Critically evaluate the statement that it is inappropriate for psychologists to use Western standards of psychological health to interpret and diagnose the behaviour of culturally different people.
The question asks to make an evaluation regarding using Western conceptions of mental health to recognise and diagnose behaviour in people of different cultures. This essay argues that, firstly, Western and non-Western worldviews are very different, in particular taking the example of intelligence; secondly, that their ideas of mental health are also very different, and incompatible; and thirdly, that if one idea of mental health is imposed on the other, then detrimental effects will occur. Thus, when looking at non-Western cultures, it is needed to take into account their worldview, and relate directly to them, so that we do not risk endangering their mental health.
Consequences of imposing Western views on other cultures: an analysis of differing ideas of psychological health
Every different person has their own set of values and ideas; their own way of explaining and defining reality, commonly called a worldview. Cultures, similarly, have unique worldviews. Unfortunately, worldviews often carry with them a sense of superiority; they deem themselves to be more dominant or correct in comparison to other worldviews (Ranzijn, 2009). When we look at the case of psychological health (which is usually equated with mental health, and is what it shall be referred to as hereon in), this becomes a serious issue. So if an examination of applying Western ideas of mental health to different cultures - with the intention of interpreting and diagnosing behaviour - is undertaken, then three main problems would quickly be recognised. That is, firstly, that non-Western cultures are significantly different to those of Western cultures, and so have differing worldviews; secondly, due to this, they have considerable distinctions in their ideas of mental health, which are potentially incompatible (Brown, 2001); and thirdly, that imposing one idea of mental health on the other can have adverse consequences (Vicary, 2003).
When looking at different cultures, one of the seemingly most obvious differences is economic, resulting in varying levels of resources available. One study done by Kathuria and Serpell noted that the subjects - African children - were more familiar with clay than pencil and paper (Kathuria & Serpell, 1999). Other differences that often come to mind can be those of language, history, or religion. All of these contribute to that culture’s worldview.
In Western cultures, there is often a focus on the individual (Hilty, 2010). This can be seen in many of the rights that are often taken for granted by many; that each person has freedom of speech; each person can freely choose any religion (or none); each person can freely move in and around the country; each person has the freedom to meet with others as they wish, or join any organisation that they choose. Of course, all of these are usually subject to the law of the country, and these are in no way solely Western ideas; they are, however, examples of individualistic thinking.
Non-Western cultures, by contrast, usually emphasise the clan, group, tribe or community. The priorities of the community are placed above that of the individual, whose main purpose is to further the goals of the community as a whole; this is known as a collectivist mindset (Ranzijn, 2009). Some ideas like this are present in our own society; the idea of community service, for example, is a fairly collectivist idea.
These two cultural backgrounds certainly seem to be very different; though it should be noted that these are not simply a binary opposition: they are two different ends of a scale, which a society can lie anywhere on. As well as this, the views of the culture are not necessarily similar or compatible to those of the individual (Brown, 2001); and, thusly, any conclusions made do not hold true to every individual, but are instead a generalisation about the society as a whole.
If we take a closer look at one aspect of psychology - intelligence - then these contrasts are further illustrated. Mpofu’s analysis of different studies (2002) in Africa about differing ideas of intelligence showed that many African cultures saw intelligence as primarily social or practical; whereas the Western idea of intelligence is mainly intellectual (Hilty, 2010).
So the variances between the different cultures is seen to be considerable.
When we narrow our focus to the issue of mental health, we can again see many important differences. Other cultures, for example, often have a more holistic approach, while Western cultures have an analytic attitude. A holistic idea is similar to the collective idea that was expressed in the previous paragraph; that is, that something is more important as a whole than just the result of adding together each different part. The community is more important as a collective entity than all the people together that are in it. An analytic mindset, conflicting with this, primarily works by breaking something down and looking at its smallest parts (Hilty, 2010).
If we take these two different views and then apply these to mental health, then further differences are noted. In an analytic view, mental health is about the lack of sickness; each part of the mental state functioning as it should. In a holistic mindset, however, this is not all that mental health is; many cultures do not distinguish between mental health and health in general, and believe that many other ideas, such as emotional, cultural and spiritual, also play a part (Ford, 2003). As well as this, health is about bringing the full potential of the individual out, so that they can then contribute and realise the full health of the entire community (Brown, 2001).
One example of these differences is mentioned by Vicary (2003), who has worked with Indigenous Australians frequently. He notes that many Indigenous Australians deliberately avoid the Western mental health system, simply because they have been sent away to mental health hospitals in the past. In an individualistic, Western mindset, sending them to the hospital makes sense, because then they can get better as a person. But in the holistic mindset of the Indigenous Australians, people being sent away detracts from the community as a whole, and means it cannot function to its full capacity.
These two differing ideas of mental health are sufficiently alien to another that they are arguably incompatible.
If, then, we accept this idea that the two alternate views of mental health are incompatible, it presents an immediate problem; because many have tried to impose the Western individualistic ideas of health onto different cultures, with negative results. In particular, a study done by Vicary (2003) on a group of Indigenous Australians indicated that they thought of the Western mental therapy as possibly detrimental; most also said that they would prefer to try to fix any problems themselves, in preference to using any Western method of treatment, even if they managed to make it worse by doing so. Similarly, Dingwall and Cairney (2010) noted that mental health issues could easily be not recognised or treated, if examiners are unaware of the cultural background.
This is a very serious setback for the Western system. If people from different cultures with various mental health problems are not treated or recognised, then the health of the population will suffer greatly. Further to this, if they are misdiagnosed, and therefore treated incorrectly, this will increase tension between the different cultures, and the affected parties may decide to not seek help again, in fear of again being incorrectly treated, and the mental health of the population may suffer even more greatly. And, as many (Brown, 2001; Cairney & Dingwall, 2010; Ford, 2003; Haswell-Elkins, Margolis, Tsey & Ypinazar, 2007) different sources note, cultures like that of the Indigenous Australians, or third-world countries similar to South Africa, often have a much poorer mental health level than usual. (However, it is fair to note that it is unclear whether this is solely due to cultural background, or also because of misdiagnosis. Nevertheless, it seems probable that at least a sizeable portion of these figures is due to the differing background.) So something certainly needs to be done, or we may well bear witness to the dwindling of many different populations.
From the points that have been argued above, it is clear that not only do Western and non-Western cultures have very different worldviews, they also have greatly differing ideas of mental health; one individualistic and analytic, the other collectivist and holistic. The two views arguably oppose one another, and are also incompatible. As has also been mentioned, this had lead to many adverse effects, when people have tried to impose one view on the other; cultural tension is increased, and the mental health of populations suffer.
And so a change must be made; if psychology is looking at the mental health of non-Western cultures and people, it needs to be able to do it from their perspective, and in a way that relates directly to them; otherwise we are at risk of endangering relations with their cultures, as well as endangering their mental health. Thankfully, there has been some (Vicary, Izod, Westerman, Kathuria, and Serpell among them) who have started to take this approach, but much work still needs to be done.
To conclude, consider this quote from Christina Lee, editor of Australian Psychologist. “...psychology cannot usefully exist without reference to other disciplines and to the sociocultural context in which it is practiced.” (2000, p. ii)
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Lee, C. (2000). Editorial. Australian Psychologist, 35, ii.
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Mpofu, E. (2002). Indigenization of the Psychology of Human Intelligence in Sub-Saharan Africa. Online Readings in Psychology and Culture (Unit 5, Chapter 2).
Ranzijn, R. (2009). Worldviews and culture. In Psychology and indigenous Australians: Foundations of cultural competence (pp. 13-30). South Yarra, Vic: Macmillan.
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