Increasing Understanding of Multicultural Mental Health Concerns

English tends to provide a robust variety of descriptions for mental health issues, whether they’re represented in the DSM or not. For the most part, we can talk about trauma, adverse childhood experiences, anxiety, and depression and trust that other people understand the feelings and sensations we describe.

But sometimes clinical terminology may not fully convey our emotions. Or perhaps we are experiencing so much at once that we have to use multiple concepts to describe our emotions.

Other cultural traditions may describe mental health issues through a spiritual lens that honors centuries of traditions and customs. Some terms have fallen out of use, but others live on in different languages and healing practices. Learn more about how people around the world conceptualize mental health issues we may have never felt or perceived.

Multicultural Concepts of Mental Health Issues

1. Maladi Moun

A Haitian concept that means “humanly caused illness,” maladi moun is a label that may be applied if it’s suspected someone has been harmed through another’s ill will. Also called “sent sickness,” it explains many medical and mental health issues in Haiti. It is believed feeling envy and malice toward another can cause harm in the form of depression, academic or social failure, psychosis, or an inability to perform daily life activities.

Because personal gain is assumed to be linked to another person’s loss in some way, economic success, high social status, intelligence, attractiveness, and good health are all seen as factors that can make someone vulnerable to attack. In other cultures, a similar concept has been called the “evil eye:” mal de ojo in Spanish and ma’occhiu in Italian.

2. Khyâl Cap

Khyâl cap, a Cambodian term that means “wind attacks,” centers on the idea that khyâl, or wind, rises in the body with blood. It can cause symptoms such as panic attacks and psychosis, as well as a range of somatic experiences. Physical health issues that may occur include tinnitus, dizziness, difficulty breathing, palpitations, and cold hands and feet.

The experience of khyâl cap may closely resemble a panic attack. Khyâl attacks might have a trigger like being in crowded spaces or some other stressful situation. But they may also happen without warning.

3. Kufungisisa

Learning about other cultures can help us increase our knowledge around mental health concepts and expand the vocabulary we use to describe mental health issues. This can help us increase our acceptance of others and broaden our worldview.

Many of us can likely relate to the experience of “thinking too much.” This concept is described in various ways across many different cultures, countries, and ethnic groups. The Shona people of Zimbabwe call this kufungisisa. It is seen as a cause of many concerns, including physical distress. For example, a person might say, “My heart is hurting because I think too much.”

Related mental health concerns include anxiety, panic, irritability, and depression. Ruminating on thoughts related to upsetting social situations, marital woes, or financial difficulties may lead to excessive worry. If a person cannot perform typical tasks due to this state of worry, they might also refer to kufungisisa as “brain fog.”

4. Taijin Kyofusho

Taijin kyofusho, which means “interpersonal fear disorder” in Japanese, is a form of social anxiety related to feelings of inadequacy or low self-esteem. Someone with taijin kyofusho might avoid interpersonal situations because they believe their appearance or actions are offensive or intolerable to others. They might be concerned about their level of body odor, level of eye contact, bodily movements, facial expressions, or blushing. Because these are physical concerns, taijin kyofusho sometimes encompasses aspects of body dysmorphia.

5. Nervios, Attaque de Nervios:

People of Latin descent, in both Latin America and the United States, may use nervios to describe general distress. Generally, it is a response to stressful life experiences or circumstances that make one vulnerable. Symptoms of nervios include both emotional and somatic distress, such as irritability, nervousness, difficulty sleeping, head and neck pain, dizziness, and stomach problems.

Attaque de nervios is a more acute form of nervios. This term describes a “fit” or episode of intense emotional upset. Anger, grief, anxiety, dissociation, and even suicidal ideation may be elements of this experience. A person might also experience physical symptoms such as fainting or seizure-like spasms. Variations on these experiences are echoed in Greek, Sicilian, Appalachian, Haitian, and other cultures.

How Do These Concepts Impact Mental Health Care?

Learning about other cultures can help us increase our knowledge around mental health concepts and expand the vocabulary we use to describe mental health issues. This can help us increase our acceptance of others and broaden our worldview. But these concepts and terms are not standalone issues relevant only to certain cultures. Differences in the ways people understand mental health and experience distress can have a huge impact on the way they search for care, as well as the relationship they develop with care providers.

Stigma and lack of access to health care continues to disproportionately affect cultural minorities. In addition, people of color and other members of marginalized populations may be more hesitant to seek help when they are in distress. There are many reasons someone might shy away from pursuing mental health treatment. Among them may be the fear that therapists may not understand (or even try to comprehend) the nature of their concerns through the lens of their culture or heritage.

Therapists can better serve minority communities, especially those for whom English is a secondary language, by studying mental health concepts from other cultures, such as the ones listed above. Racial minorities, particularly older adults, tend to approach health care with different expectations of care providers, treatment preferences, and understanding of causes of mental health concerns. Many psychotherapists may not be aware these differences exist, let alone have an idea how to address these discrepancies during treatment. Accommodating these values is key to providing quality care for all people seeking help.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2. Jimenez, D. E., Bartels, S. J., Cardenas, V., Dhaliwal, S. S., & Alegría, M. (2012). Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. The American Journal of Geriatric Psychiatry, 20(6), 533-542. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258470
3. King, W. (2016, January 20). Inequality lingers in mental health treatment for minorities. GoodTherapy.org. Retrieved from https://www.goodtherapy.org/blog/inequality-lingers-in-mental-health-treatment-for-minorities-0120162

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