Sushrut Jadhav – Caste, Stigma, and Mental Well-being: From Transition to Conversion (ASI 2014)

Caste, Stigma, and Mental Well-being: From Transition to Conversion

Sushrut Jadhav, University College London, UK; Bhargavi Davar, Bapu Trust for Research on Mind and Discourse, Pune, India; Sumeet Jain, University of Edinburgh, UK; S. Shinde, Bapu Trust for Research on Mind and Discourse, Pune, India

Dalit “untouchables” in the Indian subcontinent are largely excluded from full participation in everyday social life. They have poorer health outcomes compared to the general population, and are subject to degradation, humiliation and violent atrocities. Yet there is a striking absence of research examining the stigma of Dalit caste identity and its impact on mental well-being of Dalit “untouchables.” The paper addresses the nature of stigma associated with being an “untouchable” and how this shifts following conversion to Buddhism. This pilot ethnographic and focus group study was situated in an urban Dalit slum of Pune city, Maharashtra state, India, by a multi-caste, multi-disciplinary team of health professionals and social scientists. Results suggest that the nature of distress related to caste discrimination is both psychological and cultural, with an internalization of the “gaze” of upper castes, and spatial-temporal dimensions within which both individual and institutional discrimination operates. Whilst Dalits who have not converted tended to aspire to a sanskritised identity, Dalit converted to Buddhism appear to have carved out a political identity to contest the stigma. The strategies employed to deal with discrimination include instrumental actions and political transformation. Dalit conversion to Buddhism suggests well-being is gained through the development of a dignity that results in a more articulate and political identity that contest existing ideas of modernity in India. The authors conclude that the phenomenon of conversion is not absolute. The paper suggest further research towards an examination of cultural landscapes that
mediate the stigma of “untouchability”; ethnographic studies of innovative movements that contest and invert Dalit caste identity; and comparison of caste-related and cultural-identity stigma, with stigma associated with more formal mental or physical disorders that have been extensively researched. Furthermore, a study of castes within Indian Buddhists may identify more chronic markers of caste-related stigma. This has implications towards interventions that directly address well-being of “untouchables” in India.

Morton Weinfeld – Ethnic Match in Health and Social Services: Pros and Cons (ASI 2014)

Ethnic match is an approach to the provision of public services in various policy domains, in societies marked with significant ethnic, racial, or religious diversity. Minority recipients of services may be matched with professionals of the same background, receive services in ethnospecific agencies, or receive a type of service which is sensitive to the specific minority culture at
issue. This paper explores the evidence that deals with the issue of ethnic match in the provision of mental health care, looking mainly at literature from the fields of psychiatry and psychology, including therapists with backgrounds in social work or counseling. A review of the literature reveals no clear pattern of benefits—or harms—from these various practices for the recipients of service in this particular policy domain. Implications for education, training, and practice will be explored.

Natacha Premand – Black Sheep and Mass Immigration: The Use of Caricature in Rejection of the “Other” (ASI 2014)

In recent years, right-wing political parties in Switzerland have initiated several referenda on issues pertaining to the admission and residency of foreigners. In this paper, I will examine the ways in which the “other” is constructed in the political discourse of Switzerland’s Union Démocratique du Centre, one of the instigators of these referenda. I will argue that the image of foreigners in official discourse as important contributors to Swiss society and the economy is successfully undermined by their depiction by the right wing as “black sheep” – literally so in one controversial but effective advertising campaign. By also associating negative characteristics with particular ethnic groups, the right seeks to elicit fear and rejection. This contributes to establishing negative connotations with respect to all foreigners or minority groups, regardless of any explicit or specific voicing of concerns. In response to these campaigns, the United Nations’ Committee on the Elimination of Racial Discrimination has recommended that the Swiss Federal Commission on Racism be given more independence from government and be empowered to regulate the media and political
discourse. The paper attempts to better define the space created by these campaigns as a site of impact on the mental health of foreign populations and minority groups that has been neglected and is in need of urgent study.

Roberto Lewis-Fernández on the Cultural Formulation Interview

“What should we know about you that contextualizes you and understands you from a cultural lens?”

Roberto Lewis-Fernández, Professor of Clinical Psychiatry at Columbia University talks about the Cultural Formulation Interview (CFI): what are its uses, is it only for use with people from a cultural minority, and how can practitioners learn to use it?

Chikako Ozawa-de Silva on Naikan

“Any contemplative practice is reflective of its own culture but that doesn’t mean that each cultural practice is only limited to that culture.”

Chikako Ozawa-de Silva, Associate Professor of Anthropology at Emory University talks about the contemplative practice of Naikan. Naikan, which means “inner looking”, is a secular form of a contemplative practice derived from Japanese Mahayana Buddhist practice.

This podcast was recorded during the 2013 Advanced Studies Institute (ASI) Conference on Mindfulness in Cultural Context. The 2014 ASI theme is “The Politics of Diversity: Pluralism, Multiculturalism and Mental Health”. For more information and to register, please visit the Division of Transcultural Psychiatry’s main site.

