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culture and Mental Health
Transcript of culture and Mental Health
culture and mental health Interpretation of schizophrenia
across cultures Schizophrenia: A disorder that lasts for at least 6 months and includes at least one month of active-phase symptoms of two or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, negative symptoms In 2006, over six million Canadians (19.8% of the total population) were born outside the country. The number of Canadians who speak neither
of Canada's official language has grown
by 18.2 % since 2001 Ontario has had the highest provincial rate
of immigration, with more than half of the
1.1 million immigrants within the five years
to 2006 (52.3 per cent) choosing to
live in the province Canadian Statistics Symptoms are divided into two categories: Positive and Negative a) Positive: Excess or distortion of normal functions (delusions, hallucinations and disorganized speech)
b) Negative: Diminished functions such as affective flattening, inability to fluently participate in conversations or express complete thoughts, the inability to engage in goal-directed behaviour Acculturation & The Healthy
Immigrant Effect Barriers when accessing Mental Health Services Misdiagnosis of minority clients Differences in communication patterns, language barriers, and lack of minority staff Client’s socioeconomic status & lack of ties with the community Stigma regarding mental illness and differences in help-seeking behaviours Disconnect between the client’s culture and Western practices Factors Associated with Culture & Mental Health Sociocentricity: refers to the scale ranging from strong individualism to strong collectivism, on which a culture may be measured. Individualism VS Collectivism
Often, the delusions tend to reflect the predominant themes and values of a person's culture. Individuals that encounter stressful life events is trauma, war, or torture are at increased risk for developing schizophrenia
Stigmatization of mental health may extend the duration of untreated psychosis.
Living in a different cultural context may attribute to social isolation and increased development of schizophrenia. 8 Steps to Cultural Competence for Primary Health Care Professionals 1. Examine your values, behaviours, beliefs and assumptions. 2. Recognize racism and the institutions or behaviours that breed racism. 3. Engage in activities that help you to reframe your thinking, allowing you to hear and understand other worldviews and perspective. 4. Familiarize yourself with core cultural elements of the communities you serve. 5. Engage clients and patients to share how their reality is similar to, or different from, what you have learned about their core cultural elements. Unique experiences and histories will result in differences in behaviours, values and needs. 6. Learn how different cultures define, name and understand disease and treatment. Including: physical and biological variations, concepts of time, space and physical contact, styles, and patterns of communication, physical and social expectations, social structures, and gender roles. Engage your clients to share with you how they define, name and understand their ailments. 7. Develop a relationship of trust with clients and co-workers by interacting with openness, understanding, and a willingness to hear different perceptions. 8. Create a welcoming environment that reflects the diverse communities you serve. Upon arriving in Toronto, he maintained contact with his family but in the past three months he has been inconsistent. Mr. Singh used to attend daily religious services back home but has not been attending in Toronto. Mr. Singh is experiencing culture shock and is having difficulty feeling welcomed within his community. Since his move to Toronto, Mr. Singh has been having difficulty making friends due to his hesitation in communicating with others as a result of his limited English. Over this time period Mr. Singh’s symptoms began to worsen and interfere with his work and personal life.
Mr. Singh started to have visual delusions and auditory hallucinations at work which resulted in his employer firing him. Mr. Singh has been referred to you (the RN) and you are required to provide culturally competent care to help this individual. Mr. Singh is a 23 year old male who has recently migrated from India. He has a past diagnosis of schizophrenia but has managed well without medications in his home country. He speaks limited English. The last time Mr. Singh saw his family physician was in India. He comes from a large family, but the only relative he has in Toronto is his aunt. Class Activity have taken over the world!
You and your group are living through a zombie apocalypse. The goal of this game is to help your five characters survive. The group with the most survivors at the end of the presentation wins!
To do this, you will answer 5 questions throughout the presentation. The group who collaboratively comes up with the most answers will win each round, saving their characters. The remaining groups who lose at each round will lose one of their characters. If you lose a round, just flip a character's card over. Round 1 Can you identify positive and/or negative symptoms that Mr. Singh is demonstrating?
Name additional positive and negative symptoms not mentioned in Mr. Singh's case study. What factors may have exacerbated Mr. Singh’s symptoms? What
questions can a nurse ask to assist in exploring what may have exacerbated Mr. Singh's symptoms? Round 3 What factors may have been beneficial in managing Mr. Singh's symptoms in his home country?
As nurses, how can you investigate a client's culture as individualistic or collectivistic? Round 2 Round 4 What barriers may exist that Mr. Singh is encountering when accessing mental health services?
Can you think of additional barriers that may exist in our society that can prevent individuals with mental illness in accessing health care? As Mr. Singh's nurse, what culturally competent strategies can you employ in his plan of care? (Rhymes, Harrigan, Petrella, & Dunbar, 2010). (Dow, 2011) Ontario Federation of Mental Health and Addiction Programs. (June 2009). (Myers, 2011). (Bernstein, Park, Shin, Cho, & Park, 2011; McKenzie, K., & Mental Heath Commission of Canada, 2009; Rhymes, Harrigan, Petrella, & Dunbar, 2010; Shen, & Takeuchi, 2001; Torres, 2010) (Bae, & Brekke, 2002; Barnes, 2004; Brekke, & Barrio, 1997; Hui, & Triandis, 1986; Public broadcasting service, n.d.). Agenda Self-assessment
Review case study
Schizophrenia across cultures
Barriers when accessing mental health services
Cultural competence for nurses