Mental Illness Care . . . Be A Voice for Change!
Insurance coverage for mental health may be limited to a prescribed number of outpatient visits, inpatient stays and drug coverage. Once resources are used mental health care is unaffordable. Out of pocket expenses can run in the thousands of dollars. While awareness has increased, the social stigma that follows someone with mental illness continues to prevail. The recent tragedy in Newtown CT is a clear message about the need for community awareness and access to mental health services. The key for each of us is to recognize the change and be a voice for that person, to advocate for care. Healthcare professionals realize presenting symptoms may vary, but are they aware of the ways in which diverse cultural/ethnic/religious groups of persons may present? Displays of emotions may be considered socially unacceptable and bring shame on the family, thus may seek health care because of somatic complaints such as headache, restlessness, or backache. What do we need to know?
Cultural beliefs about mental illness
- Imbalance ~ spiritual/mental/physical (Filipino; Mexican; Vietnamese)
- Loss of harmony ~ evil spirits disrupt harmony (Chinese; Native American)
- Outside forces ~ ghosts, witches, voodoo (Hmong; Mexican; African American)
- Chemical imbalance (Anglo American)
- Individual has special powers (Mexican, Hmong, Native American)
- Religious ~ violation of religious principle (Hindu); God’s will (Islam)
- Susto ~ sudden fear caused by a frightening event leads to loss of spirit (Mexican)
Cultural Cures
- Prayer & lighting candles
- Folk healers ~ Curandero (Mexican); Hilot (Filipino) Tze Neb (Hmong)
- Mexican ~ sweep body with fresh herbs & recite ritual prayers
- Chinese ~ herbal medicine cooked for a specific period of time
- Navajo ~ consult a cryster gazer or one who interprets dreams
Implications
- Respect for diverse approaches to mental health care
- Involve the family in the discussion
- Work within the context of the cultural group
- Acknowledge diverse styles of communication & how it is used (i.e. silence; eye contact)
- Inclusion of folk healers
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