2.2 Cultural competence and mental health difficulties

Watch the following video of Patrice, a learner with The Open University in the UK, who describes attitudes towards mental health in her culture and her experiences of studying with a mental health condition. Listen to how her cultural background made it hard for her to seek help initially, but also note her positive experiences after feeling able to be open about her mental health.

Download this video clip.Video player: pmh_1_week6_studying_with_mental_health_concerns.mp4

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PATRICE BELTON

For me, growing up in the Caribbean, mental health was often stigmatised. It was taboo. And it was shunned if you so experienced it. So those who really needed the help often went unsupported or did not receive the support that they deserved.

For me, coming to the Open Uni, it was the same. I was unfamiliar with getting support around my mental health because I hadn’t declared it in such a way. And I had a lot of lack of confidence, a lot of self-doubt, a lot of self-loathing, and definitely isolated myself, which placed a lot of pressure on my studies.

However, what changed or broke that chain was my dad falling ill with cancer, which caused me to report my mental health and to defer. My advice to you as a student is if you are challenged with mental health, don’t delay. Report it. Seek help. It’s here for you. And there’s lots of it.

And I’ve never felt better knowing that I was open about that and that I could get help when I really needed it the most. My study’s been great. I’m in my final year of study. And I am just one EMA away from graduation. If I can do it, so can you.

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Patrice’s background experience is not unique; many societies and cultures describe people with mental health needs as if they are outside of the so-called ‘normal’ population. These ‘stigmatising discourses’ can cause unhelpful and unjustified feelings of shame, as someone who needs support for their mental health are made to feel different to others, and that they do not belong, or even do not deserve to belong. For example, Zolezzi et al. (2018) note that in many Middle Eastern Arab countries stigmatising views relate mental health difficulties to being ‘God’s punishment’. They also report how, in many Western countries, people experiencing poor mental health are viewed as being potentially dangerous and violent.

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A group of students and a lecturer in a lecture hall.

In Week 5 you learned how language can be stigmatising and so will appreciate how both these types of stigmatising beliefs are likely to cause affected learners to feel ashamed, or uncomfortable, about their difficulties, and to be less likely to open a conversation about their mental health and support. Section 1.1 of this week, on ethnicity and race, also showed how this can lead to stereotyping, prejudice and discrimination of minoritised people who may be experiencing poor mental health.

As a result, learners who feel uncomfortable talking openly about their mental health may instead express poor mental health via emotional or bodily symptoms. They may state that they feel generally unwell, have a stomach condition or a headache, which is more accepted in their own culture and suppresses any feelings of shame (Helman, 2007).

Nowadays there is more awareness of a body–mind connection (see for example Bullmore, 2018), and so it is more generally recognised that physical symptoms may also be linked to poor mental health.