Globalisation and Mental Disorders - Essay Example

Globalisation and Mental Disorders The author is seeking a grant to be used for the implementation of the study seeking to determine the degree and level of cultural consideration in treating depression. The design and intent of this study is to conduct a systematic and through review of the literature, regarding the cultural understanding of the diagnosis and treatment of depression, in order to determine: whether cultural differences are understood and accounted for during diagnosis and treatment and the extent to which different cultures are able to comprehend the concept of depression and the diagnosis and treatment available to them. The results of the study shall be indicative of the current situation and are valuable in the improvement of treatment provision for a population that is increasingly becoming culturally diverse due to the large influx of people from other cultural backgrounds. With this knowledge, society shall then be able to identify and take the appropriate steps to improve the way depressed people are being treated. Funding in the amount of £2,800 is requested for expenses incurred during research the bulk of which shall be used for access to publications whose material is available only for a certain fee. RESEARCH QUESTION AND IMPORTANCE A. Research Question To what extent has the relationship of depression, culture and treatment explored and how is the knowledge gained from this exploration being applied in the formulation of treatment for depressed patients? The researcher hypothesizes that there is little substantial research in this field and that results are limited due to the complexity of dealing with the subject of culture and associating it with another complex subject called depression. Hence, a lack of understanding of depression, within various cultures and communities exists, including the comprehension of the diagnosis and treatment of this condition. There is a desperate requirement for general medicine and public health services to understand the cultural needs of individuals when generating a diagnosis or treatment regime. B. Importance of the Study Depression can have debilitating effects on the individual as it can lead to self-inflicted injuries and other destructive behaviour. If left unchecked, it could also have severe consequences to society as evidenced in the school shootings and stabbings by clinically depressed individuals. However, in the field of depression treatment, there is the general tendency to adapt standards and procedures which has been developed in the past with one cultural group in mind. These concepts and procedures can prove to be unsuitable as the demographic make-up of civil society today has greatly diversified due to the influx of people from other nations and cultures. Many Western nations now have a sizeable Asian and African population. There is now the added dimension of culture to account for in the formulation of care and treatment for depression. The concept of possessing a cultural understanding with regards to depression, as well as its diagnosis and treatment, is in fact a relatively recent notion, enhanced by the onset of globalisation, technology and ageing population (Bhugra et al, 2004). The results from the research proposed within this study would greatly contribute to improving cross cultural mental health services, through the identification of the lack of cultural understanding of depression diagnosis and treatment both in the context of the public health services and general medicine, and individuals and groups belonging to different cultures. It aims to identify what has been done and can therefore provide a basis of what further needs to be conducted. If the research indicates that there is limited knowledge, then it can provide the impetus for others to conduct more intensive research about the subject which can then improve the provision of depression treatment. RESEARCH DETAILS A. Aims and Objectives of the Project The aims of this study are to: Observe whether a lack of knowledge and awareness exists among health and treatment professionals regarding the diagnosis and treatment of depression. Discover the level of awareness of individuals or groups belonging to numerous cultures, to depression and its diagnosis and treatment. In order to fulfil such aims the objectives of the study are as follows: Design a literature search strategy effective enough to generate through but relevant results. Examine the evidence relating to the cultural understanding of depression, in particular depression diagnosis and treatment, namely by health professionals working in the realms of medicine, public health or psychiatry. Observe the evidence relating to the understanding of depression, in particular depression diagnosis and treatment, by individuals or communities corresponding to various cultures. Identify the effects that a lack of cultural understanding has on the general population and worldwide. Demonstrate a requirement for further research, work and development, focussed on the understanding of the manner in which culture impacts the diagnosis and treatment of depression. B. Research Background Depression The concept of depression as a serious and debilitating illness, one which has had great impact globally, has become recognised within general medicine and the public eye in more recent times (NHS, 2010). In 1996, the World Bank published a report on the global burden of disease implicating the importance for the realisation that the impact of depression worldwide is vast (Scott et al, 2003). In 1990, 11 million sufferers of depression were identified in the US alone (Scott et al, 2003) . This illness is associated with “feelings of extreme sadness” which not only