Overview of the impact of culture on mental health: the importance of meaning and hope Philip Thomas Professor of Philosophy Diversity & Mental Health International School for Communities Rights and Inclusion University of Central Lancashire Preston PR1 2HE U.K.

Outline of talk 1.What do we mean by culture. 2.Describe recent changes in how we think about culture and the relationship between culture and identity. 3.Outline the cultural origins and assumptions of technological psychiatry as a way of understanding madness. 4.Examine the limitations of technological psychiatry in understanding madness and distress. 5.Examine how culture and meaning are central to understanding madness.

What is culture? 1 - Content 1.Language, custom and tradition 2.Belief, faith and spirituality 3.Values and morals 4.Art, literature, music: aesthetics 5.History and place

What is culture? 2 - Functions 1.Culture is that aspect of our shared humanity that: a.binds us together and b.creates human difference and diversity. 2.Through the particularity of history and geography, culture binds us to existential time and space. 3.In this way, culture is a key determinant of personal identity – who I am as a person. 4.Culture constitutes the referrents, signs and symbols that bring meaning into our lives.

Increasing Complexity of Culture 1.Migration and Mobility 2.The media and new information technology 3.The end of colonialism 4.The crisis of modernity Cultural Psychiatry in a Creolizing World: Questions for a New Research Agenda. Bibeau, G. (1997) Transcultural Psychiatry, 34,

Cogito ergo sumI think therefore I amCogito ergo sumI think therefore I am

"... the enterprise of the age of reason, gaining authority from the mid-seventeenth century onwards, was to criticise, condemn and crush whatever its protagonists considered to be foolish or unreasonable.... And all that was so labelled could be deemed inimical to society or the state - indeed could be regarded as a menace to the proper workings of an orderly, efficient, progressive, rational society" (Porter, 1987, pgs 14-15).

Psychiatry and the European Enlightenment Importance of reason Focus on Self Need for a reasonable society Emergence of Technological thinking Preoccupation with depth and interiority Exclusion of unreason Technological approaches Discourses of interior Quest for individual truth Psychiatry Great confinement Figure 1 in Postpsychiatry, Bracken, P. & Thomas, P. (2005:7)

Science and Human Experience Auguste Comte Helmholtz

HAD Scale Scoring Sheet Name: ________________________________ Date:___/___/______ This questionnaire is designed to help your advisor to know how you feel. Read each item and place a firm tick in the box opposite the reply which comes closest to how you have been feeling in the past week. Dont take too long over your replies: your immediate reaction to each item will probably be more accurate than a long thought out response. Tick only one box in each section I feel tense or wound up:I feel as if I am slowed down: A D Most of the time 3 Nearly all the time 3 A lot of the time2Very often2 Time to time/occasionally 1Sometimes1 Not at all0 0

Edmund Husserl Karl Jaspers

My glass is full of water.My heart is full of sadness.

My glass is full of water. My heart is full of sadness. Ludwig Wittgenstein

"…man is an animal suspended in webs of significance he himself has spun, I take culture to be those webs, and the analysis of it to be therefore not experimental science in search of law but an interpretative one in search of meaning." (Geertz, 1973:5)

Bracken, P. & Thomas, P. (2005) Postpsychiatry: Mental Health in a Postmodern World. Oxford, Oxford University Press. Lapsley, H., Nikora, L. & Black, R. (2002) Kia Mauri Tau!: Narratives of Recovery from Disabling Mental Health Problems. Report of the University of Waikito Mental Health Narratives Project. Mental Health Commission, Wellington NZ, Accessed 28/20/04 at Onken, S., Dumont, J., Ridgway, P., Dornan, D. & Ralph, R. (2002) Mental Health Recovery: What Helps and What Hinders? A National Research Project for the development of Recovery Facilitating System Performance Indicators. National Technical Assistance Center for State Mental Health Planning, National Association of State Mental Health Programme Directors, USA. Accessed 04/11/03 pdf pdf Tooth, B., Kalyanasundaram, V., Glover, H. & Momenzadah, S. (2003) Factors consumers identify as important to recovery from schizophrenia. Australasian Psychiatry, 11 (supplement) 70 – 77. Topor, A. (2001) Managing the Contradictions: Recovery from Severe Mental Disorders. Stockholm Studies of Social Work, 18. Stockholm, Stockholm University Press. Thornhill, H., Clare, L. & May, R. (2004) Escape, Enlightenment and Endurance: Narratives of recovery from psychosis. Anthropology and Medicine, 11, 181 – 199.