The two explanatory models of schizophrenia diagnoses we looked at this week differ in many ways. We looked at a biomedical account from Dr. Johnathan Metz looking at a hospital in Ionia, MI and a cultural account from Juli McGruder studying 3 different Zanzibarian households. Even though these apparent differences are present in the material, there are similarities. In each piece the researcher is basically discovering that people deal with mental illness according to their culture, namely schizophrenia.
Dr. Metz went on to explain that certain demographics appeared to be over-diagnosed during specific times in the history of the hospital he studied. At first women were the ones being over diagnosed, then in the mid sixties that demographic shifted to black males. Looking at the timeline of American discrimination, these stats make sense. What we see here is the way that diagnoses change with culture. At that time mental illness wasn’t seen as something that upper society suffered from (upper society being white men), and was considered a way to dehumanize somebody. In the early 1900s, women were seen as lesser human beings, which seemed to have played a role in the over diagnoses of that particular demographic. It’s interesting to note that the DSM was originally used to diagnose most white men, as said by Dr. Metz in his presentation. As time shifted, so did the demographic that was predominantly diagnosed with mental illness. The same happened to African Americans in the sixties, in the midst of the civil rights movement and blacks were heavily discriminated against. This idea began to racialize mental illness and schizophrenia. But the principle still remains that even western medicine has changed due to the culture it’s surrounded by.
McGruder gave the ethnographic accounts of 3 Muslim, Zanzibarian households. Their explanation of mental illness was mostly on a spiritual level, seeking both traditional and western solutions at times, depending on the family’s social status. Schizophrenia was considered a test sent from Allah in this paper, and thus most families would turn to traditional means of ridding themselves of the “spirits” or overcome the test that Allah sent to them. One of the families did utilize western medicine a bit more than the other two, and that reason is most likely because of social class, but they still were very spiritual in their approach to ridding themselves of the mental illness. Also, these families go about healing together and are very tolerate of the mentally ill family members. Since the spirit is plaguing a family member, each member has to deal with the test/spirit together so that they may overcome the problem as a family and give Allah His praise.
There are even different aspects of an illness that one culture will recognize and another won’t, or won’t pay as much attention to. According to Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health, culture can affect how patients communicate to their clinicians, their symptoms, what the symptoms mean, and if they even seek help in the first place. We saw all of these aspects of cultural influence on mental illness in the 2 examples we dissected this week up front and close.