Informing Perinatal Mental Health Services
SOCIETY
Culture
Culture is a complex factor that refers to a “group’s thoughts, experiences, and patterns of behaviour and its concepts, values and assumptions about life that guide behaviour” 1. Culture varies both across countries and within countries, as it can be affected by factors such as race, religion, gender etc.
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Culture different to Western view.
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Culturally sensitive care.
Culture different to Western view
Cultural belief systems that differ to the Western view of mental illness are a barrier to perinatal mental health care.
"Because depression, like if you see the symptoms of depression, it’s a mental illness. The minute you say mental illness in my country, you are crazy."
Evidence level: High
Parts of the care pathway affected: Decision to consult, Assessment, Decision to disclose, Referral, Access to treatment, Provision of optimal treatment, Women’s experience of treatment.
Key literature:
Culturally sensitive care
Mental illnesses are not spread evenly around the world. Culture influences what we see as a mental illness. For example,
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Amok – mostly experienced by Indonesian men after a social insult, characterised by brooding and then rage.
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Zar – Experienced by those living in the Middle East. Is related to spirit possession, characterised by laughing, crying, shouting and singing.
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Post-traumatic stress disorder – a western mental illness occurring after a trauma. Characterised by flashbacks to the event, and avoidance of things that remind people of the event.
Culturally sensitive care can be defined as “the ability to be appropriately responsive to the attitudes, feelings, or circumstances of groups of people that share a common and distinctive racial, national, religious, linguistic, or cultural heritage” 2. It is care that offers services in a manner that is relevant to patients’ needs and expectations 3.
Recommendations
Provide culturally sensitive care.
Collaborate with organisations such as The Motherhood Group to ensure cultural appropriateness.
Co-design care with a diverse range of people to ensure appropriateness and sensitivity.