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Relationship Between Culture and Mental HealthEssay

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Global Mental Health

One striking characteristic about the state of global mental health today -- aside from the fact that "four out of the ten diseases with the highest burden are psychiatric" -- is that in the developing world there is greater likelihood of quicker remission than in the developed, Industrial world (Kastrup, Ramos, 2007, p. 42). Schizophrenia, for instance, weighs more heavily and persistently in first-world countries than it does in the third-world. While some researchers attribute this lop-sided relationship to the belief that the developing world has a lower rater of reporting and treatment (thus skewing the statistics) (Gilbert, Patel, Farmer, Lu, 2015), others assert that the higher rate in the Industrialized world is due to a host of reasons related to modernization, such as a disconnect with nature, a greater dependence upon chemical treatment, a detachment from traditions and Old World values, and a fragmentation of culture (Gilbert, 2014). Whatever the reasons, the rate of incidence of mental disease around the world is increasing. This paper will discuss the state of global mental health today and evaluate some of the problems and theories associated with it.

Scope of the Problem

According to researchers, "13% of the global burden of disease" is caused by mental health disorders -- more than cancer and more than heart disease (Collins, Patel, Joestl et al., 2011). The range in mental health disease goes from schizophrenia to dementia to drug and alcohol abuse/dependency. It is estimated that as a result of some form of mental disease, 1.5 million people will be committing suicide every year by 2020 and nearly 30 million people will be suicidal (Bertolote, Flieschmann, 2002). These numbers highlight a serious, epidemic-like problem in the world's mental health. What has happened to make people's minds so troubled -- more troubled than their bodies? In the ancient civilizations of China, Greece, India and Rome, philosophers and doctors speculated that there was some connection between the physical and the mental or spiritual. Plato, for instance, argued that if one wishes to cure the body, he must start by curing the mind/soul (Kyziridis, 2005). The approaches to mental cures differed from one ancient civilization to the next, some emphasizing prayer and spiritual relief, others emphasizing the application of music and rest, others focusing on healing through cleansing of the blood. What each typically had in common, however, was a sense that the disorder in the mind arose from affliction that could be alleviated through the use of some form of cultural means -- whether religious, social or communal.

In the Industrialized world, a decisive break occurred between the Old World culture and the modern culture, with tensions fostered as individuals who clung to traditional values were seemingly pulled in two directions at once (Weaver, 1984). On the one hand, individuals raised with a sense of traditional culture (whether American, European or Asian) would have to contend, generally, at some point in their lives with the pressing demands of modern culture -- the need to assimilate, for instance, accept modern values, keep pace with the modern world through the use of new and increasingly rapid technology. The flood of credit upon the developed world in the mid-20th century, especially in the U.S., following WW2 essentially gave birth to the middle class, lifting millions of people out of the poverty that their families had known prior to the war and rewarding those who served in the military with considerable pensions and kickbacks as consumers. The world of high finance had been born decades earlier and incentives to loan and enjoy the apparent, new "prosperity" -- fruits of victory in Europe -- produced a high feeling of euphoric proportions as a whole new generation settled into the "good life," thanks to substantial dispensations from the government.

By the 1970s, the good life had turned to shambles. Revolutions were mounting everywhere -- not just in the U.S. Wars and coups were waged throughout Asia and Africa and Central and South America. Political strife met economical and social disorder. Even in the spiritual or religious realm, major changes were afoot among the most visible religious leaders in the world under the guidance of the Roman Catholic Pontiff, who had "updated" Church doctrine in the 1960s at the Second Vatican Council, exacerbating the disconnect between traditional values and modern ones. All of this impacted the state of global mental health: depression, drug and alcohol abuse, and schizophrenia soared. Suddenly, the fruits of modernization were manifest in a "split mind" syndrome, as everywhere people attempted outwardly to adapt to modern principles and ways of life and yet inwardly fell apart at the seams. What had kept them together? And what could make them whole once more?

Epidemiology and Causation

When the World Health Organization (WHO) focused on schizophrenia in the 1960s (at about the same time the Cold War was raging, the Roman Church was re-orienting itself along modern lines, and the global economy was shifting under the weight of Bretton Woods), it compared the development/course of the disease and rate of incidence among 10 nations. WHO showed that cases presented similarly though the wider the delineation used the greater the differences became. What was significant was that 63% of persons diagnosed with schizophrenia had improved, with the disease going into remission in only two years' time, in the non-developed world -- as opposed to only 37% of cases seeing remission in the developed world (Kastrup, Ramos, 2007). This curious finding highlighted a considerable factor differentiating the modernized world from the as-of-yet unmodernized world: the societal framework of the "past" was more conducive to mental healing than was the framework of the present (in Industrialized societies). According to Kastrup and Ramos (2007) the "more favorable prognosis" in places like Singapore and Japan is "explained by the tendency to maintain an attachment to elements of their respective traditional cultural patterns more than their technological development" (p. 42). In other words, a dependency upon modern/technological culture facilitates mental disorder, whereas a cultivation of traditional "patterns" produces mind-body harmony -- as far as scholarly schizophrenia studies indicate on the global mental health stage.

But what of other mental health diseases? Major depression is the fourth most widespread "contributor to the global burden of disease" and by 2000 accounted for 4.4% of the total amount of "years lost due to early death" and/or disability (Ustun, Ayuso-Mateos, Chatterji, 2004, p. 386). In Europe alone it was estimate that more than 20 million persons suffered from depression -- numbers that would be of epidemic proportions were they linked to something like HIV, which received major worldwide news coverage for years. Yet, depression which directly impacts so many lives is hardly covered by mainstream media. This startling observation may raise questions about the relationship between global mental health and cultural influences as guided by popular press -- or it could merely be that mental health epidemics are not newsworthy in the Brave New World of today, where so many of the world's leaders appear to operate on a level of insanity that beggars belief (Escobar, 2014).

More alarming still is the finding that depression is relative to income: in poorer countries there are significantly fewer recorded incidences of depression than there are in high-income countries. For example, in Africa depression accounts for little more than 1% of the burden of disease, while in wealthy first-world countries it accounts for nearly 9% of the total burden of disease (Kastrup, Ramos, 2007). What tremendous difference "prosperity" makes!

The question must be asked: what is it about developed, high-income nations that causes almost a tenth of its burden of disease to stem from depression? Why are the "middle-class" nations of the world more susceptible to depression than the impoverished nations? A practical consideration could be that in poorer countries there simply is not as much focus on material possessions, luxury, relaxation, enjoyment, expenditure, consumerism and status as there is in places like America, where the American Dream is based on the desire to accumulate wealth. In poorer countries, life consists of simpler ambitions -- work, providing food and shelter for oneself and one's family, and social interaction within one's local community. The kind of village life in Africa, where depression rates are low, can be compared to suburban life in, say, Cincinnati, where neighbors do not know one another beyond sight recognition, where there is little to no sociality, where the Digital Age has moved most social connectivity to the realm of the Internet, and where isolation is a mode of life (Brandtzaeg, 2012). It is no wonder, if one compares the culture of the latter to the culture of the former, that the Industrialized world is more depressed than the third world: it has essentially become much more anti-social than the so-called "developing" world, which still has a sense of natural, face-to-face social interaction and engagement. If man is a social animal by nature, the fact of his divorcing himself from society and isolating himself in his luxurious quarter-of-a-million-dollar home,… [END OF PREVIEW]

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