Culture & Society’s Influence on Mental Health

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Thousands of standard physiological tests exist to detect, identify, and measure medical conditions but, not one such test exists for mental illness. There are no blood tests, x-rays, or scans for bipolar disorder or schizophrenia currently available, although scientists work feverishly towards that goal. Instead, the expressed thoughts and behaviors of the mentally ill person define his illness. Social expectations and norms shape individual expression, which makes culture highly influential on mental health.

A boundless array of races, cultures, and ethnicities exist in the United States. This diversity brings together an endless variety of global ideas, international perspectives, and innovative and productive contributions to the fabric of the nation. Mental health is fundamental to the health and productivity of every culture and serves as the foundation for productive families, communities, and society as a whole.

Major mental illnesses like schizophrenia, depression, bipolar disorder, and panic disorders occur worldwide and to all racial and cultural groups. There are striking differences across ethnic and cultural lines, however, regarding the perceptions about mental illnesses and care given to those who suffer from it. In the United States, for example, minorities receive inferior care quality and are less likely to receive mental health services. Furthermore, there is poor representation of minorities in mental health research studies so, there are very few studies examining the effects of being a minority with a mental illness.

There is a strong association between culture and mental health stigmas. Several surveys and studies show that differences in stigma exist between the various groups, although research offers few explanations as to why these differences exist.

Stigmas regarding mental illness vary between cultures but some stigmas cross cultural and social boundaries. Examples of cultural stigmas regarding mental illnesses include:

  • The cultural perception of people with mental illness as being more dangerous, as compared to the perceptions held by another race
  • Reluctance to marry or employ someone with a mental illness
  • A call for separation from those with mental illnesses, even though research shows interaction usually reduces stigmatization
  • Reluctance to engage in treatment out of fears that their race would elicit unfair conduct on the part of healthcare workers
  • Suppressed communication between the health care professionals and patients regarding the state of an individual’s mental health status
  • Reluctance to share information or concerns about one’s mental health status with friends, co-workers, or family members
  • The perspective that mental illness reflects poorly on the entire family

Many mental health experts consider mental illness to be the product of complex interactions between biological, psychological, cultural, and social factors. The contribution of each of these factors varies by disorder.

Variations in cultural and social stigmas result in differences in the occurrence of certain mental health issues, such as:

  • Suicide rates
  • Incidence of “folk illnesses” recognized only within a specific culture or society
  • Prevalence of various mental illness types
  • Post Traumatic Stress Disorder (PTSD) rates, especially in relation to trauma experienced in

The Scope of Mental Health Disorders among Cultural Groups

In 2012, about 43.7 million adults in the U.S. experienced a mental illness within a year, according to the National Survey on Drug Use and Health statistics presented the National Institute of Mental Health (NIMH). This means about 18.6 percent of adult Americans have a mental, behavioral, or emotional disorder at any given time.

NIMH breaks down the results of the survey according to gender, age, and race. Females were more likely to report a mental illness in the survey, as were people aged 26 to 49 years. The prevalence of mental illness reported in the survey varied between races:

  • Hispanic 16 percent
  • White 19.3 percent
  • Black 18.6 percent
  • Asian 13.9 percent
  • American Indian/Alaska Native 28.3 percent
  • Two or more 20.7 percent

Cultural values are important when it comes to mental health stigma. One study showed that this was particularly true within the Asian and African American communities.

A 2010 study published in Transcultural Psychiatry investigated the understanding of mental illness and perceptions of mental health services between ethnic groups. The researchers signed up 25 African American, Latino, and Euro-American inner-city residents diagnosed with a mental illness and living in Hartford Connecticut. The scientists collected ethnographic data for 18 months.

The researchers found that Euro-Americans held a disease-oriented perspective of mental illness and were willing to seek the advice and counsel from mental health professionals. African-Americans and Latino participants interpreted the behavioral, emotional and cognitive problems of mental illness quite differently; participants in these two groups were critical of mental health services.

