What stops many mentally ill people from getting help? Their culture.

Mental illness affects millions of people worldwide.  Add to that the people in patient’s lives, and the impact easily enters into the billions.  Luckily, there have been important advances in treatment and awareness.  But access to these can be blocked by something you might not suspect: a patient’s culture.

I’ve written before about how many Asian cultures consider mental illnesses taboo, and even ruinous for an entire family’s marriage prospects or social status.  Other cultures often view mental illness similarly. For example, the Latino author of this National Alliance on Mental Illness (NAMI) guide explains that people in their culture are brought up with the saying la ropa sucia se lava en casa – that is, don’t air your dirty laundry in public.  This makes many Latinos naturally less inclined to talk about issues or symptoms with friends, family, or even medical professionals.

African Americans are another group whose culture doesn’t easily allow for reporting and treating mental conditions.  Some of the reasons, NAMI-cited studies have found, may be a reliance on healing through faith, rather than medication or therapy; a cultural tendency to minimize mental health symptoms; and a mistrust of healthcare professionals.

Sometimes, it’s not just the patient’s culture that affects their access to help; it can also be the impressions another culture has of them.  In a recent NPR piece, Dr. Mae Lynn Reyes-Rodriguez reveals that while anorexia is the mental illness with the highest mortality rate, eating disorders are underreported and undertreated among minority groups in the US.  The article gives some intriguing insights into why many healthcare professionals still tend to think these disorders almost exclusively affect Caucasian women.

Culture can even have an impact on how certain disorders are treated.  For example, when I moved to France, I was surprised at how few children here seemed to suffer from ADHD, a condition that affects an estimated 9% of American kids. As this informative article explains, French psychologists view the disorder differently than their American colleagues.  For them, ADHD isn’t usually a disease with biochemical or genetic causes; it has more to do with a child’s surroundings.  Instead of medication, French children with ADHD symptoms are typically given therapy sessions, often along with their families.

This is far from the only situation where a mental health issue is perceived and treated differently in another country and culture.  Another example, which calls into question our tendency to think of Western – perhaps especially American – medicine as the best solution, is the fact that several studies have shown schizophrenia patients have a much lower rate of relapse in certain non-Western cultures.  Western cultures tend to think of schizophrenia as a permanent condition that can be managed with medication and therapy.  But that isn’t the way it’s regarded around the world.   This article cites a healing ritual performed on a schizophrenic patient in Zanzibar who returned to their family.  There, when the disease’s symptoms are not apparent, the patient can take up their former role in society and family life, since the condition is seen as having outside, rather than internal, causes.

Luckily, there many groups and individuals are trying to get rid of the cultural impediments to mental health awareness and treatment — from local warriors like Gloria Lucas and Lynn Chen, who have created support groups for minority women with eating disorders in their communities, to internet juggernaut Buzzfeed, who recently held their Mental Health Week.  Hopefully, efforts like these will help those suffering from mental illness realize that, no matter where they come from or what they’ve been told, they’re not alone, and they can get help.

by Alysa Salzberg

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