CULTURAL EFFECTS ON MENTAL ILLNESS

Cultures Effect on the Views and Treatment of Mental Illnesses,

And the Growing Need for Acceptance
Sabrina Rodriguez
Global Connections
Instructor: Gregory Falls
December 16, 2015

CULTURES EFFECT ON MENTAL ILLNESSES

Abstract
The overall deciding factor on the way a person with a mental illness lives their life
within their society is culture. Negative stigmas created by a culture tend to prevent those with
mental illnesses from living self-sufficient lives. Theses cultural stigmas also prohibits them
from being a contributing member to society because of their inability to complete their
education, hold a job, or have social interactions with others. This forms a gap between those
with mental illnesses and those who are perceived to be the social norm. In order to bridge this
gap there needs to be a decrease in negative cultural stigmas and an increase in the acceptance of
those with mental illnesses. Each culture reacts to Autism, Bipolar Disorder, and Schizophrenia
differently. Some cultures suppress the idea that mental illnesses that affect emotions exists while
others complete acceptance can lead to illnesses, such as Bipolar Disorder, to common. However,
some societies have chosen to encourage the development of programs that help those with
mental illnesses survive on their own or with little help from others. These programs are the
beginning to the global change of social acceptance and the end of cultural rejection of mental
illnesses. Autism and Schizophrenia are similarly viewed as a weakness and causes a society to
reject those with either illness. Change can be acquired by a global acceptance and over coming
of negative cultural stigmas can lead to the greater number of those with mental illnesses actively
involved in society.

CULTURES EFFECT ON MENTAL ILLNESSES

Table of Contents
Abstract. 2
Introduction... 4
Limitations.... 5
Methodology. 6
Literature Review..... 7
Discussion 11
Stigmas created by society 11
Culture bound syndrome .. 13
Cultures effect on Autism 13
Cultures effect on Schizophrenia.. 15
Cultures effect on Bipolar Disorder... 16
Conclusion... 17
References 18

CULTURES EFFECT ON MENTAL ILLNESSES

Introduction
Throughout the world mental illness is perceived and treated in a variety of ways. Culture
is a phenomenon that can not only be a positive influence of societys reaction to mental illnesses
and treatment, but can also be a negative influence. Societies often create stigmas or marks of
disgrace that have life changing consequence for those with mental illnesses. By bringing
awareness to the effects cultural stigmas have on those with mental illnesses, societies are
presented with the opportunity to bridge the gap between those with mental illness and those
without.
Cultural stigmas hinder the lives of those with mental illnesses. They prevent those with
mental illnesses from living normal lives within their communities. It often prevents those with
mental illnesses from receiving treatment that assists in finding normalcy. However, by not
bringing awareness of how societies suppress those with mental illnesses, they will continue to
be miss treated and not given the opportunity to thrive in their communities.
Having an understanding of societys impact on the views and treatment of mental
illnesses allows for a unity within the community. When those with mental illnesses are treated
equally, they can make multiple contributions to society. If cultural stigmas, created by society,
negative effects are brought forward then the lifelong damage can be reversed or prevented for
future generations.

CULTURES EFFECT ON MENTAL ILLNESSES

Limitations
Investigating East Asian, Middle Eastern, as well as the Western cultures of The United
States and Europe will allow for a well-rounded understanding of the global perspective of
mental illness. This level of understanding provides an opportunity to compare how each culture
differentiates treatment as well as how people with mental illnesses are integrated into their
native culture. However, with conducting research there are multiple limitations that affect how
the information was collected and used by the author.
Travel Limitations:
Due to the inability to physically travel to specific countries located in Asia, the Middle
East, parts of the United States, and Europe there is a wide gap left between each area researched
as well as the cultures of these areas. However, this gap will be bridged through the use of
articles found from the specific areas of research, as well as the use of articles that involve
cultures based on those areas. Also due to the inability to travel there is a lack of first- hand
experience of how those with mental illnesses are treated by the different cultures of each
culture. However, this can be overcome by using sources from the specific regions chosen to be
researched. Another way to overcome the lack of first-hand experience is by using information
from observations of interactions between someone with a mental illness and someone of a
different culture.
Research Limitations:
The research conducted only explores the way culture effects the three most common
mental illnesses which are Autism, Bipolar Disorder and Schizophrenia. These three illnesses
were chosen to be researched due to the severity of side effects and increasing number of cases

