Chapter 3: The context of mental health care cultural, social economic and geographic Flashcards
Cultural contents of mental health care
Culture is the learns values beliefs norms and way of life that influences and individuals thinking decisions and actions in certain ways. Culture reflects the basic values and biases through which we interpret the world. Culture shapes our perceptions And attitudes from our personal space comfort zones to our adult toots about mental health. Ethnocentrism is gaining insight into your own culturally learned ideas and values and to guard against an assumption that these are the correct and proper ones for everyone.
Cultural diversity in Canada
Most Canadians are descendants of immigrants or are immigrants themselves. More than 1/5 of Canadians are foreign born the highest rate of all the G8 countries. Toronto with over half its population born outside of the country has been named the most diversity in the world. Diversity is the variation between people in terms of a range of factors such as ethnicity, national origin, race, gender, gender identity, gender expression, ability, age, physical characteristics, religion, values and beliefs, sexual orientation, social economic class or life experience.
Canadian multiculturalism policy
In 1971 Canada was the first country to adopt a policy of multiculturalism as an official government policy. It affirmed the rights dignity and values of all Canadians regardless of ethnic linguistic or religious background. It encourages broad immigration.
Cultural roots of mental health and illness
Symptoms of a disorder that are prominent in one culture may be insignificant or absent in another. PTSD can be manifested in the plight of refugees coming to new country.
Cultural identity
Culture is strongly linked to an entity. Suppression or marginalization of one’s cultural identity has a negative impact on self-worth. Individuals experience a sense of belonging and value if their culture is valued and supported. Shared cultural believes practice and language create social cohesion. Culture is the foundation of both individual and collective identity. Erosion of culture can adversely affect mental health and lead to depression anxiety substance abuse and suicide.
Cultural beliefs about health
It is important to understand how the relationship between culture and health influences health behaviours in patients. The healthy immigrant affect identifies that the health of new immigrants is generally better than that of the Canadian born but tends to decline as years lived in Canada increase. Factors contributing to this include the loss of social connections in one’s home country. For aboriginal populations moving off of reserves and into urban areas can make the maintaining of traditional cultural ties difficult. Cultural beliefs influence the ways that patients and health professionals view health illness disease and their causes. Beliefs about mental illness are linked with concepts of religion, social values, norms and ideals of human relationships. Traditional medical practises of aboriginal people are closely related to other aspects of culture especially their spirituality. Getting in touch with spirituality is identified as key to recovery or healing. Spirituality is linked to a sense of life purpose and personal identity.
Cultural beliefs and the mental health of immigrants and refugees to Canada
Some immigrants may not be familiar with western ideas about mental illness. They may use informal support services such as friends and family rather than formal services. Example some south and east Asian immigrant woman conceptualize mental health as peace with oneself and a tenable and maintainable goal in life and mental illness as a bad spirit. Cultural beliefs can affect the adoption of preventative measures such as vaccination, birth control and prenatal care. Immigrants choose to move to another country their work versus refugees fled their country of origin. This makes refugees have exacerbated affects of depression and PTSD related to past trauma. The strongest predictor for PTSD is exposure to torture for depression it is the number of traumas.
Diagnostic cultural formulations
In the DSM-V mental disorders are defined in relation to cultural social and familial norms and values. Culture provides interpretive framework’s that shape the experience and expression of the symptoms signs and behaviours that are criteria for diagnostic. Example offending others has Been added to criteria for social anxiety disorder to better reflect the appearance in Japan where avoiding harm to others is of greater concern then avoiding harm to oneself. Depending on the patient’s culture panic attacks may manifest as uncontrollable crying and headaches or as difficulty breathing. Clinician’s awareness of cultural, ethnic and linguistic differences allow for more accurate diagnosis and more effective treatment.
Religion as a cultural system
Religion is an organized set of beliefs providing answers to questions about life through sacred text, rituals and practises usually experienced within a community. Helps individuals to achieve personal understanding of life and their circumstances. Prior to modern medicine praying and offerings to the divine were often all that could be done, illness and recovery were inescapably linked with spirituality or faith
Religions in Canada
In 2011 the majority of Canadians were Christians although this number has been decreasing since 2001. No religious affiliation formed the second largest and youngest group, Muslims came third with the greatest increase in numbers. People identifying as Hindu, Sikh and Buddhist are increasing as well with Jewish number slightly decreasing.
