Socio-cultural factors Flashcards
What is intersectionality?
Crenshaw (1989)
Describes how systems of oppression overlap to create distinct
experiences for people with multiple identity categories.
What are the socio-cultural factors?
- Socio-economic status
- Urban living
- Ethnicity
- Discrimination
- Migration
- Traumatic life events
- Gender
- Childhood separation from parents
Impact of SE status
- Longitudional relationship between SE and MH
- Increased incidence of schizophrenia in Camberwell, in the most deprived areas (Boydell et al., 2004).
- Impact on standards of living, access to particular schools, social activities, diet etc.
- In a survey of British householder, it was found that African-Caribbeans and Black Africans were more likely than other ethnic minority groups to have indicators of social disadvantage (Brugha et al, 2004).
Impact of urban living
Elevted cortison levels
Less of sense of comunity
What is the social drift hypothesis?
People with poorer mental health experience a poorer position in job market and thus migrate (drift) to inner cities–> aims to explain the effect of urban dwelling on psychosis development
Challenged by the notion that people ‘cities make you sick’ –> social causation
What is the social causation hypothesis?
Living in the urban area by itself has some quality which makes people develop psychosis
What are some gender differences in psychosis?
- Men are at greater risk for psychosis, prefer solution-focus therapy (vs emotion-focused)
- More affective symptoms in women
- Women have better prognosis, social functioning, better treatment response and shorter DUI than in men
==> Could be because of men MH stigma or that women more likely seek psychological and physical health
What are some of the effects of racial discrimination on psychosis?
- Experiences of verbal abuse, physical assault, workplace discrimination and racism are associated with the risk of psychosis.
- Higher incidence of paranoid experiences amongst minority ethnic groups who experience discrimination
- Those who have experienced bullying are 2.15 times more likely to develop symptoms of psychosis than those who have not.
- Victimization increased the risk of persistent PLEs in adolescents
- Psychosis symptoms was increased 2-fold among victims of bullying at ages 8 and/or 10 years, independent of other prior psychopathology, family adversity, or child’s IQ.
==> Multi-layered discrimination (e.g. SES, ethnicity, gender, religion, sexuality
Effects of migration on psychosis
Rates of psychosis was increased amongst all ethnic minority groups
Migration to Europe is a risk factor ==> Possibly due to stress with migration to unfamiliar culture
2-4-fold increased risk of psychosis onset in first- and second-generation migrants compared to native
Migration during early adulthood (19 to 29 years)- similar risk of psychosis as natives
What are some reported racial inequalities?
- Black people are more likely to have experienced a psychotic disorder in the last year than White people
- Black people are 4 x more likely to be detained under the mental health act than White people
- Lower rate of referrals to primary care mental health services, higher rate of involuntary admissions, and dissatisfaction with the services among this group.
- B.A.M.E people are less likely to be referred for psychological therapy
- More Police involvement in admissions and readmissions of Black people
What causes the disparities between races in MH?
- Late presentation and poor GP involvement
- Biases in pathways to care (e.g. police)
- Accessibility to and acceptability of psychological therapy services
- Diagnostic biases
- Migration as a cause
- Mistrust and dissatisfaction with services
- Different conceptualizations of mental health difficulties
- Stigma
- Socio-economic deprivation
- Institutional racism in mental health system
What is institutional racism?
It is defined as the collective failure of an organisation to provide appropriate and professional services to people because of their colour, culture or ethnic origin.
It can be seen or detected in processes, attitudes and behaviour that amount to discrimination, either through unwitting prejudice, ignorance, or thoughtlessness and racist stereotyping, which disadvantage minority ethnic people. MacPherson (1999)
Mostly small subtile ways of thinking about people
Circles of fear within MH services
Fear of Mental Illness
Fear of MH srevices and what happens when they are accessed
- Fear in the commnity about what would happen if you dring a loved one to the MH, are you sending them off to death? Will we be involved in the treatment?
Fear of Black People
Seni’s Law
The MH use of Force Act- to protect vulnerable people and decrease the fear of MH services,
Better training of police officers, education on MH issues, use of body cams etc
How does different conceptualization of psychosis influence help in psychosis?
- Cultural understandings of mental distress and psychosis
- Differences in help seeking behaviours
- Religion and spirituality
- Stigma and shame