CULTURES EFFECT ON MENTAL ILLNESSES

around the world. Also because of the short period of time spent conducting research there is an
inability to expand the research from three illnesses to every mental illness known to man. There
will be some bias because the research heavily relies on cultural opinions and observations as
well as medical information provided by medical professionals. However this can be overcome
by using factual information that assists in showing how cultural can cause those in a society to
react or feel towards those with mental illnesses.
Methodology
In order to write this paper a variety of sources were used ranging from online
articles to medical reports found using Google Scholar. The research paper is based on
observations of medical professionals, news reports, and those who live in Eastern Asia, the
Middle East, Europe, and the United States. Due to the research heavily relying on observations
the research paper consists mostly of qualitative data and some quantitative data based on
Autism, Bipolar Disorder, and Schizophrenia.
Medical observations are provided by a set of articles written by the Office of the
Surgeon General titled Culture Counts which was found using Google Scholar. While some
sources provide a medical professionals point of view other information found from online
newspapers such as the Washington Post provide personal observations based on individual
research conducted by the author of the articles. This diverse range of resources provides a broad
spectrum of articles and books based on medical and personal opinions. A survey was conducting
on Facebook in order to collect data about personal experiences with those who have mental
illnesses and to further examine how culture influences opinions. Below are the questions asked
in the survey which was used to gain a better understanding of the effects culture has on a single
person.

CULTURES EFFECT ON MENTAL ILLNESSES

1.
2.
3.
4.

Have you ever met anyone who has Autism?

Have you ever met anyone with Bipolar Disorder?
Have you ever met anyone who has Schizophrenia?
If yes, how did you feel interacting with someone who has a mental illness?
Nervous, comfortable, anxious, indifferent, sympathetic, relaxed
5. Do you yourself have a mental illness?
6. If yes, do others treat you differently than someone who doesnt have a mental
illness?
7. What country do you currently live in?
8. Have you lived in another country that had a different culture than your own for
longer than 3 years?
9. What religion do you associate yourself with? If none then put N/A
10. Do you think your culture has influenced your opinion about those with mental
illnesses?
Throughout the course of research all articles, books, and surveys used were chosen to
assist in maintaining an unbiased research paper and to answer the question of how do stigmas
created by culture effect the views of mental illnesses as well as treatment for those illnesses?
Literature Review
The information was gathered by using articles written by medical professionals,
chapters in published books, national newspaper and magazines as well as smaller news sources
located around the world. Also included are interviews conducted by the Washington Post in
order to give another perspective of mental illnesses. One article specifically was written in
another language and then translated into English in order to include a global perspective in a
form other than an interview or first- hand experience in another country. Each article includes
an explanation of cultures effect on either Autism, Bipolar Disorder, or Schizophrenia.
In the articles Culture Counts on Mental Health Services and Chapter 2 Culture Counts:
The Influence of Culture and Society on Mental Health, the United States Surgeon General

