To truly appreciate the importance and complexity of culture throughout the life span, it is necessary to employ an ecological perspective that examines behavior within the "web of life." The most personal and private thoughts of each individual as well as outwardly expressed behaviors are products of the interaction of genetic and environmental forces. Cultural factors are a significant part of environmental forces, and cultural factors are a significant component of family, community values, meaning, purpose, motivations, and spiritual life. All the chapters, either directly or indirectly, address the importance of an ecological perspective in understanding cultural forces in mental health in diverse populations.
The student of mental health and culture needs to have some understanding of how culture influences behavior, both normal and abnormal. A prerequisite to understanding mental health and mental illness is having some model of how culture influences our perceptions, cognition, belief systems, emotions, values, and behaviors. Chapter 1 introduces through an historical account the shifting prominence assigned to the role of culture in the fields of psychiatry and psychology. It also introduces new conceptual and methodological frameworks that position culture as a major determinant of the onset, expression, course, and outcome of mental disorders.
In the new upgraded models of culture and behavior, individual mental health and societal mental health are seen as inextricably linked. The newer models place culture within an ecological framework, assigning culture a prominent role linked both to the individual and to the context or situation in which behavior occurs and is vitally linked to family, community, socialization processes, educational processes, and social-political and cultural processes. The multiple levels, macro to micro, existing within all communities are ecologically linked. Both the array of problems and the solutions are enormously broadened with the inclusion of culture as a determinant of behavior. As Marsella and Yamada note in Chapter 1, mental health is not only about biology and psychology but also about education, economics, social structure, religion, and politics.
Angel and Williams (Chapter 2) remind us of the importance of culture in forming the backdrop against which all human action has meaning. They emphasize that illness is as much personal and subjective as it is objective and physiological. They also note that emotions and illness are intertwined. Understanding the events and contexts that elicit and label both emotions and illness can be just as important as understanding the physiological aspects of mental health and illness. A culturally informed clinical picture includes an understanding of the relations of cultural, social, psychological, emotional, and cognitive factors as they relate to health and illness.
The behavioral sciences clearly have much to offer in the understanding and treatment of both mental and physical illnesses. The perspectives, paradigms, and models included provide conceptual practical frameworks for relating culture to illness and health.
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