Culturally Relevant Support and Advocacy: An Example

Enhancing Global Mental Health Practices

Mental health is a universal concern, but it is dependent on cultural understanding. What might be seen as distressing behavior in one culture could very well be considered typical in another, and vice versa.

Wolthusen describes how mental health professionals in one country learn by studying the work of their counterparts in other countries and cultures. He also explains how practitioners can incorporate those lessons into their own work.

Watch now to learn more about:

• How mental health conditions are experienced in different cultures
• How health care differs internationally
• What the United States can learn from other countries about mental health treatment

Wolthusen, a physician-scientist, has trained and practiced in various cultural and geographic settings, including Germany, the U.S., Ghana, Kenya, Australia, and New Zealand.

One area of his research focuses on mutual capacity building in the global mental health space.

In this session, Wolthusen describes how mental health conditions are experienced differently in different countries and cultures. The expression of symptoms, as well as the way symptoms are described, can be culturally specific.

“There’s lots of research from countries in Africa or even in Asia showing us that depression would not be associated necessarily with feeling low, feeling blue, feeling nervous,” he says.

It would manifest as not being able to sleep, or having chronic back pain that is not responding to treatment.”

Another major difference between these countries and the U.S. involves where health care takes place. While most of the health care in the U.S. occurs in hospital systems, health care in countries such as Ghana, Kenya, and New Zealand happens in the community.

Wolthusen describes how he strives to maintain cultural humility when working with other cultures. He believes these cultures have much to teach the U.S. in terms of research findings and other approaches to health care.

“Currently, one of the things in the U.S. we are suffering from is that we are short sighted,” he says. “Working internationally, we think that the U.S. can teach other countries, but the U.S. has more to learn than the U.S. can teach.”

Wolthusen gives the example of community health care workers. Like many parts of the world, the U.S. faces a shortage of mental health care providers.

He points out that other countries, including Mozambique, Ghana, and Kenya, have addressed this dilemma by training community members to provide safe and effective treatment.

He believes those countries are now well-positioned to close the current treatment gap, and that other countries can learn from this model.

Audience Questions

• How did your global experiences inform your work in global mental health?
• What are some of the lessons you’ve learned through your work about the cultural components of mental health care?
• How does trust factor into building relationships with local communities?
• What are the biggest opportunities in working with local communities to enhance mental health care? What are some of the biggest challenges?
• How do you go about finding local leaders who are perhaps gatekeepers or conduits to folks getting the help that they need? How do you identify them? How do you approach them? How do you work with them?
• What are some moments that stand out for you as times you encountered perspectives you hadn’t considered before?
• How difficult was it for you to be in other cultures with different beliefs and avoid looking at mental health care solely through the lens of your own training?
• What are some global lessons you’ve learned that you can apply to your work here in the United States?
• Do you find there’s more interest and dialogue surrounding this topic now than when you first started out?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

Resources

You may also find this information useful:

• Video: Cultural Competency and the Importance of Curiosity
• Understanding Spirituality and Mental Health
• Video: Lessons Learned From Working With Displaced Youth
• Video: Building Trust With Patients
• Let’s Face It, No One Wants To Talk About Mental Health
• Deconstructing Stigma and On the Move e.V.
• Video: Tap Into the Power of Self-Compassion

About Dr. Wolthusen

Rick Wolthusen, MD, MPP, is a physician-scientist with a clinical interest in psychotic disorders and catatonia and a research interest in neuroscience and global mental health. Dr. Wolthusen has trained and practiced in various cultural and geographic settings, including Germany, the United States, Ghana, Kenya, Australia, and New Zealand.

Dr. Wolthusen is a member of the American Psychiatric Association’s Council on International Psychiatry and Global Health and a council liaison to the Council on Advocacy and Government Relations. His award-winning research focuses on the improvement of access to mental health services in the community.