CULTURES EFFECT ON MENTAL ILLNESSES

discusses observations made in hospitals of how culture influences patients decisions about
receiving medical treatment. According to the articles in the United States a patients cultural
background bounds them to making medical decisions that would not harm their social status
within their culture. Because of culture a gap is formed between patients and medical
professionals that not only must medical professionals bridge, but also prevent other gaps from
forming.
Sayyed Ali Samadi, Roy McConkey, Cordelia Ross, and the authors of article The Impact
of Culture on Autism Diagnosis and Treatment: Considerations for Counselors and other
Professionals discuss the way that culture effects those with Autism. In Autism and Normal in
China, Ross writes of how Chinas negative view suppresses children with Autism early in their
childhood to prevent them from hindering their peers education. She also discusses how this can
effect a person with mental illnesses later in their life. The article discusses first-hand
experiences of how families prevent their children from becoming a part of society by not only
terminating their education, but also by refusing to bring them in public. In the article Autism in
Developing Countries: Lessons from Iran Samadi and McConkey discuss how Autism is handled
in developing countries and multiple ways for families to accept a child with Autism rather than
rejecting them. Also discussed is the benefits that occur in developing countries when given the
opportunity to identify children with Autism and help them thrive within their society. In the
following article the main focus is on Autism and how culture effects the illness as a whole. In
the article The Impact of Culture on Autism Diagnosis and Treatment: Considerations for
Counselors and other Professionals the authors offer others ways to handle situations where a
familys cultural background prevents a patient from receiving treatment.

CULTURES EFFECT ON MENTAL ILLNESSES

The Washington Post writer Shankar Vedantam and World of Psychology writer Therese
J. Borchard both conducted interviews that focused on how cultures impact those with mental
illnesses. In Mental Illness across Cultures: An Interview with Gayathri Ramprasad, Therese
Borchard interviews Gayathri Ramprasad the founder and president of ASHA international, who
advocates for those of all cultural backgrounds suffering from anxiety and depression which are
a symptom and emotion resulting from Bipolar Disorder. Ramprasad is asked and answers
questions based on how the different cultures of the United States and India impact the views of
mental illnesses and also allows the reader to compare the two cultures views. Shankar Vedantam
conducted an interview discussing the impact culture has on views of both mental illness and
treatment for mental illnesses as a whole. In both interviews the topics give not only a global
perspective as well as solutions to preventing or lessening stigmas effects on mental illnesses.
In the articles Cultural and Demographic Factors of Schizophrenia, The Teenage Brain:
Culture and Schizophrenia and Cultures, Cultural Factors in Psychiatric Disorders, the authors
discuss how despite Schizophrenia occurring throughout different cultures it is still seen as a
hindrance to the community not only the family. However, Judy M. Versola-Russo the author of
Cultural and Demographic Factors of Schizophrenia, goes into further detail of how culture can
lead to different diagnosis of Schizophrenia based on symptoms culture specific. While Russo
discusses the differences in symptoms, PBS differentiates how families would react depending
on if they are located in a developing or developed country. The author also discusses how
western society reacts to those with Schizophrenia and also technologies effect on these views.
Both articles include a number of cultures views, including Asian, Hispanic, developing and
developed countries, of Schizophrenia as well as how possible reactions if a family member were
diagnosed with the disorder. The third article provides a medical perspective of how specific

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10

factors in culture can be the leading cause of Schizophrenia. Overall each article concentrates on
how influential culture is on the opinion of Schizophrenia and how it can cause symptoms
related to Schizophrenia and the illness itself.
In Sociology of Depression- Effects of Culture and Transcultural aspects of Bipolar
Disorder the authors discuss how cultural stigmas can negatively influence familys to believe
that depression or Bipolar Disorder do not exist within the culture. These beliefs lead to the
rejection of the illnesses or symptoms that may be present in a person which also prevents those
with the illnesses from receiving treatment. The author of the article states that culture focuses
on oneself and ones place within the social hierarchy meaning that in order to gain or maintain
a high social status one must be entirely accepted by the culture that they identify with. If a
person has a mental illness themselves or knows a family member who lives with an illness there
is a risk of losing their positon in society. It also discusses the topic of why society continues to
allow culture to dictate what is seen as acceptable in society and mental illnesses should be
handled as a whole. In Transcultural aspects of Bipolar Disorder, which was originally written in
Portuguese, the author claims that if he same mental illness was observed by different cultures
result can vary due to cultures identifying symptoms that are significant or relevant to the
culture. This can lead to the incorrect diagnosis of a patient and the incorrect treatment received
by the patient. Each culture has a different view on the symptoms of a mental illness and without
each culture identifying mental illnesses the same way there will continue to be incorrect
diagnosis made.
The author of Stigma of mental illness and ways of diminishing it, Peter Byrne, defines
stigma as a sign of disgrace or discredit, which sets a person apart from others. Later he
discusses what cultural stigmas mean in society, how harmful they can be, and finally ways to

