Conceptions of mental illness cultural perspectives and treatment implications

Mental illness is a prevalent, bleak reality in today’s society, with anxiety and mood
disorders, comprising the majority of diagnosed cases (Corrigan, 2004). While there is often
stigma attached to the term “mental illness,” for a variety of reasons, less common are cultural
considerations accounted for when diagnosing and treating mental illness. Sellers, Ward and
Pate (2006) examine depression as it affects Black African immigrant women. Although this
was a relatively small exploratory study, with only five participants, each woman reported
depression to be a major health concern, adversely affecting their current daily living
circumstances. This determination was made when four primary factors were considered,
including perception, context, symptomatology and culturally supported coping strategies,
gathered via an extensive interview process (Sellers, Ward and Pate, 2006). These factors all
contributed to the subjects’ perceptions of effective, culturally sensitive treatment, further
providing insight into sound social work interventions for this population.
The Cultural Formulation Interview, included in the DSM – IV, was designed to identify
the impact culture has on both the treatment and potential outcomes of diverse individuals
(American Psychiatric Association, 2013). This 16 question assessment takes into account the
perceptions of the patient, as well as the other contributing factors related to culture, that may
adversely affect the delivery of effective treatment. This interview would be utilized when
working with an individual to gain information regarding their perceptions of their diagnosis, as
well as their perceived treatment options (American Psychiatric Association,
2013). Additionally, this interview would provide insight into the client’s support network, as well
as their coping skills. Cultural factors will weigh on the client’s responses.
Acculturation, the complex process of gradually blending cultures, can potentially have
significant effects on the individual who has undergone the process (Berry, 2005). The lens with
which the person views this process can determine whether these effects are positive or
negative. To expand, should the individual view the meshing of two cultures as a sign of losing
his/ her original culture, there can potentially be psychological ramifications. As a result
sociocultural immersion can be compromised (Berry, 2005). On the contrary, should the
individual see the initial benefits of acculturation, the process can be a positive experience,
having positive psychological effects regarding the transition, further reinforcing the patient’s
As a clinician working with individuals undergoing this process, it is vital to recognize the
perceptions of the client, first and foremost. Perhaps the client is not choosing to mesh with a
second culture, but feels pressured to do so. Validating the journey, therefore, becomes the
responsibility of the social worker. Encouraging the client to journal their experiences, while
becoming familiarized with the nuances of the secondary culture, would be an appropriate
approach to employ.