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U N I T E D N
A T I O N S
N A T I O N S U N I E S
THE SECRETARY-GENERAL
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MESSAGE ON WORLD MENTAL HEALTH DAY
10 October 2007
Culture and diversity influence
many aspects of mental health. First, culture determines what is
seen as “normal” and “abnormal” within a given society. Culture
also affects how individuals manifest and communicate symptoms,
styles of coping, family and community support and willingness
to seek treatment. Likewise, the cultures of clinicians and
service provision influence the nature of health system
services.
We live in a culturally
interconnected world. Formerly distant people now compete for
the same resources as they struggle to maintain their own
cultures or fit into new ones. Dramatically different languages,
religions and cultures coexist in a single country, or even
single communities. Dislocation from native communities,
rejection by the host community and difficulties in adapting to
the cultural norms of the host society are intensely stressful,
and can contribute to mental illness in those who are
vulnerable.
How can we overcome the
barriers of cultural difference? We need to use approaches that
incorporate cultural backgrounds and beliefs, address language
barriers, and create culturally sensitive forms of dialogue. We
need to incorporate cultural sensitivity in training, social
policy and service provision.
There are enormous challenges
to developing culturally competent mental health care services.
Resources for mental health are scarce; the treatment gap -- the
proportion of those who need but do not receive care -- is more
than 60 per cent. The rate of mental disorders and the need for
care is highest among disadvantaged people -- yet these are
precisely the groups with the lowest access to appropriate
services. At the same time, fear of stigma leads many to avoid
seeking care. The consequences are enormous in terms of
disability, human suffering, and economic loss.
We have a pressing obligation
to scale up care and services for mental disorders, especially
among the disadvantaged, while stepping up efforts to protect
the human rights of those affected. We must mobilize political
will and solidarity in the entire global health community. On
this World Mental Health Day, let us rededicate ourselves to
this mission.
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Cultural
Diversity Presents Special Challenges for Mental Health
The Pan American Health Organization
joins the World Federation for Mental Health on World Mental
Health Day 2007
| Washington, D.C.,
October 10, 2007 (PAHO)—One out of 35 people in the
world is an immigrant, and in virtually every
country, different languages, beliefs and cultures
coexist. In this context, promoting mental health
requires incorporating cultural sensitivity into
mental health services and programs, experts said
today at a special event held to observe World
Mental Health Day 2007.
"Culture and
diversity are central to the everyday perceptions,
behavior, and interactions of individuals," said Dr.
Carissa |
 (Photo:
Sonia Mey/PAHO) |
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Etienne, Assistant
Director of the Pan American Health Organization (PAHO).
"It is no wonder therefore that culture and
diversity influence the way that mental illness
manifests itself, how individuals and communities
perceive and cope with this illness, and how health
care providers diagnose, treat, and care for persons
with mental illness." |
Led by the World Federation for
Mental Health and supported by PAHO and other institutions, this
year's World Mental Health Day focuses on the growing importance
of cultural competency and sensitivity in ensuring effective
mental health programs and services around the world.
One in four people suffers from
a mental disorder at some time in his or her life, Etienne
noted. "They are universal problems that affect people of all
societies and countries, women and men of all ages, the rich and
particularly the poor, those who live in cities and those who
live in rural areas."
Since every individual has the
right to his or her own values, culture and beliefs, it is the
responsibility of health providers to develop intercultural
competencies to be able to provide the appropriate care, said
Etienne.
"In the PAHO region, one of the
top priorities in this area is technical cooperation with the
countries to develop programs aimed at protecting the mental
health of indigenous and minority populations, as well as
vulnerable groups," said Dr. Jorge Rodríguez, Chief of PAHO's
Mental Health Unit. "Health services that are developed to serve
psychosocial needs must be not only accessible but also
culturally acceptable."
In addition to the challenge of
diversity, Etienne noted that the countries of the Americas face
a growing gap between the burden of mental illness and
specialized services for the mentally ill. According to the
recent PAHO report Health in the Americas 2007, the contribution
of psychiatric and neurological conditions to the burden of
illness in Latin America and the Caribbean more than doubled
between 1990 and 2002, from an estimated 8.8 percent to 22.2
percent. Yet today there are only two psychiatrists per 100,000
population in the Americas, compared with 9.8 per 100,000 in
Europe.
(Photo: Sonia Mey/PAHO) |
According
to the same report, an estimated 1 percent of people in
the PAHO Region suffer from nonaffective psychoses
(including schizophrenia), 4.9 percent suffer major
depression, and 5.7 percent suffer from alcohol abuse or
dependency. Yet more than one-third of those suffering
from nonaffective psychoses, more than half of those
suffering from anxiety disorders, and about
three-quarters of people dependent on or abusing alcohol
do not receive specialized mental health care.
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These gaps are due to both
shortages of mental health personnel and to cultural factors,
particularly the stigma associated with mental illness in many
of the Region's cultures.
According to the World
Federation for Mental Health, social and cultural influences
play a key role in individual mental health, the use of mental
health services, and the provision of mental health care.
"A female mental health
professional born and trained in India may have moved to the
United Kingdom and is seeing a male client born and raised in
Ecuador-how do they communicate and how do each view the same
mental illness?" the federation asks in a special booklet
prepared for World Mental Health Day. "How do we overcome the
barriers of language and cultural differences, views of mental
illness, gender issues, and different training and teaching
methods?"
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To confront this
challenge, the World Federation, PAHO and other
supporters say that mental health services should be
developed and strengthened so they can provide the best
care possible to individuals from different cultural
backgrounds. |
New
The full text of the recently launched
Health in the Americas 2007 is now available
online. |
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In the Americas, these efforts
form part of a larger process of reform linked to the 1990
Declaration of Caracas, which committed signatory countries to
restructuring psychiatric care as a key component of their
public health strategies. The declaration called, among other
things, for shifting the focus of mental health services from
so-called "mental institutions" to community-based programs and
primary health care networks.
Participants in today's
observance of World Mental Health Day at PAHO headquarters
included Dr. Preston J. Garrison, Secretary-General of the World
Federation for Mental Health, and Dr. Eliot Sorel, Professor of
Global Health at George Washington University.
Additional Information:
24 Tips for Culturally
Sensitive Programming
PAHO, founded in 1902, works with all the countries of the
Americas to improve the health and raise the quality of life of
their peoples. It also serves as the Regional Office for the
Americas of WHO.
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Richard C Hunter WMHDay Awards