Christian group in Canada is divided into each sub groups. Anglican, Baptist, Catholic, Christian Orthodox, Lutheran, Pentecostal, Presbyterian, united church, and other Christian. 19 religions are listed under other including traditional aboriginal spiritual. T
Religious beliefs and approaches to mental illness
Religion can play a role in coping with illness, improving quality of life and sustaining recovery. If one believes that mental health symptoms are holy spiritual in nature, help will not be sought in health services. It’s important that mental health services are available to new immigrants in an accessible form so that lack of knowledge is not a factor. Canada’s healthcare system may not sufficiently acknowledge the spiritual aspects of care and be more science-based. Many practitioners are reluctant to incorporate spirituality due to historical beliefs that it is antithetical to science, ambiguity of their understandings of spirituality and lack of training in implementing spirituality.
Aboriginal people in Canada
1,400,685 people in Canada self identify as first nation, Métis for Inuit. 4.3% of the total population.
Cultural diversity amongst aboriginal people of Canada
Cultural and linguistic differences among aboriginal groups are greater than the differences that divide European nations. There is an enormous diversity of values, lifestyles and perspectives within any community
Colonialism, assimilation and historical intergenerational trauma
Colonialism is the institutionalized, political domination of one nation over another, including when one nation overthrows another for the purpose of domination. Involves direct political administration by the colonial power, control of all economic relationships and a systematic attempt to transform the culture. Before Confederation and through the first half of the 20th century the strategy of the Canadian government towards first nations was a colonial one. Assimilation was the government policy to aboriginal people To the extent that they would abandon their own culture and adopt the coming culture and religion. Aboriginal populations have been subjected to historical trauma which is cumulative effects of maltreatment across generations which results in the reproduction of maladaptive social and cultural patterns with each generation
Effects of colonialism
The effect had many mental health issues including depression, alcoholism, suicide and violence. Foetal alcohol spectrum disorder and residential school syndrome, a form of PTSD with a significant cultural component and impacting children. A case study of £.95 aboriginal survivors of residential school showed that all but two had a mental disorder, the most common being PTSD, substance abuse disorder and major depression. I’ll have experienced sexual abuse. Further trauma is perpetuated today in the form of suicide and family violence. Alcohol related aboriginal deaths are almost double that of the non-aboriginal Canadian population. Drug-related overdose rates are 2 to 5 times higher.
Residential schools
The Indian residential school system arose out of European ministries trying to convert local aboriginal people. In 1870for the federal government began to develop and administer the IRS. Schools were located in every province and territory. Approximately 150,000 children some as young as four were taken to the schools between 1896 and 1996. In 1996 the last school on the Gordon reserve in Saskatchewan was closed. Approximately 80,000 people alive today attended an IRS in Canada. The effects of this racist beast forced assimilation has had lasting and profound effects. Many of the children experienced physical, psychological, sexual abuse that greatly deep in to the traumatic legacy. This is linked to the high suicide rates, mental illness, and adequate parenting skills and sexual physical violence that or is found in some communities.
Effects of mental health and addiction
Survivors of IRS face various health problems such as poor general and self rated health, increased rates of chronic and infectious diseases and mental and emotional well-being including mental distress, depression, addictive behaviours and substance miss. Lower self perceived physical and mental health and higher risk for disease and suicidal thoughts and behaviors, with the odds of a suicide attempt within the past 12 months twice as high for those with Family attendance in the IRS. A growing concern is gang activity among aboriginal youth. although group membership can bring young people a sense of belonging and purpose, gangs are more susceptible to making poor life choices.
National efforts to make amends and support recovery from the IRS system
In 1996 the Canadian government published the report of the royal commission of aboriginal peoples; people to people nation to nation which recommend the number of aboriginal healthcare workers to increase. In 1998 the Indian affairs minister apologized to aboriginal people in Canada for the IRS system announcing a 350,000,000 healing fund. In September 2007, The largest class action settlement in Canadian history, the IRS settlement agreement came into affect recognizing the damage inflicted by the IRS system and establishing a multibillion dollar fund to help former students in the recovery. It has five main components: common experience payment, independent assessment process, the truth and reconciliation commission, commemoration, and health and healing services.
