“Mental Illness” Symptoms as Extensions of Strategic Social Behaviour: The Case of Multicultural Mental Health

Abstract

To better analyse transcultural mental health issues, a model of social relationships is presented that allows more complex formulations of the differences between some western social strategies and those of non-western, or collectivist groups. This requires more lengthy and detailed observations of clients and their communities whether or not the particular version of analysis presented here is accepted. An example is given of low self-efficacy in depression and how different contexts can lead to similar-looking symptoms but through very different forms of social relationships. Two case studies are presented of ‘mental’ health issues with Somali women and how ‘individual’ treatments could be conceptualised as changes made in the community. In the first case some of the western treatments were successful in the short-term, while in the second case non-western treatments worked and western help was eschewed. We conclude that assessments and treatments for ‘mental’ ill-health will only be as good as the social analyses made, and more detailed analyses are needed regardless of one’s perspectives when dealing with transcultural groups.