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11

prevent them from continuing to occur in societies that are less accepting of abnormalities. The
article also describes the process and history of stigmatization and its effectiveness in society.
However, not only does the author identify causes of cultural stigmas, he also offers suggestions
for changing the amount of influence a culture has over a person with mental illnesses.
EuroMed Info and Pasadena Villa both wrote articles discussing how culture impacts
those with mental illnesses and includes the thought process someone with a mental illness may
have based a specific culture. In the Pasadena Villa White Papers article, Culture and Societys
Influence on Mental Health, statistical information is given on different demographics in the
United States to show cultures impact on person. The author further distinguishes which cultures
were willing to receive medical treatment due to their lack of focus on stigmas and which ones
refused due to cultural stigmas heavy influences on those with mental illnesses. EuroMed Info
article, How Culture Influences Health Beliefs, discusses sub-groups of a specific cultures and
the views on health as a whole. Together these articles provide a view of mental illness as a
whole and how individual groups respond to stigmas.
The final article The Culture of Mental Illness: The Startling Effects of Culture on the
Presentation of Mental Illness author Neel Burton discusses illnesses specifically found in the
western world, such as post-traumatic stress disorder (PTSD). He also includes syndromes that
are created by or bound to a specific culture and how it may have originated. The article is meant
to differentiate illnesses specific to region while discussing ones found across the cultural
spectrum.
Discussion

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Throughout the course of history and most currently the cultural stigma of mental illness
has evolved while in some cultures it has mostly dissipated. With the dissipation of the cultural
stigma being relatively new to some cultures, it poses a greater question of how do we integrate
those with mental illnesses within our communities while allowing them to be self-sufficient.
Despite creating possible solutions integration cannot occur without the breaking of the cultural
barriers that surrounds treatment for mental illnesses.
Stigmas created by society:
Cultures that tend to be based on a traditional foundation have the inability to accept a
mental illnesses because of the barrier it creates in order to separate both medicine and culture.
This barrier prohibits those with mental illnesses from seeking and receiving treatment due to the
risk of being out casted, and marked as a disgrace to their family or community due to their
circumstance (Unite for Site). Having this label hinders their future and possible achievements of
becoming a self-sufficient member of the community. Theses social barriers are called stigmas
and they are created in order to form a system of hierarchy that consists of those who have
abnormalities existing at the bottom while those who are accepted in society thrive at the top.
Despite each culture having at least one stigma they vary across the cultural spectrum. As a
whole these stigmas have the same end result of preventing those with mental illnesses from
living a normal life that consists of having a job, marrying and having a family, and most
importantly interacting with others within the community (Pasadenavilla, 2015).
Due to the negative impact stigmas have, those with mental illnesses opt to living with
their illness in secret, ignoring symptoms, and refusing treatment. Those who have mental
illnesses chose to separate themselves from family members and others within the community in
order to avoid being found out and forced to admit to their illness (Byrne, 2000). Stigmas

