We often expect people with mental health problems to accept themselves. We underestimate the effects of our broader culture on the process of acceptance of a mental health problem. In this post, I describe the ways that culture can impact this process based on research in my book, Acceptance of Mental Illness: Promoting Recovery Among Culturally Diverse Groups. Here, you will see that culture offers a number of challenges and resources to the acceptance process.
1. Cultural stigma. Most of us are familiar with the exacting toll that a culture can take with regard to stigma. One Jewish American woman I interviewed described this phenomenon in the U.S. She stated, “In America you're not supposed to be depressed, and, if you are, you're supposed to snap out of it, and pull yourself up by your bootstraps.” While some empowerment can be found in Western cultural values of autonomy and self-reliance, these expectations can also make it difficult to accept a mental health problem and seek help.
2. Explanatory models. The medical anthropologist and psychiatrist Arthur Kleinman went around the world listening to people’s stories about their medical and mental health problems. He learned of the explanatory models that their health narratives revealed—cultural explanations for the origin of a mental health problem. It’s not surprising that these explanatory models would have an effect on acceptance, posing risk and/or resilience. Risk could result from a cultural view of mental illness as the effect of demon possession requiring banishment from the group. In turn, resilience could result from a cultural view of mental illness as a connection to a higher power, elevating the person’s social status.
3. Cultural isolation versus cultural supports. As a result of stigma, people may feel a sense of isolation within their cultural group. One interviewee in my book spoke of feeling that members of his cultural group “don’t accept people who have mental illnesses. A lot of cultures understand it, but they…don’t want to understand it.” He identified this lack of support as a key barrier to accepting his mental health problem. On the other hand, another woman described her depression advocacy group for women of color as a source of cultural support that was central to her acceptance process.
4. Cultural pride. Some research has found that cultural and ethnic identity pride can buffer against the mental health effects of racism and prejudice. One African American woman spoke to the centrality of cultural pride to her acceptance process. She stated, “When you meet people that are doing good in your cultural identity, it makes you want to do good, too. It makes you want to say, ‘Well, they can do it, I can do it.’ It gives you a broader outlook than the stereotypes that people have about people.” Cultural pride can buffer against not only racism and prejudice, but also foster acceptance of a mental health problem.
An important topic to close with is the issue of public versus personal acceptance. We can teach individuals to accept themselves until we are blue in the face. But ultimately, more effort is needed among the general public to accept mental health problems in order to prevent the cultural stigma that blocks the self-acceptance of others.