WEEK 3: GENDER, ETHNICITY AND MENTAL HEALTH Flashcards
What is mental health?
*Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.
It includes our emotional, psychological, and social well-being.
*As a condition whereby, there is a balance among all aspects of life that impacts on how one manages her or his surroundings including making choices and relating to self and others
What is race?
*Race is defined as “a category of humankind that shares certain distinctive physical traits.”
Race is thought to be biologically determined
What is an ethnic group?
1.An ethnicity or ethnic group is a grouping of people who identify with each other on the basis of perceived shared attributes that distinguish them from other groups.
Those attributes can include common sets of traditions, ancestry, language, history, society, nation, religion, or social treatment within their residing area.[1]
The term ethnicity is often used interchangeably with the term nation, particularly in cases of ethnic nationalism.
Ethnicity may be construed as an inherited or as a societally imposed construct.
Ethnic membership tends to be defined by a shared cultural heritage, ancestry, origin myth, history, homeland, language, dialect, religion, mythology, folklore, ritual, cuisine, dressing style, art, or physical appearance.
Ethnic groups may share a narrow or broad spectrum of genetic ancestry, depending on group identification, with many groups having mixed genetic ancestry.
Characterised by a sense of belonging or group identity (so the common practice of researchers assigning people to ethnic groups may lead to error)
Determined by social pressures and psychological needs; and they are dynamic.
E.g. in one American study where people had to assign themselves to an ethnic group in two consecutive years, one third of the population chose a different ethnic group on the second occasion
Describe culture
1.Culture is a social construct which is characterised by the behaviour and attitudes of a social group
Determined by upbringing and choice
It is constantly changing and is notoriously difficult to measure
*Consists of, among other things:
Repertoire of values
Institutions,
Practices
Those sustain a group of people
Give them an identity that distinguishes them from other groups
*Thus, culture includes language, ideas, beliefs, customs, codes, institutions, tools, techniques, works of art, rituals, and ceremonies, among other elements.
Describe the relationship between culture and schizophrenia
WHO Global Study: Collaborative:
Results:
Similar rates of schizophrenia no matter what country was investigated
There are varying rates found within countries.
E.g. African-Caribbean people in the UK :-
Reported as suffering extraordinarily high rates of schizophrenia for unknown reasons
*Some people argue behavior which is acceptable in one culture is mislabeled in another as mental illness - but this is now probably a minority view within the academic field
*An alternative view that has been proposed is that some cultures might smoke a lot of cannabis or chew khat, and this could also account for varying rates of mental illness.
Describe pathways to care in different cultures
Reasons for care delay:
- Stigma around mental illness
*Difficulty engaging with services
This could account for varying rates of diagnosis, use of forced admission, or involvement of police
Describe variations in different cultures contributing to mental health
*The culture you originate from may also determine how much stress you experience:
Altered rates of unemployment
Discrimination in a host culture
This may explain why being an emigrant has been found to be a particularly ominous risk factor for the development of major mental illness
*Contrasts in approach to treatment depending on culture
E.g. exorcism is considered appropriate in some cultures
But it is deemed positively dangerous by some western doctors as deaths have been reported following beatings used to drive demons out of the mentally ill.
*Rates of depression vary between countries
This suggests the importance of macro-social factors
Nevertheless, depression is almost always reported to be twice as common in women compared with men across diverse societies and social contexts.
Link co-morbidity to mental illness
*Comorbidities are distinct health conditions that are present at the same time.
Co-morbidity is associated with increased severity
Higher levels of disability and higher utilization of services
Women have:
Higher prevalence rates than men of both lifetime
12 month co-morbidity involving >/ = 3 disorders
Depression and anxiety - most common co-morbid disorders
Concurrent disorders include: (females more):
*agoraphobia
*panic disorder
*somatoform disorders
*post traumatic stress disorder
Link co-morbidity to mental illness
*Comorbidities are distinct health conditions that are present at the same time.
Co-morbidity is associated with increased severity
Higher levels of disability and higher utilization of services
Women have:
Higher prevalence rates than men of both lifetime
12 month co-morbidity involving >/ = 3 disorders
Depression and anxiety - most common co-morbid disorders
Concurrent disorders include: (females more):
*agoraphobia
*panic disorder
*somatoform disorders
*post traumatic stress disorder
Link between gender and mental illness
Gender acquired risks are multiple and interconnected
Women’s greater exposure due to:
Poverty
Discrimination
Socioeconomic disadvantage
Postnatal depression
The social gradient in health is heavily gendered
Women constitute around 70% of the world’s poor
Women earn less than men when in paid work
Describe the Low Rank _Powerful Predictor of Depression
Women’s subordinate social status is reinforced:
*In the workplace
They are more likely to occupy insecure jobs
Low status jobs with no decision making authority.
*Those in such jobs experience:
Higher levels of negative life events
Insecure housing tenure
More chronic stressors
Reduced social support
*Traditional gender roles further increase susceptibility:
Passivity is stressed
Submission
Dependence
Imposition of:
A duty to take on the unremitting care of others
Unpaid domestic and agricultural labor.
Relate suicide to gender and mental illness
Men: have higher completed suicide rates
Women: have higher rates for suicide attempts
Source: A 9 country study report
Gender-based violence (GBV):
A significant predictor of suicide attempt in women
> 20% of women with history of GBV attempt suicide
Rates of both suicide ideation and suicide attempts vary widely between countries
Conversely, gains in gender development that improve women’s status are likely to bring with them improvements in women’s mental health.
Women as Care-givers - Botswana
The assumption of the care giving responsibility was either
voluntary or was delegated by other members of the family
Factors which influenced delegation of this responsibility:
Unemployment
Financial power
Previous relationships with the ill person
How responsible the person was
Individuals who earned less were normally asked to assume
caregiving responsibility and leave their employment if they
were employed. [Seloilwe 2006
