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Society as a Patient

Written by QCMHA EDII Coordinator Marium Naqvi

Those of us who grew up in Canada are lucky to have been exposed to mental health awareness from a young age, whether in school or in the media. However, in a culturally diverse society, Western mental healthcare does not come without its drawbacks.

I've found that Western society is individualistic by nature, and this translates into mental health approaches, too, including psychotherapy. Unfortunately, research has shown that there is distrust among certain cultures towards mental health professionals in Canada and the US, such as First Nations and African Americans, who share a history of persecution and discrimination. The discrimination carries forward till today, as Western therapy has led to the overdiagnosis of particular cultural groups. For example, African Americans have been overdiagnosed with schizophrenia in the US, implicating a lack of cultural sensitivity. Hence, it's no secret why members of marginalized communities tend to fear public spaces, which leads to a loss of access to services, including therapy–if needed. Intergenerational trauma also points to a collective experience, which can be challenging to combat using today's therapy systems. Representation is also a significant barrier, as it is very daunting for the patient to carry the burden of educating mental health professionals on cultural nuances or why they have opposing perspectives on a situation.

I recently came across an interesting term, "society as a patient." Dr. Anthony J. Marsella at the University of Hawaii coined the phrase to refer to mental health patients who are victims of societal factors such as discrimination, persecution, poverty, etc. Often, external factors are overlooked when the patient is approached through an individualistic lens. Dr. Marsella explains that it is dangerous to ignore socio-political circumstances, as a patient must be aware of the life context that has contributed to their current state. This outlook highlights the need to fix society's communal issues through activism as a root factor in individual mental health.

However, balancing communal values within an individualistic society can also be tricky. Growing up, I struggled to coexist with the "put yourself first" culture I was surrounded with and the selflessness ingrained in my upbringing. Particularly, the "you don't owe anything to others" or "protect your peace" ideas promoted under the banner of mental health never felt right to me, especially in times of global crises. Sure, the "put your oxygen mask on first" example we hear on the plane applies, but that is in case of emergencies. And if I'm not about to be sucked out of a plane window, I know for a fact that my feelings are not more important than someone's life, whether in my local community or across the world. I can afford to be aware of their plight at the cost of my privileged comfort, even if it helps their situation or cause in the slightest.

Individualism makes it easier to look away because how is a global crisis impacting my life tangibly if I protect my peace and choose comfort over advocacy? To me, mental health is undoubtedly complex and takes various forms across cultures, but I would never want my empathy to dwindle under the guise of me doing self-care.

Overall, it’s a blessing that we live in a society where we can take mental health days off from work with little to no explanation, but there is still a lot of work to be done for culturally sensitive mental health approaches.

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