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13

contribute to a persons feeling of helplessness as well as trapped within their society, but also
within themselves. Those with mental illnesses are stuck between deciding if the treatment that
will be received for their illnesses is worth disownment from family members and community
members. There is a fear planted within someone with a mental illness that effects their home
lives. There is also a doubt formed based on the idea that doctors are unwilling or unable to help
better their mental conditions. Medical professionals must overcome the stigmas set by a culture
in order to properly treat the patients conditions and create a safe haven for those with mental
illnesses. This safe haven allows patients to feel comfortable discussing their illness without
fearing rejection by society.
Culture has also lead to the development of cultural bound syndromes that share similar
symptoms of global mental illnesses, but are only found in a given region. These syndromes can
also influences the severity of their illness as well as whether patients show symptoms
(Arkowits, Lilienfeld, 2009). For example, in the Western world depression and Bipolar Disorder
rates have steadily increased and has had a greater number of patients show symptoms of this
illness. In the Asian culture, specifically Japan and China, depression is seen as a weakness and
something that only prevents the community from thriving (Nemade, Reiss, Dombeck, 2007).
This information shows that by dismissing depression as a mental illness, the Asian culture does
not view emotional illnesses as significant and there for cannot be seen as a common illness. This
also shows that because of its acceptance of emotional illnesses the Western world tends to have
more cases involving these illnesses than any other culture in the world. These constantly
occurring syndromes share similar features to mental illnesses, but are seen as less of an
abnormality in some societies due to its strict following of a patients culture. The formation of
these syndrome show how damaging a culture can be to its own people because despite its

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14

similarities to a global mental illness, these syndromes are formed based on what is seen as
acceptable in a culture.
Cultural Effects on Autism:
Each of the three specific mental illnesses researched have similar yet different reactions
to culture due to the intense pressure placed on people to remain seen as a normal self-sufficient
member of society. However in more accepting cultures, such as some places in the United
States, the severity of the Autism disorder dictates whether family members must assist in the
caring of their relative or if the person is able to survive on their own.
In the Middle East people are usually diagnosed through privately owned medical
practice because it is seen as a private family matter. However, if the outcome is positive for a
mental illness, families that can afford treatment tend make arrangements that allow for their
relative to adapt to life with Autism. In Iran specifically the government has created state funded
and welfare based programs that children can participate in order to further their education
despite having a mental illness (Samadi, McConkey 2011). However, these programs tend to
better assist with Autism in the cities than those living in the countryside. Unlike parents in Asian
countries, parents in the Middle East tend to force their children into normal schooling because
of the special educations programs that have been developed. These special education programs
help those with Autism and other mental illnesses continue being involved in society and allows
interaction with others. The negative cultural stigma that the Middle Eastern culture has on its
people is that those in rural areas cannot afford to lose their communities acceptance. Also
religion plays a key role in positive views of mental illnesses. Those with Autism can be viewed
as healers who help others in their society (Yahia, 2012). Despite both negative and positive

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15

views, as a whole, the Middle Eastern culture is viewed as more accepting than the Asian culture
whom are disowned for having any sign of a mental illness.
According to Cordelia Ross (2011), the Chinese culture forces conformity and views
anyone who stands out as an abnormality. In schools and work specifically, there are mandatory
uniforms, and similar preferences in appearances such as similar haircuts, sock colors, and shoes.
Unlike Iran, China forces children with mental illnesses to stay home because they are believed
to negatively impact other students ability to learn. It not only holds students back from
furthering their education, but it also impacts relatives who are expected to take care of their
family member with Autism.
Between the Middle Eastern and Asian cultures someone with Autism can be treated in
entirely different ways. The Middle Eastern culture chooses to allow those with Autism to thrive
within the community and continue schooling as a contributing member of society even at a
young age. Despite the slight stigma surrounding rural areas, whom chose to deny their autistic
child education, as a whole the Middle East has created multiple solutions that allow those with
Autism to create a life for themselves. The Chinese culture entirely suppresses those with Autism
due to their inability to conform to society. Despite the severity their disorder, family members
tend to disown the autistic relative or leave them to be taken care of by grandparents or distant
relative. The Chinese government offers no solutions to assisting those with Autism and only
view the education of normal students as the most important. The Asian culture entirely
eliminates the possibility of an autistic person from thriving in society because of the negative
influence conformity has on society (Ross, 2010).
Cultural Effects on Schizophrenia:

