Mental Illness: The Hmong Culture

According to research, African Americans tend to have more shameful attitudes towards individuals with mental illness compared to European Americans (Ward et al, 2009; Poussaint & Alexander, 2000). Within African American culture, admitting one has mental illness is sometimes viewed as a personal weakness or lack of faith (Ward et al 2009; Boyd-Franklin, 2003). This perceived stigma often deters African Americans from discussing their mental health concerns with family and professionals. For Black women in particular, the issue of stereotype has been an overlapping factor affecting the use of services for mental illness. Sexual objectification can be linked to mental health problems among African American women. Objectification theory hypothesizes

The DSM (IV-TR) identifies depressive symptoms as having a depressed mood most of the day, diminished interest or pleasure in all or most activities, significant unintentional weight loss or gain, insomnia or sleeping too much, agitation or psychomotor retardation noticed by others, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, or indecisiveness, recurrent thoughts of death or suicide (Carson. R et al, 2008). The DSM- IV (1994) also states that, culture can influence depressive symptoms e.g. in many Asian countries, depression is often manifested through complaints of weakness, tiredness or imbalance, rather than feelings of guilt, difficulty concentrating etc. This then

Mental health is a state of psychological well-being. According to World Health Organization (WHO) mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others." (Organization, WHO 2001) However, cultural differences, race, ethnicity, personal background, subjective assessment, and socioeconomic status all affect how mental health is defined. This variation in definitions of mental health between different sects of our society further causes drift in methods of treatment, and may cause the burden of mental health to be greater on some cultures.

Ethnomedicine has been historically defined as any healthcare system not present in the West; now, ethnomedicine is defined as the any cultural beliefs which surround healing in a community. The Hmong—an ethnic group located within present day Laos, Vietnam, and Thailand—have a particular system of ethnomedicine which is described as personalistic. Within a personalistic system, an active agent is the underlying cause of a disease—or etiology. Humans can be the cause of the disease as well as a number of non-human and supernatural agents. When Lia Lee began seizing at three months of age, her parents understood that the active agent which caused her epilepsy was a door slamming which caused her soul to fly from her body, an illness called quag

Social distance has been applied to give an insight into stigma and negative attitude towards the mentally ill as shown in research conducted by Marie & Miles, (2008), Arboleda-Florez & Sartorius, (2008), Giannakopoulos et al., (2012), Economou,et al. , (2014), Murman, et al., (2014). Emory Bogardus (1925), was first credited with implementing social distance in his research on the intergroup relation, and it is still applied today on how group fare and social acceptance (Parrillo & Donoghue, 2013) towards other groups. Based on literature (e.g., Marie & Miles, 2008; Ayazi, Lien, Eide, Shadar, & Hauff, 2014) mental illness is a factor which influence social distance, where individuals will seek to avoid this particular group leading to rejection and fractured identity (Vogel, Bitman, Hammer, & Wade, 2013; Feldman & Crandell, 2007). CONSTRUCT-

The stigma’s greatest advocate is the general public’s ignorance on the subject of Schizophrenia. That coupled with the media’s portrayal of Schizophrenia leads to an unfounded stigma that society perpetuates (Ellison et al 341). One of the universal facts about mankind is that they have a fear of the unknown. In relation to Schizophrenia, the unknown is the illness itself and following that scenario, the lack of knowledge leads to a fear of the illness. Due to the lack of knowledge about the true nature of the illness, the general public is more inclined to allow other information to fill in the void.

There are those who take mental illnesses seriously and those who do not. Mental illness does not have a set definition and its importance is widely varied. Sometimes, the way that people from certain cultures, different socioeconomic statuses, and different educational backgrounds view mental illness or mental illnesses in general can affect the way that one individual sees their own symptoms of mental illness and others who are mentally ill.

Much has been written about the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Feminist critiques are abundant. However, it appears that despite criticism of the medicalization of the field of psychology from psychologists, social workers, marriage and family therapists, and mental health counselors, the DSM remains the primary basis for the teaching of psychopathology to future mental health professionals. The reasons for this are complex. This paper attempts to elucidate the multiple social, political, and economic forces at work in maintaining the dominance of the psychiatric profession, with its medical approach to psychological distress, in the field of mental health. In addition, the effects of gender biases,

When people hear the words, “mental illness,” they think of insane asylums and psychiatric wards, but that’s not necessarily the case. Yes, back in the 1800’s they did have asylums for people with mental disorders. But that was when doctors didn’t fully understand mental illnesses and disorders. But currently, doctors are able to comprehend illnesses and disorders.

In a study by Sarah Garcia-Siberman (1998:1-12), mental health issues can be seen at any age from the very young to the elderly, those with a higher level of education are less likely to develop cultural-bound syndromes. They are more likely to seek out the assistant of mental health providers (psychotherapy) and take medication (pharmacological treatment) if needed. This makes since to me, when someone is educated and are able to cope with the stresses of everyday life, the person is better equip to deal with whatever changes occur, making mental health issues less likely in this population. The older population and those that have little to no education, view these syndromes as evil, spiritual possession, or witchcraft, which can only be cured through herbal remedies, religious or shaman healers, and ritual ceremonies (Piñeros 1998:1425). If a culture is isolated and has no contact with civilization, I can see why they would not be able to seek professional help.

Stigmatization of mental illness existed well before psychiatry became a formal discipline, but was not formally labeled and defined as a societal problem until the publication of Goffman’s book (1963). Mental illnesses are among the most stigmatizing conditions, regardless of the specific psychiatric diagnosis. Unlike other illnesses, mental illness is still considered by some to be a sign of weakness, as well as a source of shame and disgrace. Many psychiatric patients are concerned about how people will view them if knowledge of their condition becomes public Mental health stigma can be divided into two distinct types: • social stigma is characterized by prejudicial attitudes and discriminating behavior directed towards individuals with mental health problems as a result of the psychiatric label they have been given and has those types stereotypes, prejudice, and discrimination Stereotypes are based on knowledge available to members of a group and provide a way to categorize information about other groups in society Prejudiced persons agree with these negative stereotypes, and these attitudes lead to discrimination through negative behaviors toward mentally ill individuals those negative perceptions create fear of and social distance from mentally ill persons. • perceived stigma or

Stigma surrounding the patients using mental health servicesurrounding the patients using = = =mental services Panova G, Zisovska E, Joveva E, Serafimov A, Karakolevska Ilova M FACULTY OF MEDICAL SCIENCES UNIVERSITY OF GOCE DELCHEV, SHTIP, MACEDONIA Stigma is used as a synonym for designation of individuals or group with some characteristic differ from other population. This means that any disease by itself can carry stigma. But the greatest stigmatization is still associated with mental illness.

Why do the people of today still associate stigma, shame and blame with mental health issues? Mental health issues are extremely and widely misunderstood. Despite the fact one in four people are likely to experience some kind of mental health problem a year in the United Kingdom. “Mental health is a person’s condition with regard to their psychological and emotional well-being and it affects how we feel, think and act. It also helps to determine how we handle situations such as stress, how we relate to others and how we make decisions.

Very few countries have an actual legal framework that adequately protects the rights of people with mental disorders. Globally, there is huge inequity in the distribution of skilled human resources for mental health. Shortages of psychiatrists are among the main barriers to providing adequate treatment and care in low and middle-income developing countries. The rate of psychiatrists in high income developed countries is 170 times greater and for nurses is 70 times greater than the ones in the underdeveloped

Mental illnesses do not just affect a minority; they affect the people who have them and their friends. Likewise, the