The Mental Health of a Woman in the Asian Community - Essay Example

Mental Health Issues Focusing on SOUTH ASIAN WOMEN Name University Module Instructor Submission Date © 2012 INTRODUCTION Mental health when taken from the context of Asian community has a very strong meaning and is usually an issue that is best left alone without any further discussion. If one has mental, then the individual is not normal and cannot therefore cope with daily living skills (Ali and Kagan, 2003). To this person, life is very embarrassing and the only recourse is isolation from the rest of the community. According to the World Health Organization, mental health is a common occurrence with the majority showing signs of anxiety and depression (cited by Akutsu et al, 2007). The adversely affected by mental health include those individuals with inadequate access to primary care, asylum seekers and the homeless in foreign lands (Abraham, 2006). Mental health is shown to cause grievous emotional, social and economic strains on the victims and those who are concerned with their care in one way or the other. Following this realisation, the present essay is initiated to examine the attitudes to mental health with particular reference to the requirements and experience of women in Southern Asia. The essay therefore explores the social, cultural and historical views of mental illness affecting Women in Southern Asia and their access to appropriate services for Mental Health users. PRESENTATION OF SOCIAL CULTURAL AND HISTORICAL VIEWS OF MENTAL PROBLEMS RELATED TO WOMEN IN SOUTHERN ASIA Considering the plight of Women in Southern Asia suffering from mental health, it is noticed that the social, cultural and historical views are very critical in influencing the attitudes, needs as well as experiences of these people. The social, cultural and historical views all affect the South Asian Women with mental health problems differently as illustrated below. Social Views On a social perspective, women suffering from mental illness in South Asia experience stigma and discrimination due to a number of reasons. Firstly, mental illness is largely surrounded by a feeling of shame, fear and secrecy within the family and community at large in South Asia (Bowl, 2007). Additionally, mental illness is considered a taboo subject in the Asian community and no one should therefore engage in open discussion of matters concerning mental health problems (Soorkia et al, 2011). It is for the same reasons that people diagnosed with mental health problems agree to have their conditions kept secret and away from open discussions even between close family members (Ryan and Pritchard, 2004). Laura (2010) attributes this high level secrecy to the paramount need of preserving the family’s reputation and status in the eyes of the community. In addition to the foregoing, another social influence to mental health problems is found resident in the fact that South Asian Women are highly dependent on male support when it comes to mental illness (Gray, 2006). Majority claim that men play a pivotal role when it comes to the ease or difficulty with which women with mental health problems access formal support. This belief has variously contributed to the enormous isolation of South Asian Women with mental health problems as observed in a number of study findings (Laura, 2010). To compound their problems, these women are already constricted by the values held dear in the society regarding issues associated with mental illnesses. This implies that their means of recovery are totally oblique (Bowl, 2007). As already indicated elsewhere in this essay, taking care of an individual suffering from mental illness in the South Asian community is considered a family responsibility. In this instance, Laura (2010) indicates that most families have turned out to be both a source of solace and agony. Cases where families are known to hide children and other victims of mental illnesses in the family for many years on end have been reported in some studies (see Ryan and Pritchard, 2004). Their defense for their actions is cited as an effort to protect the victims from the prying eyes of the community as well as preserve the family’s reputation. The end result of this action has been incidentally very detrimental in most cases – wounding the relatives’ feelings as well as isolating the victim tremendously. This has led to the victim’s condition deteriorating to the level of committing suicide in certain instances as reported by Ahmed and friends (2007). Cultural Views Mental health problems have variously been reported to be treated with utmost secrecy in South Asian community. This has been shown to impact negatively on the needs and experiences of women afflicted by this problem. The victims become isolated and discriminated against to the level of being denied the opportunity to access medical attention as their family members as well as the community