Understanding Cultural Influences on Mental Health

Mental health is a multifaceted matter influenced by various crucial factors. Cultural influences play a significant role in shaping mental health and well-being, often acting as both a source of support and a potential barrier. Culture shapes people’s understanding of mental health by influencing their attitudes toward mental disorders, coping strategies, health-seeking behaviors, and the availability of resources. It dictates how mental health is perceived, expressed, diagnosed, and treated, impacting everything from the stigma associated with mental illness to the therapeutic approaches which are deemed acceptable or effective in a society. As global migration and multiculturalism become more prevalent, understanding these cultural dimensions becomes increasingly important for providing effective and inclusive mental health care.

Traditional beliefs and practices in various cultures play a crucial role in mental health care. For example, cultures may rely heavily on community and familial support systems, while other cultures might integrate spiritual or religious practices into their approach to mental health. Conversely, there can be significant cultural barriers which prevent people from seeking help, such as stigma, lack of culturally competent care, or a preference for alternative remedies over conventional therapy.

Understanding these cultural dimensions is essential for developing effective mental health care. By acknowledging and integrating cultural perspectives, mental health professionals can better address the diverse needs of individuals and communities as well as issues around cultural stereotyping and discrimination.

Important Key Components of Culture

As discussed by Gopalkrishnan (2018), there are five key cultural components that have implications for mental health care. To improve the quality of care for different individuals, mental health professionals need to be mindful of the impacts of these components during their work with diverse clients.

Emotional Expression

The first key component to consider is emotional expression (Gopalkrishnan, 2018), which refers to how an internal mental state is externally manifested. Diverse cultures have different norms regarding which emotions are appropriate to express and in what manner. For instance, Western cultures encourage open and expressive communication of emotions, where directness and individuality are valued. Contrarily, Eastern cultures emphasize emotional restraint and harmony, thus valuing qualities like agreeableness and conflict avoidance. This can lead to differences in how openly people discuss and express their feelings.

Cultural expectations also shape how people regulate their emotions. In cultures that value stoicism, people may learn to manage their emotions internally, focusing on self-control and suppressing outward emotional expression. In contrast, cultures who value emotional expression encourage people to share their feelings more freely. These differences can impact coping mechanisms, support systems, interpersonal boundaries, and emotional resilience. Furthermore, culture influences how emotions are interpreted in social contexts. In collectivist cultures, where group harmony and social roles are emphasized, emotions might be more closely tied to interpersonal dynamics and relationships. In individualist cultures, emotions may be viewed as expressions of individual identity and autonomy. In turn, this affects how people relate to one another and how emotional support is provided and received. The way emotions are communicated can also vary widely from one culture to another. For instance, while eye contact and facial expressions are important in Western cultures, other cultures might emphasize different nonverbal cues. Understanding these variations is important for effective cross-cultural communication and avoiding misunderstandings during mental health treatment.

Lastly, cultures provide scripts or frameworks for understanding and interpreting emotional experiences. These frameworks guide how people perceive their own emotions and those of others. For instance, a culture might have specific ways of framing sadness or joy, which would influence how people process these emotions, how they communicate about them, and what kind of supports they seek.

Shame

The second key component to consider is shame (Gopalkrishnan, 2018). This is a component that can hinder individuals from seeking mental health support, especially in societies where one’s public image and reputation are highly valued. In Asian and Middle Eastern cultures, shame plays a key role in mental health support-seeking behaviours. This is due to the powerful roles that family and community play in the lives of Asian and Middle Eastern individuals who are mentally struggling. In such instances, mental health issues may be viewed as a poor reflection on the family or community. Consequently, those who are struggling may fear being negatively judged by others or bringing shame and dishonour to their loved ones by seeking mental health care. This can lead people to silently suffer in avoidance of perceived stigma.

Power Distance

The third key component worth considering, as discussed by Gopalkrishnan (2018), is power distance. Power distance can influence the dynamics between patients and mental health professionals, as well as the overall effectiveness of the therapy provided. It refers to the extent to which less powerful individuals in society seek out support from more powerful individuals. People from lower socio-economic backgrounds or marginalized groups may feel less empowered to seek help due to perceived or actual power imbalances. They might also be less likely to advocate for their own needs or question the adequacy of the services they receive. In cultures with high power distance, patients might view mental health professionals as authority figures who should not be questioned. They may passively accept treatment without fully engaging in the process or voicing their concerns, and they may be discouraged from expressing their own perspectives or preferences. Consequently, this can have significant impacts on the mental health outcomes of these patients.

On the other hand, cultures with low power distance often involve a more collaborative approach to mental health care. Patients may feel more comfortable discussing their opinions openly and collaborating with providers on treatment plans. This can foster a more engaging and personalized approach to mental health care. Additionally, creating a collaborative patient-provider relationship can facilitate better access to care, as patients feel more empowered to seek support and advocate for themselves.

Collectivism

 The fourth key cultural element to consider is collectivism and its impacts on resilience and coping (Gopalkrishnan, 2018). Although collectivism can perpetuate stigma and shame if mental health struggles are perceived as a familial or community failure, it can also be a major source of support for people. In collectivist cultures, people often have strong social networks that consist of family, friends, and community members. These networks can provide a dedicated support system, offering emotional, practical, and/or financial assistance to those in need. In turn, collective support can improve resilience by alleviating the negative impacts of stress and adversity. There is a sense of shared responsibility in collectivist cultures, which means that mental health challenges of individuals are often addressed collectively. Individuals learn to cope by relying on their support networks. This helps to foster a sense of belonging and mutual support, which can be crucial for building resilience.

Spirituality and Religion

Lastly, Gopalkrishnan (2018) discusses the important implications of spirituality and religion on mental health across diverse cultures and societies. Some cultures, for example, hold the belief that black magic, demonic possessions, immorality, or the “evil eye” are to blame for the onset of mental disorders. Consequently, people may turn to traditional healers, spiritual leaders, or elders for support. Individuals from cultures where religion and spirituality are emphasized may turn to God or a higher power for divine interventions and support.

Religion and spirituality can provide a framework for understanding life’s challenges and finding meaning in suffering. This existential comfort can be important for those dealing with mental health issues, offering a sense of purpose and a way to make sense of their experiences. Beliefs in a higher power or spiritual purpose can also foster hope and optimism, which are important for resilience and recovery. This can help people maintain a positive outlook and persevere through challenging times.

On the other hand, people from secular societies and cultures have a different perception and understanding of mental health issues. Secular societies often emphasize evidence-based approaches to mental health care. This means mental health issues are typically understood through scientific research and clinical evidence, focusing on biological, psychological, and social factors. Treatments involve a combination of medication and variety types of psychotherapies.

Conclusion

As demonstrated in this article, culture plays a significant role on mental health in many ways. In a world consisting of multiple diverse cultures and beliefs, it is inevitable for mental health care providers to be well equipped with the knowledge of culturally informed treatments. The rise of multiculturalism brings with it an opportunity to expand multicultural knowledge, continue to address mental health stigmas, and encourage marginalized groups to seek more competent, quality care.