Culture and chronic mental illness

Abstract

The relationship of culture to chronic mental illness is reviewed in a cross-national and cross-ed,-nic perspective. The author criti-cally examines the argument, based on different ial prognosis for serious mental illness in develop-ing and industrial countries, that chronicity is a cultural artifact. Key questions include whether cul-tural beliefs and practices that minimize social stigma, self-deval-uation, and patients ’ assumption oftbe sick role are linked to better prognosis. World view, religion, alternative healing resources, val-ues of interdependence, extended kinship structure, family support, and professionals ’ willingness to work collaboratively with families are viewed as cultural strengths that may help to mediate the course of mental illness. Issues that are relevant to treatment of long-term psychiatric disability in ethnic pa-tients in the United States include interetbnic differences in the dis-tribution ofcases and service util-ization patterns, diagnostic and medication issues, and develop-ment of culturally rekvant treat-ment modalities. Dr. Lefley is professor of psychia-try and director of the collabora-tive family training project at th