CROSS-CULTURAL CUSTOMS, BELIEFS LINKED TO MENTAL ILLNESS

Not too many years ago, cultural factors in the diagnosis of mental illness were excluded from traditional approaches to assessment. Evaluations by the National Mental Illness Screening Project(1991)were intended to spot bipolar disorder, depression, anxiety disorders and the like using assessment tools based on mostly Western criteria for appropriate behavior.

But they left a growing mental health issue behind. Does one size truly "fit all"?

As we approach 2000, a cultural approach has been gaining popularity among psychology and psychiatry, with many claims that it is the long-awaited and best way to assess mental illness in an increasingly multicultural society. Knowledge and understanding shown a client who may be disabled, a single mother, or black is beginning to heal these clients more efficiently and accurately.

In fact, Delores Parron of the National Institute of Mental Health (NIMH), spoke of "the profound influence of culture on the experience and expression of symptoms, creating. . .distress and behavioral patterns unique to cultures and subcultures."

And, the APA (American Psychiatric Association), has published a position statement regarding diversity, stating that more psychiatrists from minority cultures should be included in the Association and among their membership. The APA hopes that cultural knowledge will filter down to psychiatrists, clinicians, clients and the general population as well.

Sound terrific? There are dissenters. In one position paper on cross-cultural social psychiatry, the researcher stated basic and universal laws should govern social behavior and consequences: not cultural or cross-cultural factors.

Still, the well-documented need to view cultural beliefs as an approach to mental illness is coming into its own. Big time.

Hispanics are becoming recognized as the largest minority group in USA today. In the San Antonio Express-News, assimilating into a larger society is a key factor in mental illness among Hispanics. "When people come to this country, there are prices to pay such as the weakening of the family system, which creates more alcoholism and drug abuse," according to William A. Vega, director of the Metropolitan Research and Policy Institute at the University of Texas at San Antonio.

Vega said that close ties to family and the support it offers can be the best indicator of Hispanic mental health. He also concluded that new immigrants are more prone to mental distress than those Hispanics who have lived in the US over the past several years.

Critics thought it was the other way around. Once the period of excitement and dazzle in American pop culture ends, the new immigrant may find himself in conflict with himself and his cultural roots and spending less time with "mi familia."

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