Some participants described their expectations and experiences regarding mental health stigmas. Euro-American participants were aware that having a mental illness posed a risk for social rejection but these subjects did not focus on these stigmas. African Americans did describe a great deal of stigma in their narrative accounts. Many of these participants considered severe mental illness to be private family business. Latino participants described very little stigma associated with nervios, an idiom used to describe susceptibility to nervousness, but viewed psychiatric labels as socially damaging.

The researchers’ findings suggest a number of differences in the ways people from various ethnic and racial backgrounds interpret and define mental illnesses. The participants’ first-person narratives provide valuable insight into how members of various cultural and social groups accept and use mental health care. Mental health practitioners can utilize the information gained from the first-person narratives to improve acceptance and utilization of and compliance with treatment in diverse populations.

Ethnic, racial, and cultural minorities experience a special social and economic environment of inequality that increases their risk for exposure to racism and discrimination, violence, and poverty. There is a strong association between poverty and mental illness, according to the World Health Organization (WHO), with common mental disorders occurring about twice as often among poor people as in the rich. The highest rates of mental illness often occur in those with the lowest levels of education and in the unemployed. In particular, individuals with the lowest socioeconomic status have eight times the relative risk for schizophrenia than those in the top socioeconomic class.

The relationship between socioeconomic status and mental illness is cyclical, where having a mental illness increases the risk for poverty and low socioeconomic status increases the likelihood of developing a mental illness. People with schizophrenia are four times more likely to be unemployed or underemployed as compared to those without the illness.

Part of the reason for this cyclic relationship is that people living in poverty have fewer opportunities for education or employment, suffer exposure to harsh living conditions, have little access to good health care, and lack the financial resources necessary to maintain basic standards of living. These stressful conditions can contribute to the development of a mental disorder that can prevent these individuals from working or increase their risk for suffering discrimination in the workplace. Without a job, people are unable to pay for the effective treatment they need.

The cultures of some racial and ethnic minorities affect which types of mental services their constituents need. Clinical environments that seem disrespectful or incompatible with the values of these cultures may deter from seeking out appropriate care or engaging in those services.

There are many opportunities to cultivate an empathetic and therapeutic cultural and societal approach to mental health. Increased awareness, education, and communication about mental health between cultural groups improve understanding about mental health and reduce stigmas. Anti-stigma campaigns and success stories can change an ethnic group’s misperceptions about people with mental illness.

One of the most obvious and unfortunate responses to someone with cognitive and emotional disabilities, is that other people simply do not want to be around them, regardless of their ethnicity or socioeconomic status. This could even include the individual’s family and friends.  Pasadena Villa programs promote mental health and a socially fulfilling future. We do things throughout treatment that a normal family would usually do. Our staff and residents learn and model appropriate social and communication skills, from daily mealtimes, to many fun and relaxing activities.

Our mental health professionals work directly with residents. They observe them in actual social situations and incorporate these observations directly into the resident’s ongoing treatment plan.  This individual real life personalized attention makes the Pasadena Villa treatment experience more appropriate, relevant and beneficial for each of our residents, especially when compared to any other available adult residential treatment mental health services. As one of the very first programs in the country to base its treatment upon Social Integration, our mental health facilities offer help through a unique mix of individualized therapy and group residential programs with a clear focus towards achieving more independent living.

Pasadena Villa’s Smoky Mountain Lodge is an adult intensive psychiatric residential treatment center for clients with serious mental illnesses. We also provide other individualized therapy programs, step-down residential programs, and less intensive mental health services, such as Community Residential Homes, Supportive Housing, Day Treatment Programs and Life Skills training. Pasadena Villa’s Outpatient Center in Raleigh, North Carolina offers partial hospitalization (PHP) and an intensive outpatient program (PHP). If you or someone you know may need mental health services, please complete our contact form or call us at 407-215-2519 for more information.



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