at large culturally believe that mental health is not a treatable condition (Wilson, 2006). In their culture, they strongly hold that most problems of the mind are a result of such causes like ‘black magic, the will of God, genetic and bad parenting’ (Bowl, 2007). This culture of associating ‘misconceptions’ to the cause of mental health has left ‘the family care’ as the only available help accorded to the suffering relative – they believe the problems cannot be treated professionally (Anders et al, 2007). The strong cultural views found within the South Asian community further restrict even knowledgeable families from seeking appropriate treatment for their mentally challenged relatives. The reason for this is probably because they fear to hurt the family reputation (Ahmed et al, 2007) or simply because they associate the cause of the problem to genetic which cannot be cured (Andre´s et al, 2005). Moreover, adhering to cultural norms within the South Asian community is something to cherish very much. Anyone deviating from this provision is considered abnormal and a cultural misfit. Participants in studies conducted in this area have always concurred that majority of people within the South Asian community abhor being associated with someone suffering from a mental health problem (Arnault, 2009). Since the South Asian culture associates mental illness with failure and a digression against God’s will, then it wouldn’t actually look good in the eyes of the community for someone to be associated with a mental cretin (Ryan and Pritchard, 2004). The culture in the South Asian community highly regards ‘successful’ members of the community, who are individuals deemed be associated with professions of high echelons including law and pharmacy (Gray, 2006). To maintain their high esteem in the community, these people are greatly pressurised to conform and feign that they don’t experience mental health problems in their midst. To hide this misconception long enough, these people end up hiding any instance of mental health problem in their families, effectively increasing the isolation of their relatives suffering from mental health problems (Aquila et al, 2007). Historical Views Since the history of South Asian community, problems of mental illness have been considered to be very retrogressive. Moreover, Gask (2004) adds that those individuals diagnosed with mental health problems within the community are not given an opportunity to say anything in the presence of ‘normal’ people nor are their points of views valued by anyone considered to belong in the ‘higher social standing’. When considered along historical views, mental health problems have been noted to damage marriage prospects both for males and females in the South Asian community (Bowl, 2007). Historical documentations have numerous claims illustrating that mental health problems have had serious threats to the institution of marriage especially in closely-knit families with unpopular practices. Since it is mandatory for the concerned families to investigate the backgrounds of both the bride and bridegroom, any identified cases of mental health problems can scuttle the whole marriage arrangements. This is simply because no one has the guts of marrying a ‘mental crack’ (Anitha, 2007). Historically, people found associating themselves with those suffering from mental health have been excommunicated in the past in South Asian communities as highlighted by Ahmed and associates (2007. Because of this then, strong proponents of equitable treatment of victims of mental health problems find themselves shunning these people for fear of being alienated by the community. Although this seems to be a selfish attitude, the stigma associated with the individual suffering from mental illness is far too much for anyone to bear (quoted in Choi and Kim, 2010). PROVISION OF APPROPRIATE SERVICES FOR SOUTH ASIAN WOMEN WITH MENTAL HEALTH The requirements and experiences of women of Southern Asian origin suffering from mental illness are many and varied. Access to appropriate intervention actions has been barred in part by the retrogressive attitudes that have been associated with mental health especially in South Asian women. The fact that there are unfathomed levels of stigmatisation and discrimination of mental health victims occasioned by very close associates, (Wilson, 2006) agrees that access to appropriate services for Mental Health users is not very possible. This is further amplified by the attitude that mental illness has to be kept secret as it image-damaging. Drawing from these two observations, it is not uncommon to note that victims of mental health are experiencing all manner of mistreatments particularly from their close family members who are supposed to be their carers. Commonest among these acts of abuse is the increased occurrence of cases of domestic violence unleashed against South Asian Women. A recent study conducted