Vculture And Mental Health

The relations of culture and mental health have been of long-standing interest in the fields of psychology, anthropology, sociology, and psychiatry. Culture has been at times given a prominent role in some theories and a minuscule role in others (also see chapters 1 and 2, this volume). Culture has been viewed as having a potential impact on numerous aspects of health, illness, and adaptation. Culture is seen as composing a major component of illness in Kleinman's Illness Model (Kleinman, 1988). In this model, culture is viewed as having a potentiating influence on the definition of illness, the manifestations of illness, the prevalence of illness, and on the treatment of illness, particularly so for the treatment of mental illness. It was the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) that included culture for the first time as an important potentiating variable influencing manifestations, prevalence, and etiological factors in mental disorders.

People and cultures are constantly changing as a result of interactions with others. These changes take place at various ecological levels (Bronfenbrenner, 1989), namely, macrosystem, exosystem, mesosystem, and microsystem. Figure 1 shows a model of the interaction among systems. Many different kinds of changes can transpire as a function of acculturation processes. These changes include changes in multiple systems including social, cultural, architectural, political, economic, and cognitive. Acculturative changes can take place in individuals or can take place at the broader community level (see Figure 1). The point here is that all these changes are termed "acculturative changes." No direction is implied when reference is made to one "acculturating." A majority-group member acculturates to the extent he or she changes as a result of contact with minorities. Minority members in the United States, for example, who are acquiring characteristics of mainstream America are indeed "acculturating," but

Multilevel Inclusive situational context

Exosystem

Mesosystem

Microsystem

Macrosystem

Multilevel Inclusive situational context

Exosystem

Mesosystem

Microsystem

Macrosystem

Situational context FIGURE 1 Bronfenbrenner's ecological model.

so are majority-group members who change as a result of their contact with the minority group. Although both majority- and minority-group members are ac-culturating, the rate of acculturation as well as qualitative aspects of the acculturation experience will differ greatly for both groups. In summary, both majority and minority group members are acculturating but in different directions, at different rates, and under very different contextual conditions. Bidirectional changes are sometimes referred to as "transcultural" processes. Most acculturative processes are transcultural to some extent.

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