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THE SOCIAL AND CULTURAL CONTEXTS OF PSYCHOLOGICAL TREATMENT


THE HAPPENINGS OUTSIDE A CLINIC

“Mental health illness is nothing to be ashamed of, but stigma and bias shame us all.” –Bill Clinton

Today, the sci-fi generation of the 21st century are lured by incentives, slammed and snowed under overtime and extra work. About 970 million people worldwide had some sort of mental illnesses in 2017. With mental illness gradually turning into a global epidemic, it is sombre to believe that little or no focus is given to mental health. According to the World Health Organization (WHO), over 90 million Indians suffer from some form of mental disorder. However, the prevalence rate could be higher.

The mental health services used by the consumers or the clients are altered and shaped by the cultural and societal contexts.

Culture = shared set of beliefs, norms, and values.





Culture and society play an important role in shaping an individual’s ideas and behaviour. The same is the impact on mental health. It can influence what kind of help a person seeks, whether one seeks help or not, and the type of mental service.





Society urges people to “just talk to someone” when one is mentally ill/disturbed and rarely advises them to go to a professional. This leads to dangerous advice. This leaves the patient in an isolated condition. We have modified this society where most people function “well enough” and have “well-settled lives”. Is that really living? We don’t really discuss mental health. They are just labelled ‘mad’. Once this happens then they undergo a long period of hibernation and there is no coming back.

Most ‘mad’ people are excluded from getting married, finding employment, and even getting the right treatment. This creates a strong force and eventually prevents people from expressing themselves or even asking for help.




The presentation of symptoms varies significantly across cultures. For example, Asian patients are more likely to present organic complaints rather than emotional symptoms. A study by Kleinman in 1977 showed that the patients in different cultures tend to present the symptoms in culturally acceptable ways. The culture of the clinician and the system influences the whole equation. The difference in the treatment can be felt when one relocates to a whole new place. For cultural differences to be felt and experienced one has to travel or just enter a different community. Until one leaves the country, it is too easy to lose sight of the importance of culture.

The cyclonic and contagious pressure built up by society then leads to stigma. Self- stigma, institutional stigma and public stigma are all the variants of the same. It affects the individual and the immediate family. Studies found that self-stigma leads to negative effects on the recovery of those with severe mental illnesses. It leads to:

  • Low self-esteem

  • ↓ Hope

  • Reduced likelihood of continuing treatment

  • Worsening of the symptoms








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