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Mental health can be defined as how people think, feel, and act when faced with life’s situations. It impacts greatly on how individuals handle stress, make decisions or how they relate to other people or to the society in general. It also influences the ways individuals perceive themselves and others in their lives. “The DSM refers to the Diagnostic and Statistical Manual of Mental Disorders and this is a form of reference as to what a mental disorder is” (Boulevard, 1825, p.123).
Culturally the exact view of the V Axes diagnostic system is essential in all mental issue because they give a complete picture of the patient and are also used to provide an excellent review of the clinician evaluation on the patient.
DSM-V is yet to be published in the year 2012 but effort is being made to go beyond the DSM-IV framework. However, there are six research groups that have managed to shed light on DSM-V. These groups were sponsored by the National Institute of Mental Health in conjunction with APA. This group did not include experts that had been involved in the DSM-IV framework. They tackled many issues including Cross-Cultural Issues which was presented in their series of white paper.
Cultural issues affecting the mental health
One of the major cultural issues is religion. These are a set of spiritual beliefs that act as individual’s codes for conduct. Religion is a powerful force that impact strongly on the individual emotional and mental aspect and one can argue that belief and experience go hand in hand. People who are extremely religious strictly behave according to what their faith subscribes and any opinion including that of the psychiatrist must coincide with what their faith holds. The way you would handle a Muslim for example is different from the way you would deal with a Christian or an atheist. Religion for example may affect the way we understand the mind-body
phenomena, our diet, or even how a patient explains his/her sickness and also influence the kind of medication a patient may be willing to take. Depression in non-western countries in a religious sense may be perceived as soul loss (Mezzich, 1996).
A psychiatrist, for example, may face a case of a Muslim victim of rape, who happens to be pregnant and is struggling with the issue of abortion, and is torn between the fear of being stoned to death for suspicion of immorality and her value for the sacred life of the unborn baby. The patient might argue that she fears that society might not believe her that she was raped. Such a case poses a dilemma to both the psychiatrist and the patient because whatever the solutions are given they must be in harmony with societal standards and they must also not compromise the patient life. In such a scenario, every fact counts, and a simple misinterpretation can translate to a major setback. If the above case occurred in a non-Islamist country where “sharia” law is not applicable especially where abortion is legal, then the issue can be dealt with at whichever angle.
The actual diagnostic and assessment need to address the cultural differences as determinants to the patient’s behavior (David, 2002). Right from the time a human being is young, the world imposes itself on the individual and personality is greatly shaped by the various societal forces that are constituted in the cultural set-ups in our society that enable us to interact, such can therefore not be ignored in any therapy.
- Boulevard Wilson. (1825). DSM-V: The Future Manual. Boulevard: American Psychiatric Association.
- Mezzich Juan. (1996).Culture and psychiatric diagnosis. USA: American Psychiatric Publishing Inc.
- Kupferv David.(2002)..A definition of DSM-V. USA: Published by American Psychiatric Pub.