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Anthropology

How physical health may be culturally defined, particularly in different societies, an interesting question remains: does the same idea of culturally established notions of mental health also exist?

This is a complex question; however, the answer seems to be yes for two reasons. First, although physical diseases usually have well-established biomarkers (e.g., a low white blood cell count), mental disease usually is diagnosed via observed (abnormal) behavior.  Thus, unless certain types of behavior are universally considered “abnormal” across different cultures (likely a stretch in logic), there is likely variation in what is considered to be mental illness in different countries. For example, western nations (including the US and UK) have a relatively low threshold for mental illness, even including grieving (and prolonged grieving) as potential signs of declining mental health.  There is also a clear prescription for these mental maladies: pharmaceuticals, and for those who can afford it, some type of psychological counseling.

Second, there is evidence that one culture’s notion of mental health and treatment regimens do not necessarily work across cultures. In the book “Crazy Like Us,” author Ethan Waters traces the often times disastrous consequences of “exporting” mental diagnostic standards and treatments of purportedly more “advanced” countries abroad. The results show that conceptions of mental illness and health have firm foundations in local culture: the psychotherapists who attempt to help “trauma” victims of the tsunami in Sri Lanka find that their methods likely inflict more harm than help; the use of pharmacological treatments for depression in Japan are not found to be efficacious in many cases; western psychologists are baffled by individuals with eating disorders that starve themselves to death in Hong Kong. Although this list is not a full reckoning of the damage inflicted by assuming similar notions of mental health, it does provide initial evidence that mental health notions differ across cultures.

The way that disease is perceived by individuals that have it is very important for a health practitioner to pursue. Even if the practitioner doesn’t believe that such information is necessarily relevant to an accurate diagnosis, in an age of measuring treatment success by patient input, it will assist in understanding what symptoms should be addressed. This is particularly the case for patients with complex conditions that include both physical and mental dimensions such as Alzheimer’s. Another potential example would be those with depression: a doctor could have many different options to find out what the patient needs from a symptom point of view.

References:

Waters, E. (2011).  Crazy Like Us: The Globalization of the American Psyche. Free Press.