by Young and associates (2010) indicates that approximately 90% of South Asian Women experiencing high level mental health problems are being physically battered and psychologically abused by their spouses on the average. The emotional effects of domestic violence on the victims of mental health have been reported to include ‘low self esteem; anxiety and depression’ (Gray, 2006). On comparison, research has further demonstrated that women who have been put on ‘mental health services’ tend to be “much more likely to experience domestic violence than other women in the general population” (Ryan and Pritchard, 2004). Consequently, women suffering from one or more mental health complications are more prone to life threatening instances than the rest of the female population. The preceding argument is confirmed by more research findings indicating that cases of suicide and self-harm instances are more common among women who have experienced domestic violence (Warsi et al, 2004). Worse still, increased rates of suicides have been reported among women experiencing domestic violence with one or more type of mental health problem (Roth, 2006). More disturbing to this revelation is the fact that even after managing to leave these violent relationships, South Asian Women still report instances of long-term effects on their mental health as noted by Daines and Gask (2007). Psychologists have drawn from the above illustration and have been able to find a connection between the effects of continued domestic violence on women and the development of Post Traumatic Stress Disorder (Chiu et al, 2005). The longer the women with mental health problems are subjected to domestic violence, the earlier they develop PTSD. The same is found to be replicated when hostages are subjected to long periods of torture and difficult imprisonment (Roth, 2006). More research findings report that South Asian Women are more at risk of committing suicide and other self-harm actions particularly if they are immigrants and are experiencing any one type of mental health problems (see Burch and Gallup, 2004). When hospital admissions for attempted suicide and self-harm were explored for example, Anitha (2007) discovered that the rates of admission for young South Asian women were three times more than those of white British women. The mode of committing suicide and inflicting self-harm amongst the mentally demented was largely through attempted poisoning and burning (Aquila et al, 2007). In view of these foregoing experiences, South Asian women suffering from mental health problems need to access certain services meant for Mental Health users. Firstly, victims of mental health need a lot of help. They initially need medical interventions to alleviate their suffering. This is provided in the form of psychiatric interventions offered by professional practitioners as highlighted by Gask (2004). If this fails to yield results, research has suggested that (Arnault, 2009) therapeutic approaches can be initiated. An example of help may include allowing such a person to talk to someone who understands their condition, especially counsellors from minority ethnic backgrounds as is the case with South Asian Women. Additionally, there are other well publicised easy to access services aimed at creating that publicity for the South Asian women. Roth (2006) advocates for enlightening individuals on the varied range of support services available for women faced with all nature of sexual abuses. The training package will involve such things as being able to identify cases of stigmatisation and discrimination and hence being able to know what to do about them (Roth, 2006). Apart from these preceding services, research has highlighted the availability of broader range of services (Ryan and Pritchard, 2004). Thus, Soorkia and colleagues (2011) underscore the importance of social inclusion of the victims of mental health atrocities in the mainstream population after they have been identified. This is intervention is taken beyond medication attempts that may have failed to succeed. Moreover, women in Southern Asia who have extricated themselves from instances of sexual harassment (Wilson, 2006) are helped to overcome dependency and if possible, nurture self-confidence that can facilitate positive living. In consideration of the services mentioned above, research findings have variously indicated that South Asian women with mental health issues have benefited tremendously from these services. For one, there has been a noticeable reduction of strain on the part of South Asian women coming out of mental health problems. Warsi and friends (2004) claim that training interventions have helped very much in alleviating tensions between couples in marriages where one or both of the partners experience mental health problems. Before the interventions, a lot of tensions had been observed to exist in these types of marriages. Similarly, the