States are less likely to get mental health treatment or that they will wait until symptoms are severe before seeking support.
The research also shows that only 66% of minority adults have a regular health care provider compared to 80% of white adults. Hispanic (58%) and Asian (60%) populations report the lowest rates of having a regular healthcare provider.
Four Ways Culture Impacts Mental Health
Understanding the role of cultural influences in mental health can help us, as professionals, better connect with and get to the heart of the support our clients most need.
Here are four ways culture may impact mental health:
- Cultural Stigma: Stigmatization around mental health has existed for decades. While in some cultures, particularly Western cultures, this has reduced dramatically in recent years, for many, there is growing stigma around mental health. Stigma, including embarrassment and isolation from community groups, can make it harder for those struggling to talk openly and ask for help.
- Understanding Symptoms: In cultures where mental health is simply not discussed openly or at all, it can be extremely difficult for those struggling with their mental health to get knowledge about their symptoms. Culture can also influence the ways people think and talk about symptoms, with some being more normalized or marginalized than others. This can dramatically impact whether someone can recognize and openly talk about their symptoms and their decision-making about how and when to get help.
- Community Support: In some cultures where mental health is still heavily stigmatized, there can be a significant lack of community support for anyone who talks openly about their mental health or attempts to seek treatment. Support networks are crucial for people experiencing poor mental health, affecting how people choose to disclose and seek the support they need.
- Resources Available: People from different cultural backgrounds need to feel that their individual experiences and backgrounds are considered when seeking treatment. Unfortunately, this can be challenging to mediate, with many mental health individuals simply not aware of patients’ cultural differences and needs. This can impact how and why individuals seek support.
Acknowledging Cultural Differences in Our Work
It’s always vital for any mental health practitioner to understand their clients and the lived experiences that inform how they engage, disclose, and seek support.
But for immigration evaluation professionals, it’s even more critical.
For us, our clients may have been through several different healthcare screenings or may have never sought support previously for their mental health. They may have increased concerns about who may find out about their mental health and how their family and relatives may react.
Added to this are the pressures of the evaluation to secure the immigration status they may be pursuing. This pressure may make them more likely to withhold certain information that is already considered culturally stigmatized.
Understanding cultural and global differences in mental health isn’t a burden or extra to our work; it is the pinnacle of our work.
Acknowledging and reassuring clients that you understand their background and the potential challenges they may have faced can help us establish more robust connections and therapeutic relationships.
From there, we can significantly offer more value and support to our clients; the help they might desperately need but have as yet not felt safe to access.
I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 500 evaluations and work with dozens of lawyers in various states. Immigrants are my passion, I believe they add to the fabric of our country.
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