As a psychiatrist who is also in therapy, I remember feeling misunderstood when it came to my culture as a filipino-american, but meant a lot to me to have my therapist express a genuine interest in understanding my culture and asking me for details regarding my experience. Oftentimes I believe clinicians don’t prioritize someone’s identity (ethnicity, culture, religion, sexuality) when it comes to health, especially mental health, yet these factors play a significant role in someone’s values and way of life.
July is Minority Mental Health Awareness Month and although today might be the last day, having knowledge of the disparities and struggles that several minorities experience is important if we’re going to eliminate stigma surrounding mental illness. I consider myself as someone who prioritizes cultural competency, yet reading statistics and information regarding certain minorities surprised me and I was happy that this month existed and motivated me to read more about it. Which is the reason why I’m sharing some of the following information with you here on my blog, in addition to some techniques that I use to incorporate someone’s ethnicity/culture/sexual identity, etc into the conversation during treatment (continue reading below).
- African American attitudes toward mental illness are another barrier to seeking mental health care. Mental illness retains considerable stigma, and seeking treatment is not always encouraged. One study found that the proportion of African Americans who feared mental health treatment was 2.5 times greater than the proportion of whites (Sussman et al., 1987). (1)
- A report from the U.S. Surgeon General found that violent deaths – unintentional injuries, homicide, and suicide – account for 75% of all mortality in the second decade of life for American Indian/Alaska Natives (U.S. Dept of Health & Human Services Office of Minority Health)
- Southeast Asian refugees are at risk for post-traumatic stress disorder (PTSD) associated with trauma experienced before and after immigration to the U.S. One study found that 70% of Southeast Asian refugees receiving mental health care were diagnosed with PTSD (U.S. Dept of Health & Human Services Office of Minority Health)
- Western culture makes a distinction between the mind and body, but many Asian cultures do not (Lin, 1996). Therefore, it has long been hypothesized that Asians express more somatic symptoms of distress than white Americans (1).
- Mexican immigrants who lived fewer than 13 years in the United States, or Puerto Ricans who resided on the island of Puerto Rico had lower prevalence rates of depression and other disorders than did Mexican Americans who were born in the United States, Mexican immigrants who lived in the United States 13 years or more, or Puerto Ricans who lived on the mainland. This consistent pattern of findings across independent investigators, different sites, and two Latino subgroups (Mexican Americans and Puerto Ricans) suggests that factors associated with living in the United States are related to an increased risk of mental disorders (1).
The following are a few questions I ask to promote discussion of someone’s identity and incorporate someone’s culture, race, ethnicity into treatment (some of these may sound so simple, yet raising the questions can feel awkward at first especially since the subject of someone’s identity might be perceived as a sensitive subject):
- What is your ethnic background?
- For someone who is mixed race: Is there a specific ethnicity/culture/race that you identify with most?
- What is your sexual identity?
- How has your cultural identity influenced the way you approach current issues in your life?
- How does your family cope with issues related to mental health?
- Tell me what are some of the most misunderstood aspects about your culture that you wish people could better understand?
If you’ve had any positive/negative experiences with clinicians in regards to addressing your health/mental health, please share and comment below!