We explored how different cultures perceive and address mental health. Inevitably, there is no one-size fits all approach to mental health treatment but culturally sensitive services are necessary to provide relevant and effective support for individuals.

Cultural Variances in Mental Health: Diverse Perspectives at Across Boundaries

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As an organization focused on supporting individuals from racialized communities, we learned that many service users seeking our support had come with misdiagnoses linked to biases, stereotypes, and cultural misunderstandings in mainstream healthcare.

The following are examples of some of the misconceptions of mental health and addictions that we often hear.

“In families and communities, mental health is often hidden, viewed as a curse, and burdened with stigma.” – Across Boundaries Service User, Pakistani, Male

“I used to view mental health as a bad thing. I felt like something was wrong with me. During my most difficult times, I never even opened up to my family members because I was scared that they would shame me for my thoughts and feelings.” – Across Boundaries Service User, Caribbean, Black Female

“In my culture, mental health is seen as an evil spell or a punishment from God for your parents’ wrongs. Some perceive it as an excuse to be lazy and avoid work or to cover up criminal behaviour. Prayer is the only solution.” – Across Boundaries, Service User, African, Male

“Mental health is perceived as a lack of faith and a sign of weakness. Some even believe it’s contagious.” – Across Boundaries Service User, Latin, Male.

“Mental illness is seen as a product of evil. Some believe that people can put something in your food to affect your mind.”– Across Boundaries Service User, South Asian, Female

Recognizing cultural background is vital. Let us explore how different cultures perceive and address mental health and how this lens impacts treatment.

South Asian:

Mental health often remains concealed within families and communities in South Asian cultures. A study published in the International Journal of Mental Health Systems found that individuals of Indian descent often seek religious or traditional healers as their initial recourse to treating mental health concerns. This practice involves herbs and sacred rituals to ward off supernatural elements which are thought to be the cause of mental illness (1). By acknowledging the importance of faith and religion, professionals can integrate mental health treatment in tandem with traditional practices, fostering a comprehensive and holistic approach.

East Asian:

In East Asian countries such as Taiwan, Japan, South Korea, and Singapore, traditional medicine plays a substantial role, with 60%- 75% of the population seeking such services annually (2). In China, traditional Chinese Medicine (TCM) views mental and physical health as interconnected spheres. For this reason, imbalances in the major organs are thought to underlie emotional and mental challenges. For instance, sadness relates to lung deficiency and worry is associated with spleen imbalance (3). Acupuncture, cupping, and herbal medicine are used to treat dysregulation in these regions. To effectively support our clients, we provide Traditional Chinese Medicine therapy with counseling.

African:

A concerning disparity exists in mental health treatment in South Africa, where a substantial portion of the population faces anxiety, depression, or substance-use problems, yet a mere 27% receive treatment (4). Among the Zulu ethnic group, there isn’t a word for depression, as it’s perceived as a figment of imagination rather than a genuine illness. This belief inhibits individuals from seeking help due to fear of societal judgment. Addressing this situation requires dismantling cultural misconceptions to provide effective support.

Across Boundaries’ Commitment to Inclusive and Inquisitive Care:

While cultures differ in their perspectives, a common theme emerges—our universal desire for acceptance and validation. We dislike sharing our struggles because they reveal our imperfections. But this unrealistic idea of perfection pigeonholes us from receiving the help and support we need to grow and thrive. Luckily, the right therapy has the power to transform our experiences into coping mechanisms, celebrating our identities rather than shaming them.

Finding a therapist who understands one’s cultural context can be challenging. This challenge though is compounded with the many individual and systemic barriers which limit how the mental health of people from non – white communities are perceived and the inequitable health outcomes experienced. Recognizing the impacts of racism, oppression, colonization and trauma, Across Boundaries offers a space where individuals from diverse cultures can access supports relevant to their lived realities. We offer services in over 17 languages, including Caribbean Dialects, African, Central Asian, South Asian and Southeast Asian languages.

Client Centered Support at Across Boundaries:

Inevitably there is no one-size-fits all approach to treatment, but there is a way to provide culturally sensitive, culturally appropriate mental health and addictions support.

While cultural competency is a crucial aspect to providing effective mental health services, it is not the only component. Providing equitable mental health is a multi-faceted approach and cultural awareness alone does not fully address the broader systemic issues that contribute to oppression and inequalities. Which is why our programs and services are rooted in an anti-oppressive and anti-black racism framework.

Culturally Sensitive Strategies:

Our case managers shared their insights on how they incorporate cultural competence in tandem with our frameworks to best serve our communities.

“As a Case Manager and member of a racialized group, I am committed to expanding my knowledge of cultural competence to support service users from various culturally diverse backgrounds. This has increased my ability to identify my relationship with my own culture and, at the same time, recognize and respect the differences of the cultures of service users I serve. I incorporate the Anti-Racism and Anti-Oppression frameworks into my daily interactions with service users. Incorporating this approach helps me to understand how the mental health challenges experienced by racialized service users are exacerbated by systems of oppression such as racism, sexism, homophobia, transphobia, classism, and ableism. A comprehensive understanding of how systems of oppression operate, has allowed me to form meaningful relationships with racialized service users and simultaneously support them to navigate the systems, overcome systemic barriers, and achieve their recovery goals.”

– Ana De Garcia, Case Manager at Across Boundaries

“Working from Across Boundaries Anti-Racism/resisting Anti-Black racism and Anti-Oppression frameworks, I have found that being culturally sensitive, actively listening and asking questions about Service Users culture/customs and experiences has helped me to connect with Service Users from various backgrounds. This strategy has also helped me to provide services/support that is relevant to everyone. As a racialized case worker, my focus is to provide inclusive, client centered care, with mindfulness of service users experiences and needs. I also work with them and their families to explore opportunities for care that are relevant for them and their cultural practices. I am aware that each service user has unique strengths, experiences and goals, so the services I provide are inclusive and unique, to cater to diverse needs and situations. In this way, service users can achieve their goals, recover and grow at their own pace according to their own choices.”

-Devi Kirkham, Case Manager at Across Boundaries

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