The Charter of Quebec Values: A View from Cultural Psychiatry

Dr. Laurence Kirmayer, Head of the Division of Social and Transcultural Psychiatry at McGill University and Dr. Jaswant Guzder, Head of Child Psychiatry at the Jewish General Hospital in Montreal have co-authored “The Charter of Quebec Values: A View from Cultural Psychiatry” – the paper provides references to support claims made by Drs. Kirmayer, Guzder and other professors and researchers at McGill in their open letter on the potential negative effects of the proposed Charter of Quebec Values.

From the abstract:
Cultural diversity can contribute to mental health. Research demonstrates that familiarity with others can reduce prejudice and that the positive valuation of one’s own cultural identity by others can reinforce self-esteem and well-being. Recognition in public institutions is one important dimension of such social recognition. As well, there is evidence that systematic recognition of cultural and religious identity in health services contributes to improved care. The presence of clinicians from diverse backgrounds in the health care system is an essential resource to improve the accessibility, appropriateness and effectiveness of health care. In addition to undermining fundamental human rights, therefore, the proposed Quebec Charter of Values may negatively affect the health of minority groups as well as impeding their access to safe, equitable, and effective health care. 

You can read the entire paper here.


An open letter in response to the proposed Charter of Quebec Values

Dr. Laurence Kirmayer, head of the division of Social and Transcultural Psychiatry at McGill University along with other professors and mental health researchers at McGill have written an open letter published in The Gazette voicing their concerns about the proposed Charter of Quebec Values. The proposed charter calls for a ban on wearing “overtly religious” symbols for public employees such as doctors and nurses, judges, the police, and daycare workers. Spearheaded by Democractic Institutions Minister Bernard Drainville, the proposed charter has spurred many voices of both support and dissent.

Those who support it say that enforced secularization is an important step towards protecting the rights of women by ensuring equality of the sexes. Those against the charter, such as Dr. Kirmayer and his co-signatories, warn that the charter will divide Quebec society. “Excluding personal expressions of culture, religion and spirituality by employees working in public institutions will prevent people from learning about each other and will lead to more stereotyping, discrimination and social exclusion” the letter states. The authors are concerned about the effect the charter would have on the mental health of immigrants and minorities in Quebec: “Diversity is good for your health: Recognition of cultural identity is important for the mental health and well-being of individuals and communities. Language, religion, ethnicity and other aspects of cultural background are sources of strength, resilience and belonging. There is evidence that many of those who practice religion or other spiritual or moral traditions have better mental health — perhaps because they enjoy a supportive community — and a world view that provides meaning and value to their lives. The positive effects of identity also come from recognition by, and respect from, others. To promote mental health, therefore, we need to actively engage others in ways that respect their backgrounds.”

You can read the entire letter on the Montreal Gazette’s website.

The details of the proposal are still being debated within the Parti Quebecois and legislation has yet to be presented at the Quebec National Assembly. The Quebec Human Rights Commission has stated that the proposed Charter would contravene the existing human rights charter. For further information, please see their commentary on the charter on their website.

Kwame McKenzie – Globalization and Mental Health

“Globalization itself, the idea of everyone connecting isn’t necessarily a bad thing but the way it’s being enacted is causing problems”

Kwame McKenzie, of the Univesity of Toronto shares his thoughts about mental health issues surrounding globalization. In a globalized economy, city centres swell as populations move from rural to urban spaces to better access opportunities, especially in low income countries. In tandem with higher urbanization there is an increased prevalence of depression, schizophrenia, anxiety disorders, and poverty, which presents a pressing mental health issue in a time of rapid social change.  Stressing the link of mental well being to economic prosperity, Dr. McKenzie advocates for a public health approach where the causes of mental health problems are addressed directly, as a better alternative to increasing services, which he feels is “a solution” but not “the solution”.

Laurence Kirmayer – Revisioning Psychiatry

Laurence Kirmayer recently gave a new version of his lecture “Revisioning psychiatry: Cultural phenomenology, critical neuroscience, and global mental health”. The talk was presented as a guest lecture at the FPR-UCLA Programme for Culture, Brain, Development, and Mental Health in January 2013. Click here for more information on the programme.

Rachel Tribe – Interpreters and Mental Health

“Working with interpreters has enriched all my clinical work. What it has made me do is make me think about how I construct my language, how I construct explanatory models of mental health.”

Rachel Tribe, Professor at the School of Psychology at the University of East London talks about the benefits and challenges involved in working with interpreters in mental health care. Given that complex cultural constructs are communicated through language, Tribe puts forward suggestions on how mental health practitioners and interpreters can work together to provide the best care for their patients.

To obtain a copy of the guidelines for Working with Interpreters in Health Settings, mentioned at the end of Dr. Tribe’s interview, click here

Blog authors are solely responsible for the content of the blogs listed in the directory. Neither the content of these blogs, nor the links to other web sites, are screened, approved, reviewed or endorsed by McGill University. The text and other material on these blogs are the opinion of the specific author and are not statements of advice, opinion, or information of McGill.