instances of stigmatisation as well as discrimination of South Asian women suffering from mental health problems have reduced wonderfully after initiation of these services as illustrated by Gray (2006). Despite these progressive advances in actions to help people with mental health problems, research has increasingly pointed out that barriers to accessing these services still exist amongst the South Asian Women. According to Abraham (2006), feelings of shame and honour amongst the close family members of the suffering individuals were cited as one of the greatest barriers to seeking help. This feeling is in line with other study findings highlighted elsewhere in this essay. Secondly, stigmatisation and being isolated are other issues that barring victims of mental health problems and their families from accessing services intended for Mental Health users (Ali and Kagan, 2003). This in my view conforms to the culture of secrecy and the attitudes towards mental health issues mentioned earlier in this essay and extant literature in research (Ahmed et al, 2007). In line with this, people suffering from mental health are hidden away from the public domain because the condition is misconceived in the South Asian community. In retrospect, victims are considered as ‘stupid mad women who cannot have anything important to say in the midst of normal people’ (Anitha, 2007). For this reason, they are even subjected to domestic violence and other forms of abuse of their fundamental human rights. The third barrier is cited to be the fear of re-percussion in case one is known to be seeking help. This extends from the victim herself across her close family to the community at large. Since on the historical perspective is noted that there is possible excommunication to anyone found affiliating with an individual suffering from mental health problems, then everyone is weary of these possibilities (Pilgrim, 2005). This barrier borrows very much from the other one on concerns of disownments pointed out by (Quayum et al, 2006) and also mentioned elsewhere in this essay. Lastly, lack of finances and general dependency amongst the South Asian women have been very instrumental in denying them easy access to appropriate services meant for Mental Health users. This is particularly the case for those women in South Asia who are recovering from domestic violence and have been rendered permanently dependent on others for help. These individuals are shown by research to rely on the whims and caprices of their carers to access help, otherwise they remain oblivious of the availability of services for Mental Health users. MY PERSONAL AND PROFESSIONAL INTEREST IN THIS TOPIC It is not with any special affiliations that I chose to examine the attitudes to mental health concentrating on the needs and experiences of South Asian women. My choice was informed by sheer curiosity and the fact that South Asia has a varied and diverse ethnicity of Indians, Pakistanis, the Hindus as well as other Asiatic populations. A wide range of research work that has been conducted in this area in the past presents a wealthy of information regarding the lives of Asian women, both at home and as immigrants (Young et al, 2010). Results of these studies have depicted the South Asian Women as the greatest victims of mental health and as such, have received their fair share of stigmatisation, discrimination and domestic violence. How then can they be helped? CONCLUSIONS Throughout this essay, the author has been able to reach wide a variety of audience interested in discovering some of the interventions that can be initiated to address mental health problems. The essay has been of particular concerns to people bend on changing the attitudes and behaviours of the world’s populations as regards to mental health problems. Dealing with people’s attitudes and behaviours regarding mental health problems among the South Asian Women has been shown as a most daunting task. But research has variously illustrated that the South Asian community has some advantages over the rest of the country when it comes to addressing mental health problems (Chung and Bemak, 2002). Gill (2006) accepts that the immediate family is charged with responsibility of taking care of their relatives with mental health problems. While offering this noble service to the less privileged, the family has also been shown as a constant source of stigmatisation and discrimination that has resulted in total isolation of the mental health victim (Priest and Gibbs, 2004). This is confirmed by numerous misconceptions that reside in the causes of mental health problems. Based on these misconceptions, victims of mental health have been seen as a disgrace to the family and community at large and have therefore been increasingly isolated. Additionally, the essay has clearly presented the social, cultural and historical views of mental health problems within the South Asian women. Among these three, the social and cultural views were depicted as having stronger influences on mental health problems within the South Asian women than the historical views. South Asian Women have been shown in the essay as being able to benefit from the various appropriate services for Mental Health users, even though there are particular barriers that exist. BIBLIOGRAPHY Abraham, M. (2006) Model minority and marital violence: South Asian immigrants in the United States. Lawrence Erlbaum Associates Inc: New Jersey, USA. 11: 197-216. Ahmed, K., Mohan, R. and Bhugra, D. (2007) Self-harm in South Asian women: A literature review informed approach to assessment and formulation. American Journal of Psychotherapy 61(1). 