last for long periods of time, but it is also recurrent and may further develop into suicidal tendencies (NHS, 2010). Criteria for the diagnosis and treatment of depression are flexible and are not based on a standard or specific range of symptoms, unlike many illnesses or disorders. This may be accountable to the fact that there are numerous forms of depression including unipolar or bipolar disorder and dysthymia (longer in duration and less severe than major depression (Lon Schneider, 1991; NHS, 2010). Similarly, treatment of depression is also multifaceted, involving talking therapies; the use of a variety of medication, dependent on the form of depression, and self help (Cuijpers et al, 2008; NHS, 2010). Culture and Increasing Diversity The Cambridge Dictionary (2008) defines culture as "the integrated pattern of human behaviour that includes thought, speech, action; the customary beliefs, social forms, and material traits of a racial, religious, or social group." While the definition seems simple enough, culture is actually a complex term involving a myriad of issues that took many years to develop and understand. , it must be stipulated that culture and ethnicity in themselves are constantly dynamic, and certain individuals do not fit into a particular culture or ethnic group (BMJ, 1996). There are three important phenomena that are shaping our world today: globalisation, technology and the aging Western population. Globalisation has resulted to the relaxation of national barriers to facilitate international trade and commerce. The flow of goods and people is now much easier than it was before. In the European Union, for example, visa is no longer required when travelling in member states. Technology is also revolutionizing the means of communication and transportation greatly reducing the cost and other problematic issues associated with global travel. In many Western nations, birth rates have severely decreased leading to the situation where the population is ageing. Foreseeing that there would not be enough nationals to man their industries and provide care for their elderly, many governments now like the UK and Australia have relaxed their immigration quotas. The combination of these three phenomena has greatly increased migration and settlement to other countries with the effect of diversifying culture in many population settings. In the UK, the last census in 2001, implicated a growth in the emergence of both ethnic minorities and religious groups. 7.9% of the UK population is from non-White ethnicity (BBC News, 2003; ONS, 2004). A Cultural Understanding of Depression The impact of globalisation is vast, delegating both positive and negative attributes. This impingement, has had a direct affect on public health, and in turn on the requirement for a culturally sensitive response in dealing with health related issues (Bhugra et al, 2004). The importance of culture has lead to the development of a new branch of medicine termed “ethnomedicine”, dealing with the manner in which culture effects the health of an individual (Nemade et al, 2007). A number of studies have been conducted worldwide suggesting the requirement for a culturally influenced diagnosis and treatment regime. However, the dynamic nature of different cultures and the complex nature of depressive illnesses hinder the development of these regimes (McGilloway et al, 2010). The cultural based understanding of the treatment and diagnosis for depression is inherently double faceted. In the first context there is a requirement for the medical, psychological and public health domains to understand the nature of different cultures and communities. Misunderstandings with regards to culture-specific depression symptoms may lead to misdiagnosis (L. J. Kirmayer, 2001; Miranda et al, 2003; J. P. Shapiro, 2009). Secondly, there is a lack of knowledge and understanding within different cultures and ethnic groups, as to what depression comprises of, as well as its causes, cures and the necessity to seek treatment (Lavender et al, 2006; R. L. Waite, 2006). These issues shall be discussed further throughout this study. C. Research Design and Methodology In order to fulfil the aforementioned aims and objectives, a literature search strategy is devised and involves the identification of certain keywords with inclusion and exclusion criteria through the application of psychological and health based databases The search is to be carried out in available databases to collect relevant literature including but not limited to Pubmed, Medline, Biomed, psycINFO and Google scholar. Pubmed, Medline and Biomed are medical databases which is very much appropriate as the subject is a health based topic. PsycINFO can provide further assistance in the accumulation of psychological based literature while Google scholar substantially aiding in the identification of a few extra resources. The inclusion criteria are to be set widely to enable papers relevant to depression, culture, diagnosis and treatment to be accessed. The main exclusion criterion to be applied is to exclude literature which was dated later than 10 years. This is chosen due to the vast number of studies generated within the search and to identify papers of relevance to date. Forward and backward citations are also to be used. SUMMARY OF FINANCIAL SUPPORT REQUESTED Duration of the Study (Client to Fill Up) Purchase of Published Literature £2,500 Consumables (printing and stationery) £300 REFERENCES BBC News., 2003. Ethnic Groups Growing – Census. 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BMC psychiatry, 7, 57. WAITE, R.L., 2006. Variations in the experiences and expressions of depression among ethnic minorities. Journal of National Black Nurses' Association : JNBNA, 17(1), 29-35. Read More