We are not all the same

As a population of over seven billion people, it is silly to think that we all think about mental illness the same way. We have many factors that influence the way we think about illness, and what actually dictates us titling something with a diagnosis. Where a person lives, the environment they grow up in, the social circumstances of their living, their religious beliefs, and much more are all influences on someone’s perception of mental illness. In this unit the two studies we learned about took place in two different continents (North American and Africa). The studies showed us the massive differences that we see in different cultures. The same exact illnesses can just as easily affect both types of people, but how these problems are interpreted by the patient and close family of the patients can be as opposite as black and white.

Dr. Metzl’s presentation showed us that explanatory models are subject to change and can be influenced by outside factors. The likely hood of African Americans to be misdiagnosed was obscurely high less than fifty years ago (Metzl, 2010). The doctors who were giving these patients all these diagnosis had a misconception in their own explanatory models. Race was brought into the equation, thus influencing how they may diagnose a specific patient. The fact that these statistics have decreased for African American’s over the twentieth century  is proof that the diagnoses were misconstrued.

A person’s own explanatory model is unique to that individual but may be influenced by their environment, peers, or personal beliefs. This is why explanatory models differ not only across continents, like we see in our examples, but even in our own friend and family groups. The study conducted by McGruder showed us that people of different cultures perceive mental illness differently. The family McGruder visited in Zanzibar told her that they believed the victim (who was diagnosed with schizophrenia) was made ill by Allah, and that they did not know the exact reason behind Allah’s doing (McGruder, 2003). What we call mental illness, may not even be categorized as that by people of a different culture. Thus they probably have their own ideas of how to treat a disease. Personal beliefs, that form one’s explanatory model would dictate how the disease is treated and what sorts of social, political, and health outcomes may ensue. It is important to understand from a clinician’s perspective that we must take into account every single patient’s personal explanatory model. Dr. Kandula said this in regards to understanding a patient’s view, “I cannot effectively counsel a patient with high blood pressure to change her diet or take medication unless I understand her way of explaining her hypertension and how she thinks her blood pressure should be treated. Once I understand that, we can discuss her issues in a language that we both understand” (Kandula, 2013). We need to make it about the patient, like Kandula insists. In a world where we are constantly pushed to go faster and be more time efficient, it’s essential to see what aspects of life could use some slowing down. Doctor to patient communication is one of these areas that we need to reassess in order to provide optimal care. If we strive to understand a patient’s individual explanatory model before a diagnosis is assessed, we can better determine how to help the patient to our fullest potential.

Kandula, Namratha. “The Patient Explanatory Model,” The Health Care Blog (2013).  Accessed July 14th, 2016. http://thehealthcareblog.com/blog/2013/06/11/the-patient-explanatory-model/

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