71-81. Akutsu, P., Castillo, E.and Snowden, L. (2007) Differential referral patterns to ethnic-specific and mainstream mental health programs for four Asian American groups. American Journal of Orthopsychiatry 77(1). 95-103. Ali, R.and Kagan, C. (2003) ‘The context of mental health difficulties and well being’. British Ethnic Health Awareness Foundation Ali, S., Dearman, S. P. and McWilliam, C. (2007) Are Asians at greater risk of compulsory psychiatry admission than Caucasians in the acute general adult setting? In Medical Science & Law 47(4). 311-314. Anders, R., Olson, T. and Bader, J. (2007) Assessment of acutely mentally ill patients’ satisfaction of care: There is a difference among ethnic groups. In Issues in Mental Health Nursing 28(3). 297-308. Andre´s, J., Pumariega, B. and Rothe, E. (2005) Mental Health of Immigrants and Refugees. Community Mental Health Journal, Vol. 41, No. 5 Anitha, S. (2007) ‘Forgotten women: domestic violence, poverty and ‘women with no recourse to public funds’’, Manchester: Saheli. Appignnanesi, L. (2008) Mad, Bad and Sad: A History of Women and the Mind Doctors From 1800 to the Present. Virago. Aquila, M., Anitha, S., Chopra, P. and Farouk, W. (2007) Domestic violence and mental health: experiences of South Asian women in Manchester. The Centre for Ethnicity and Health, University of Central Lancashire Arnault, D. S. (2009) Cultural determinants of help seeking: A model for research and practice. In Research and Theory for Nursing Practice: An International Journal 23(4). 259-278. Barn, R. (2008) Ethnicity, gender and mental health: Social worker perspectives. International Journal of Social Psychiatry 54(1). 69-82. Bottorff, J. L. et al. (2004) “Othering and being Othered in the context of health care services”. Health Communication 16(2): 253-271. Bowl, R. (2007) The need for change in UK mental health services: South Asian service users’ views. Ethnicity and Health 12(1). 1-19. Burch, R. L. and Gallup, G. G. (2004) ‘Pregnancy as a stimulus for domestic violence’, Journal of Family Violence, 19(4): 243-253. Chaudhury, S. R. (2011) Attitudes towards the Diagnosis and Treatment of Depression among South Asian Muslim Americans. PhD Thesis, Columbia University Chiu, L. et al. (2005) “Spirituality and treatment choices by South and East Asian women with serious mental illness”. Transcultural Psychiatry 42(4): 630-656. Choi, N. G. and Kim, J. (2010) Utilization of complementary and alternative medicines for mental health problems among Asian Americans. Community Mental Health Journal 46(570-578. Chung, R. C. and Bemak, F. (2002) Revisiting the California Southeast Asian mental health needs assessment data: An examination of refugee ethnic and gender differences. Journal of Counseling and Development, 80, 111–119. Daines, B. and Gask, L. (2007) Medical and Psychiatric Issues for Counsellors. Second edition. London: Sage Gask, L. (2004) A Short Introduction To Psychiatry. London: Sage. Gill, A. (2006) ‘Patriarchal Violence in the Name of ‘Honour’’, International Journal of Criminal Justice Sciences, Volume 1, Issue 1, 1-12. Gray, P. (2006) The Madness of Our Lives: Experiences of Mental Breakdown and Recovery. London: Jessica Kingsley. Hansen, D., Eugenia, H. and Corrie, D. (2004) “Understanding mental health needs of Southeast Asian refugees: Historical, cultural and contextual challenges”. Faculty Publications, Department of Psychology. Paper 86. Joughin, C. and Malek, M. (2004) Mental Health Services for Minority Ethnic Children and Adolescents. London: Jessica Kingsley Laura, M. (2010) Family Matters: A report into attitudes towards mental health problems in the South Asian community in Harrow, North West London. BME Pilot Campaign Pilgrim, D. (2005) Key Concepts In Mental Health. London: Sage. Priest, H. and Gibbs, M. (2004) Mental Health Care for People with Learning Disabilities. London: Churchill Livingstone Quayum, N., Hardy, A., Shazia, Q. and Sanghera, H. (2006) The Mental Health And Well Being Needs Of South Asian Women Re-Settling In Derby Following Domestic Violence. Karma Nirvana - Derby Roth, A. (2006) What Works For Whom? A Critical Review of Psychotherapy Research. (Second edition) London: Guilford Ryan, T. and Pritchard, J. (2004) Good Practice in Adult Mental Health. London: Jessica Kingsley Soorkia, R., Snelgar, R. and Swami, V. (2011) Factors influencing attitudes towards seeking professional psychological help among South Asian students in Britain. Mental Health, Religion & Culture 14(6). 