Culture, mental health and psychiatry

While mental illness has recently been framed in largely neurobiological terms as brain disease, there has also been an increasing awareness of the contingency of psychiatric diagnoses. In this course, we will draw upon readings from medical and psychological anthropology, cultural psychiatry, and science studies to examine this paradox and to examine mental health and illness as a set of subjective experiences, social processes and objects of knowledge and intervention. On a conceptual level, the course invites students to think through the complex relationships between categories of knowledge and clinical technologies (in this case, mainly psychiatric ones) and the subjectivities of persons living with mental illness. Put in slightly different terms, we will look at the multiple links between psychiatrists’ professional accounts of mental illness and patients' experiences of it. Questions explored include: Does mental illness vary across social and cultural settings? How are experiences of people suffering from mental illness shaped by psychiatry’s knowledge of their afflictions?

Anthropology and psychiatry have long shared common intellectual and scientific ground. Both are interested in human beings, the societies within which they live and their behaviours. A key starting difference between the two is anthropology’s interest in relativism, whereas psychiatry has been interested in universalism. Also, both anthropology and psychiatry have a long history of common interest in phenomenology and the qualitative dimensions of human experience, as well as a broader comparative and epidemiological approach. Jenkins illustrates the common ground by emphasizing that both disciplines contribute to the philosophical questions of and experience raised by cultural diversity in mental illness and healing. Both disciplines also contribute to the practical problems of identifying and treating distress of patients from diverse ethnic, gender, class and religious backgrounds. Psychiatry focuses on individual biography and pathology, thereby giving it a unique relevance and transformation.Patient narratives thus become of great interest to clinicians and anthropologists. Development of specializations such as medical or clinical anthropology puts medicine in general and psychiatry in particular under a magnifying glass. The nexus between anthropology of emotion and the study of psychopathology looks at normality and abnormality, feeling and emotion, variability of course and outcome, among others. The article concludes by highlighting the convergence between these two disciplines as a very fertile ground for the burgeoning field of Global Mental Health.

Online Readings in Psychology and Culture, 2012

In this paper, we discuss the intricate relationship between culture and mental illness. Our central position is that there cannot be mental illness without culture. We argue that our limited knowledge to the onset, manifestation, course and outcome of mental illness is due in part to the cross-cultural psychological conceptualization of culture, where culture is seen as an independent variable influencing mental illness, the dependent variable. This is in addition to the limitations of the biomedical model in accounting for the origins of mental illness. Using depression and schizophrenia as examples, we argue for the need to see culture and mental illness as mutually embedded in each other.

Culture Medicine and Psychiatry, 2004

Studies in Medical Anthropology: Cambridge, UK. 357pp.

Doing fieldwork in consultations of autistic children and their families with a child neurologist in Brazil, I noticed how important is for the doctor's work, for the purpose of diagnostic, treatment and care in general, to take into consideration the history, the socioeconomic and the cultural contexts of her patients and their kin. My ethnography shows that, to establish the diagnosis of autism and to choose treatments, the clinician considers the relational issues of her patients just as the brain ones. However, on the other side, reading the contemporary medical anthropology literature, one realizes that biomedical psychiatry is almost always interpreted as profoundly determined by the molecular gaze, as if its practitioners were disregarding the relational dimensions of the patients. In my presentation, I propose to tackle this apparent contradiction, firstly, by affirming that no matter how molecular biomedical psychiatry is understood, when it comes to its clinical practice, the relational and cultural dimensions are taken into account to complete the task of diagnosis, treatment definition and care in general. Secondly, as a consequence of the first conclusion, I suggest that anthropology, to fully comprehend contemporary biomedicine, has to constant counterbalance its cabinet theoretical analysis by first hand ethnographies of clinical practices. Finally, based on these conclusions, I argue that no matter how global mental health and biomedical psychiatry are, the good practice in medicine is defined by the consideration of local and relational contexts. That is the knowledge anthropology can offer to global mental health point of view.

Andrew Scull (ed.), Cultural Sociology of Mental Illness : an A-to-Z Guide , Sage, 2014, pp. 31-32, 2014

Madness is a major disorder of social ties and a universal problem for all societies. The formation and transformation of local treatments of madness are therefore a major area of study within social and cultural anthropology. In this perspective, “treatment” should be understood on three different levels. First, as treatment of the problem that madness poses to social order; Second, as treatment of an ailment on the basis of a therapeutic system that can call upon specialist knowledge or not (e.g. a classification, an etiology, a pharmacopoeia, etc.) in order to identify the disorder or to determine its nature and to then provide the appropriate intervention; Finally, as moral treatment of people experiencing madness and trying to find a solution to their state of disorder.

Culture, Medicine, and Psychiatry

The author suggests to consider some important hidden connections in Global Mental Health (GMH) discourse and interventions, above all the political meaning of suffering and symptoms, the power of psychiatric diagnostic categories (both Western and traditional) to name and to occult at once other conflicts, and the implicit criticism expressed by so-called local healing knowledge and its epistemologies. These issues, by emphasizing the importance to explore other ontologies, help to understand the perplexity and resistance that GMH and its agenda meet among many scholars and professionals, who denounce the risks of reproducing and globalizing Western hegemonic values concerning health, illness, and healing. Keywords ''Palimpsest nature'' of psychiatric disorders Á Hegemonic dimensions of psychiatric diagnostic apparatus Á Crypto-racism Á Indocile suffering Á ''Minor'' and ''subjugated'' (healing) knowledge

. I. M. Salloum & J. E. Mezzich (Eds.), Psychiatric Diagnosis: Patterns and Prospects. New York: John Wiley & Sons., 2009