mental health conditions, culture and stigma

reflexivity

being mindful of the fact that everyone brings their own lens to clinical practice

culture

shared patterns of meaning that are learned within a particular social world (laroj et al 2014)

considering culture in the practice includes

• understanding the influence of culture on symptoms are expressed and what is considered to be a disorder

• cultural identity of clients

• being aware of cultural explanations of individual experiences

• understanding cultural expectations related to psychological experiences and levels of functioning

• being mindful of cultural elements of the relationship between the individual and client

hippocrates and freud

wandering uterus and hysteria

homosexuality as pathological

indicative sign of biological defect, developmental failure, morally and sinful, socially evil

→ influenced by powerful institutions (church, legal/justice system), darwinsim and more. seen as mental disorder in early versions of DSM

alfred kinsey and the kinsey reports (sexual Behaviour in the Human male/female’)

demonstrated higher prevalence of homosexual orientation and activity.

• 37% of men had experienced at least one homosexual encounter in order to orgasm in a lifetime

evelyn hooker

demonstrated no link between homosexuality and psychological maladjustment 

culturally bound syndromes

a cluster of group of co-occuring relatively invariant symptoms found in a specific cultural group, community or context

—> longing for country

longing for country

spiritual disconnection when seperated to removed from traditional lands

symptoms of longing for country

physical illness, weakness, nausea, spiritual ill health, cognitive disorientation, dissociative future, cultural ‘ill-health’ including identity confusion, disorientation, acculturative stress

treatment for longing for country

returning to country

four primary domains of stigma

public stigma, internalised stigma, stigma by association, structural stigma

public stigma

inks beliefs, emotions and behaviour. Negative stereotyped beliefs, prejudicial emotions and discriminatory behavioural responses relating to people living with mental health problems 

internalised stigma

happens when a person applies negative societal stereotypes and prejudices about mental illness to themselves

Corrigan’s paradox

what

stigma by association

experienced by people who are close to someone living with mental illness

how it operates” negative stereotypes and discrimination and transferred to supporters

structural stigma

stigma that is built into society’s rules. refers to societal level laws, policies, systems and practices that discriminate against people with mental illness

intersectional stigma

fifth and related domain

• mental health related stigma can intersect with and be compounded by other forms of marginalisation. These forms of discrimination interact rather than occurring in isolation.

ways to reduce stigma and discrimination

• positive contact

• psychoeducation

• modelling

• storytelling

• human rights education

• coming out

• connection

• cognitive, acceptance-based, narrative enhancement, self compassion approaches