613-623. Warsi, A., Wang, P., Valley, M., Avorn, J. and Solomon, D. (2004) Self-management Education Programs in Chronic Disease: A Systematic Review and Methodological Critique of the Literature. Arch Intern Med; 164: 1641–1649. Wilson, A. (2006) Dreams, Questions, Struggles: South Asian Women in Britain. London & Ann Arbor, MI: Pluto Press. Young, C. B., Fang, D. Z. and Zisook, S. (2010). Depression in Asian-American and Caucasian undergraduate students. In Journal of Affective Disorders 125(1-3). 379-382. Read More

In addition to the foregoing, another social influence to mental health problems is found resident in the fact that South Asian Women are highly dependent on male support when it comes to mental illness (Gray, 2006). Majority claim that men play a pivotal role when it comes to the ease or difficulty with which women with mental health problems access formal support. This belief has variously contributed to the enormous isolation of South Asian Women with mental health problems as observed in a number of study findings (Laura, 2010).

To compound their problems, these women are already constricted by the values held dear in the society regarding issues associated with mental illnesses. This implies that their means of recovery are totally oblique (Bowl, 2007). As already indicated elsewhere in this essay, taking care of an individual suffering from mental illness in the South Asian community is considered a family responsibility. In this instance, Laura (2010) indicates that most families have turned out to be both a source of solace and agony.

Cases where families are known to hide children and other victims of mental illnesses in the family for many years on end have been reported in some studies (see Ryan and Pritchard, 2004). Their defense for their actions is cited as an effort to protect the victims from the prying eyes of the community as well as preserve the family’s reputation. The end result of this action has been incidentally very detrimental in most cases – wounding the relatives’ feelings as well as isolating the victim tremendously.

This has led to the victim’s condition deteriorating to the level of committing suicide in certain instances as reported by Ahmed and friends (2007). Cultural Views Mental health problems have variously been reported to be treated with utmost secrecy in South Asian community. This has been shown to impact negatively on the needs and experiences of women afflicted by this problem. The victims become isolated and discriminated against to the level of being denied the opportunity to access medical attention as their family members as well as the community at large culturally believe that mental health is not a treatable condition (Wilson, 2006).

In their culture, they strongly hold that most problems of the mind are a result of such causes like ‘black magic, the will of God, genetic and bad parenting’ (Bowl, 2007). This culture of associating ‘misconceptions’ to the cause of mental health has left ‘the family care’ as the only available help accorded to the suffering relative – they believe the problems cannot be treated professionally (Anders et al, 2007). The strong cultural views found within the South Asian community further restrict even knowledgeable families from seeking appropriate treatment for their mentally challenged relatives.

The reason for this is probably because they fear to hurt the family reputation (Ahmed et al, 2007) or simply because they associate the cause of the problem to genetic which cannot be cured (Andre´s et al, 2005). Moreover, adhering to cultural norms within the South Asian community is something to cherish very much. Anyone deviating from this provision is considered abnormal and a cultural misfit. Participants in studies conducted in this area have always concurred that majority of people within the South Asian community abhor being associated with someone suffering from a mental health problem (Arnault, 2009).

Since the South Asian culture associates mental illness with failure and a digression against God’s will, then it wouldn’t actually look good in the eyes of the community for someone to be associated with a mental cretin (Ryan and Pritchard, 2004). The culture in the South Asian community highly regards ‘successful’ members of the community, who are individuals deemed be associated with professions of high echelons including law and pharmacy (Gray, 2006). To maintain their high esteem in the community, these people are greatly pressurised to conform and feign that they don’t experience mental health problems in their midst.

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