CULTURE SYSTEMS OF MEANING, GOALS, AND VALUES THAT ARE COMMON WITHIN A GROUP AND DIFFERENT FROM OTHER GROUPS RELIGION, POLITICS, SOCIAL CLASS, ETHNICITY

ETHNICITY ETHNICITY = SOCIAL GROUPS THAT DISTINGUISH THEMSELVES FROM OTHER GROUPS BASED ON SHARED DESCENT, CULTURE, AND IDENTITY VARIES IN IMPORTANCE BY INDIVIDUALS AND GROUPS

RECENT INTEREST IN ETHNICITY IMMIGRATION - 31 MILLION OF 292 MILLION FOREIGN BORN – MOST EVER E.G. NYC – 40 % IN 2000 VS. 28% IN 1990; WHITES NOW MINORITY DIVERSITY OF CULTURES MULTICULTURALISM

PROBLEMS IN STUDYING ETHNICITY COMPLEXITY OF ETHNIC GROUPS HOW TO SEPARATE ETHNIC CULTURE FROM OTHER FACTORS INCOME, FAMILY STRUCTURE, ACCULTURATION, ETC. CULTURALLY INSENSITIVE INSTRUMENTS

3 WAYS ETHNICITY AFFECTS MENTAL ILLNESS RATES OF MENTAL ILLNESS EXPRESSION OF MENTAL ILLNESS RESPONSE TO MENTAL ILLNESS

AFRICAN AMERICANS EXPECT HIGHER DISCRIMINATION, LOWER INCOME FIND RATES NOT HIGHER THAN WHITES ANXIETY DISORDERS (PHOBIAS) ARE EXCEPTION PERHAPS BETTER COPING ABILITIES, SOCIAL SUPPORT, RELIGION

HISPANICS HISPANICS TOTALLY INCONSISTENT - SOMETIMES HIGHER, SOMETIMES LOWER PERHAPS DIVERSITY OF GROUPS, POOR INSTRUMENTS

HISPANICS THOSE BORN IN US HAVE HIGHER RATES THAN THOSE BORN IN NATIVE COUNTRIES MORE ACCULTURATED HAVE HIGHER RATES THAN LESS ACCULTURATED ASSIMILATION BAD FOR MENTAL HEALTH?

OTHER ETHNIC GROUPS ASIANS - LOW RATES MORE PHYSIOLOGICAL EXPRESSIONS, HIGHER INCOME? NATIVE AMERICANS VERY HIGH RATES, ESPECIALLY ALCOHOLISM AND SUICIDE

CONCLUSION DIFFERENT ETHNIC GROUPS HAVE DIFFERENT RATES OF M.I. BUT, LITTLE CONSISTENCY

GROUPS HAVE DIFFERENT ILLNESS VOCABULARIES “STRUCTURING” - GENERAL SENSATIONS BECOME PARTICULAR ENTITIES E.G. DEPRESSION - SOME: PSYCHOLOGICAL - SADNESS, HOPELESSNESS, LOW SELF ESTEEM OTHERS: PHYSICAL - FATIGUE, ACHES, LOSE APPETITE, NOT PSYCH

EXPRESSIONS WESTERN CULTURES = PSYCHOLOGICAL EXPRESSIONS NON-WESTERN CULTURES = PHYSIOLOGICAL EXPRESSIONS

IMMIGRANTS COMPARE SYMPTOMS OF NEW AND LONG-TERM IMMIGRANTS STUDY OF CHINESE-AMERICANS NEW IMMIGRANTS SHOW MORE PHYSICAL SYMPTOMS LONG-TERM IMMIGRANTS SHOW MORE PSYCHOLOGICAL SYMPTOMS ASSIMILATION CHANGES SYMPTOMS

IMPLICATIONS CLINICIANS SHOULD BE SENSITIVE TO CULTURAL NATURE OF SYMPTOMS CLINICIANS CAN UNDERSTATE OR OVERSTATE MENTAL ILLNESS OUR MENTAL ILLNESSES - EATING DISORDERS, A.D.D. ETC. CAN BE “CULTURE BOUND” TOO

PSYCHOTHERAPY WHITES FAR MORE LIKELY TO BE IN P.T. EVEN MORE LIKELY TO STAY IN P.T. BLACKS ESPECIALLY UNLIKELY

REASONS FOR ETHNIC DIFFERENCES DEFINITIONS OF M.I. USE OF INFORMAL OR FORMAL RESOURCES TRUST IN MENTAL HEALTH PROFS RESPONSE OF MENTAL HEALTH SYSTEM

RESPONSE TO SCHIZOPHRENIA IN L.A. MEXICANS DEFINE AS “NERVIOS” KEEP IN FAMILY GAP IN COMMUNICATION WITH M.H.P. ANGLOS DEFINE AS PSYCHOSES BRING TO M.H.P. SHARED DEFINITIONS OF PROBLEM

COSTS AND BENEFITS MEXICANS DELAYED TREATMENT MORE SEVERITY LESS COMMUNICATION MORE FAMILY SUPPORT WHITES QUICKER TREATMENT LESS SEVERITY MORE COMMUNICATION LESS FAMILY SUPPORT

HORWITZ STUDY IN NJ COMPARE WHITE AND BLACK PARENTS AND SIBLINGS OF SERIOUSLY MENTALLY ILL HOW MUCH HELP PROVIDE HOW MUCH BURDEN THEY HAVE

RESULTS WHITE AND BLACK PARENTS PROVIDE SAME AMOUNT OF HELP WHITE PARENTS REPORT MORE BURDEN THAN BLACK PARENTS BLACK SIBLINGS PROVIDE MORE HELP THAN WHITE SIBLINGS BLACK SIBLINGS FEEL LESS BURDENED THAN WHITE SIBLINGS

REASONS DIFFERENT CULTURAL EXPECTATIONS? SENSE OF FAMILY OBLIGATION EXTENDS FURTHER AMONG BLACKS THAN WHITES, LESS INDIVIDUALISM

FAMILY SUPPORT MANY ETHNIC GROUPS – ESPECIALLY NEW IMMIGRANTS GREATER SENSE OF FAMILY OBLIGATION AND LESS INDIVIDUALISM LESS ADEQUATE PROFESSIONAL TREATMENT

SUMMARY FEW OVERALL CONCLUSIONS FOR RATES IN US ETHNICITY AFFECTS WAY PEOPLE EXPRESS DISORDERS ETHNICITY AFFECTS DEFINITIONS, SOCIAL SUPPORT AND HELP- SEEKING

IMPLICATIONS PROFESSIONALS SHOULD BE CULTURALLY SENSITIVE ETHNIC-SENSITIVE PROGRAMS TEND TO WORK BETTER PARTICULARLY IMPORTANT NOW WITH HIGH RATES OF IMMIGRATION