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Dictionary.Com defines Schizophrenia as a mental illness that involves a persons

inability to decipher the differences between reality and fantasy. In Western culture, such as the
United States and Europe, a variety of support systems have been created to better the lives of for
those suffering from schizophrenia due to the advanced technologies in these regions. These
technologies allow for early identification and ways to reverse the effects of Schizophrenia
through mostly through medicine (PBS). Since numerous countries lack access to these advanced
technologies culture tends to be the determining factor whether a person has Schizophrenia.
The different cultures of developed and developing countries are the greatest indicators
of how others will react. Developing countries tend to have cultures that are heavily based on
spiritual ideologies that view the symptoms of Schizophrenia as a spiritual gift or has a spiritual
explanation behind it. People who have Schizophrenia are idealized within these communities
and are seen as gods or mediums to ancestors or other deceased family members. A developing
countries culture accepts those with Schizophrenia and allows for them to live without receiving
treatment and live freely because of its positive views on Schizophrenia. However, those in
developed countries prefer to treat or reverse the side effects Schizophrenia tends to have on a
persons life especially in the later stages of the illness (PBS). A developed countries culture can
show an economical downfall because of some familys inability afford treatments, and
medicines prescribed by medical professionals (Versola-Russo, 2006). A developing country is
most likely to accept those with Schizophrenia because of the spiritual and supernatural services
they can provide for their community. This allows for the person suffering from Schizophrenia to
have a key role in society and self-sufficiently live. In developed countries society tends to
influence those with Schizophrenia to receive treatment to prolong their lives as well as lessen
their suffering depending on the severity of the illness.

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Cultural Effects on Bipolar Disorder:

Bipolar Disorder is found across all cultures around the world, but is seen mostly
throughout the western world. Culture is not the only deciding factor as to what effects Bipolar
Disorder, but transcultural, and sub-cultural communities also impact decisions about receiving
treatment (Sanches, Jorge, 2004).
People who have Bipolar Disorder tend to feel that they bring shame to their families
name because of their association to the Bipolar Disorder community and by being an
abnormality. Even within the United States and Europe sub-cultures affect their overall view
on treatments because they are influenced by both the culture they grew up with, but also are
surrounded by. In some cultures it is seen as weak to have Bipolar Disorder because of its effects
on emotions. Symptoms of this illness can worsen and develop into an illness with a greater
severity depending on how a culture views the illness as a whole. Acceptance can benefit a
person with Bipolar Disorder because they can receive treatment that allows them to function
normally or similar to the way others function on a daily basis (Sanches, Jorge, 2004).

Conclusion

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After collecting research written by medical professionals and credible news sources as
well as conducting individual original research one can conclude that stigmas created by culture
can negatively affect a persons view on not only mental illnesses, but on receiving treatment as
well. A culture dictates what is acceptable and what is seen as a disgrace, and while mental
illness is a natural occurrence, people fear the consequences in openly claiming they have a
mental illness. Stigmas negatively impact not only the individual with the mental illness, but also
the individuals family and status within the community.
According to original research, in the western world having or knowing someone with a
mental illness is not uncommon; seeing as out of forty-five responses, ninety-one percent knew
someone with Autism, eighty-eight percent knew someone with Bipolar Disorder, thirty-one
percent knew someone with Schizophrenia, and eighty-nine percent of those who responded who
had a mental illness said that people do not treat them differently because of their illness. This
data shows that humans as a whole are capable of accepting others and allowing those with
mental illness to have self-sufficient lives despite their illness.
By breaking the barriers of culture, society can see firsthand how simple it is to offer
education to children with mental illnesses. Allowing them to thrive in society and recognizing
that they are not completely helpless, will give them opportunity to expand their contributions.
As a Spanish proverb says Caras vemos, corazones no sabemos or we cannot know some
ones story just by looking at them.

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