Mental health (MH) is a positive state of well-being, where an individual is productive and can effectively cope with life’s stressors (WHO, 2004). MH is challenging to asses as it’s hard to objectively substantiate (Angel & Williams, 2000), but by understanding a person’s culture (Rosenberg & Kosslyn, 2014) clinicians can make more informed diagnoses.
The Diagnostic and Statistical Manual of MentalDisorders (American Psychiatric Association, 2013) is a classification system for MH. Previous editions failed to take other cultures into account; resulting in extreme universalism (Schweder, 2015). For example, white British teenagers with Anorexia often say they’re afraid of becoming fat and show preoccupation with their weight; which are in diagnosis criteria. Asian/British teenagers do not report this, but do report a loss of appetite, which was not within diagnosis criteria (Tareen et al., 2005). Consequently, Asian teenagers avoid diagnosis, with serious health implications and even death. However, the DSM has taken steps towards moderate universalism by modifying some culturally determined criteria, for example; criteria for Social Anxiety Disorder now incorporates ‘the fear of offending others’, which reflects the Japanese cultures importance of avoiding harm to others over avoiding harm to self (Hofmann & Hinton 2014).
Subsequently, MH diagnosis is moving in the right direction through the DSM integrating culture into their diagnosis (American Psychiatric Association, 2013; Hofman et al., 2014). However, cultural difference still underlie reporting rates cross-culturally; as MH assessments are done face-to-face. Some cultures feel more comfortable explaining MH whereas other cultures may minimize the severity of their symptoms due to cultural norms (WHO, 2004). Further research needs to look into alternative ways of reporting MH issues.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC
Angel, R. J., and Williams, K. (2000). Cultural models of health and illness. In L. Cuellar and F. R. Paniagua (eds.), Handbook of multicultural mental health (pp. 25-44). San Diego: Academic Press.
Hofmann, S. G., & Hinton, D. E. (2014). Cross-cultural aspects of anxiety disorders. Current psychiatry reports, 16(6), 450.
Rosenberg, R. and Kosslyn, S. (2014). Abnormal psychology. 2nd ed. New York: Worth Publishers, pp.207-209.
Shweder, R. A. (2015). Chapter 5: Relativism and Universalism. In F. D., A Compantion to Moral Anthropology (pp. 85-102). Chichester: Wiley-Blackwell.
Tareen, A., Hodes, M., & Rangel, L. (2005). Non-fat phobic anorexia nervosa in British South Asian adolescents. International Journal of eating Disorders, 37, 161-165
World Health Organization. Promoting mental health: concepts, emerging evidence, practice (Summary Report) Geneva: World Health Organization; 2004.
Reflections on Culture in Psychology 