SOCIAL%20CLASS%20AND%20MENTAL%20ILLNESS

1
ETHNICITY AND MENTAL ILLNESS
2
ETHNICITY

• ETHNICITY SOCIAL GROUPS THAT DISTINGUISH
  THEMSELVES FROM OTHER GROUPS BASED ON SHARED
  DESCENT, CULTURE, AND IDENTITY
• VARIES IN IMPORTANCE BY INDIVIDUALS AND GROUPS

3
RECENT INTEREST

• IMMIGRATION - 31 MILLION OF 292 MILLION FOREIGN
  BORN MOST EVER
• E.G. NYC 40 IN 2000 VS. 28 IN 1990
• DIVERSITY OF CULTURES
• MULTICULTURALISM

4
PROBLEMS IN STUDYING ETHNICITY

• COMPLEXITY OF ETHNIC GROUPS
• HOW TO SEPARATE ETHNIC CULTURE FROM OTHER FACTORS
• SOCIAL CLASS, FAMILY STRUCTURE, ACCULTURATION,
  ETC.
• CULTURALLY INSENSITIVE INSTRUMENTS

5
3 WAYS ETHNICITY AFFECTS MENTAL ILLNESS

• RATES OF MENTAL ILLNESS
• EXPRESSION OF MENTAL ILLNESS
• RESPONSE TO MENTAL ILLNESS

6
RATES OF MENTAL ILLNESS
7
AFRICAN AMERICANS

• EXPECT HIGHER DISCRIMINATION, LOWER SES
• FIND RATES NOT HIGHER THAN WHITES
• ANXIETY DISORDERS (PHOBIAS) EXCEPTION
• PERHAPS BETTER COPING ABILITIES - SOCIAL SUPPORT,
  RELIGION

8
HISPANICS

• HISPANICS TOTALLY INCONSISTENT - SOMETIMES
  HIGHER, SOMETIMES LOWER
• PERHAPS DIVERSITY OF GROUPS, POOR INSTRUMENTS

9
HISPANICS

• THOSE BORN IN US HAVE HIGHER RATES THAN THOSE
  BORN IN NATIVE COUNTRIES
• MORE ACCULTURATED HAVE HIGHER RATES THAN LESS
  ACCULTURATED

10
OTHER ETHNIC GROUPS

• ASIANS - LOW RATES BUT MAYBE BECAUSE MORE
  PHYSIOLOGICAL EXPRESSIONS
• NATIVE AMERICANS HIGH RATES, ESPECIALLY
  ALCOHOLISM AND SUICIDE

11
CONCLUSION

• DIFFERENT ETHNIC GROUPS HAVE DIFFERENT RATES OF
  M.I.
• BUT, NO CONSISTENCY

12
EXPRESSION OF SYMPTOMS
13
GROUPS HAVE DIFFERENT ILLNESS VOCABULARIES

• STRUCTURING - GENERAL SENSATIONS BECOME
  PARTICULAR ENTITIES
• E.G. DEPRESSION -
• SOME PSYCHOLOGICAL - SADNESS, HOPELESSNESS, LOW
  SELF ESTEEM
• OTHERS PHYSICAL -FATIGUE, ACHES, LOSE APPETITE,
  NOT PSYCH

14
EXPRESSIONS

• WESTERN CULTURES PSYCHOLOGICAL EXPRESSIONS
• NON-WESTERN CULTURES PHYSIOLOGICAL EXPRESSIONS

15
IMMIGRANTS

• COMPARE SYMPTOMS OF NEW AND LONG-TERM IMMIGRANTS
• STUDY OF CHINESE-AMERICANS
• NEW IMMIGRANTS SHOW MORE PHYSICAL SYMPTOMS
• LONG-TERM IMMIGRANTS SHOW MORE PSYCHOLOGICAL
  SYMPTOMS
• ASSIMILATION CHANGES SYMPTOMS

16
IMPLICATIONS

• CLINICIANS SHOULD BE SENSITIVE TO CULTURAL NATURE
  OF SYMPTOMS
• CLINICIANS CAN OVERSTATE OR UNDERSTATE MENTAL
  ILLNESS
• OUR MENTAL ILLNESSES - EATING DISORDERS, A.D.D.
  ETC. ARE CULTURE BOUND TOO

17
SOCIAL RESPONSES
18
PSYCHOTHERAPY

• WHITES FAR MORE LIKELY TO BE IN P.T.
• EVEN MORE LIKELY TO STAY IN P.T.
• BLACKS ESPECIALLY UNLIKELY

19
REASONS FOR ETHNIC DIFFERENCES

• DEFINITIONS OF M.I.
• USE OF INFORMAL OR FORMAL RESOURCES
• TRUST IN MENTAL HEALTH PROFS
• RESPONSE OF MENTAL HEALTH SYSTEM
• USE OF MEDICATION

20
RESPONSE TO SCHIZOPHRENIA IN L.A.

• MEXICANS
• DEFINE AS NERVIOS
• KEEP IN FAMILY
• GAP IN COMMUNICATION WITH M.H.P.

• ANGLOS
• DEFINE AS PSYCHOSES
• BRING TO M.H.P.
• SHARED DEFINITIONS OF PROBLEM

21
COSTS AND BENEFITS

• MEXICANS
• DELAYED TREATMENT
• MORE SEVERITY
• LESS COMMUNICATION
• MORE FAMILY SUPPORT

• WHITES
• QUICKER TREATMENT
• LESS SEVERITY
• MORE COMMUNICATION
• LESS FAMILY SUPPORT

22
FAMILY SUPPORT

• MANY ETHNIC GROUPS ESPECIALLY NEW IMMIGRANTS
• GREATER SENSE OF FAMILY OBLIGATION AND LESS
  INDIVIDUALISM
• LESS ADEQUATE PROFESSIONAL TREATMENT

23
SUMMARY

• FEW OVERALL CONCLUSIONS FOR RATES IN US
• ETHNICITY AFFECTS WAY PEOPLE EXPRESS DISORDERS
• ETHNICITY AFFECTS DEFINITIONS, SOCIAL SUPPORT AND
  HELP-SEEKING

24
IMPLICATIONS

• PROFESSIONALS SHOULD BE CULTURALLY SENSITIVE
• ETHNIC-SENSITIVE PROGRAMS TEND TO WORK BETTER
• PARTICULARLY IMPORTANT NOW WITH HIGH RATES OF
  IMMIGRATION