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The construction of religious and cultural meaning in Egyptian psychiatric patient charts
- Author:
- COKER Elizabeth M.
- Journal article citation:
- Mental Health Religion and Culture, 7(4), December 2004, pp.323-347.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper explores the use of religious symbols and metaphors in Egyptian psychiatric inpatient charts to portray psychiatric pathology and, by extension, the role that religious symbols play in constructing psychiatric illnesses. This represents a deconstruction of patient charts, assuming that the psychiatrist chooses aspects of family and patient discourse which best represent unexamined cultural ideas of person and illness, normality and abnormality. All of the psychiatrists writing the charts were Egyptian and shared much of the same cultural background with their patients, excluding their medical training. Therefore, while chart discourse is used to justify a psychiatric diagnosis, it is also the product of a shared cultural history; a tacit agreement about what constitutes a meaningful story. This paper focuses mainly upon discourse that has religious connotations, for the reason that these seemed to be more invested with cultural meaning than other delusional themes. These religious symbols and metaphors are interpreted in light of their symbolic associations with certain existential states, the family unit and with society as a whole.
Asian Americans and mental health services:a study of utilization patterns in the 1990s
- Authors:
- CHEN Sheying, et al
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 12(2), 2003, pp.19-41.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Research in the 1970s and 1980s revealed that Asian Americans, compared with other ethnic groups, tended to underutilize mental health services. This article is aimed at adding new information to the literature by examining data from the 1990s. The raw data comprised 97,212 total admissions representing 45,774 total individuals utilizing mental health services during a four-year period in San Diego County,California. By comparing findings with previous research cases on utilization patterns of mental health services, new evidence is found about Asian Americans in terms of their (1) underrepresentation in mental health services, (2) presentation of more severe symptoms than those of other racial/ethnic groups when first seen at clinics, (3) lower dropout rates and higher average lengths of stay than other racial/ethnic groups, and (4) higher percentages of using day treatment and outpatient programmes but lower percentage of using inpatient programmes. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Medication, healing and resistance in East Malaysia
- Author:
- CRABTREE Sara Ashencaen
- Journal article citation:
- Mental Health Religion and Culture, 8(1), March 2005, pp.17-25.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper considers some findings from an ethnographic study of psychiatric patients in hospital care in East Malaysia. The subject of treatment is considered with regard to professional attitudes towards patient 'compliance' and the demonstration of resistance by users within a multicultural context in which traditional healing continues to be a popular alternative to biomedicine. 'Resistance' here is used in its literal meaning, rather than as an abstract, theoretical construct. The narratives of Malaysian patients in relation to resisting treatment in this study form some direct comparisons with, for example, the quotes from service users on the topic of medication, 'control and coercion' in the UK. Resistance to treatment then is interpreted by staff as the outcome of sickness behaviour, which frequently results in coercive strategies. The undisputed power of the medical profession in Malaysia has contributed to the lack of an evolved 'service-user' perspective in which few patient rights are recognised, especially non-treatment. These responses remain embedded in a paternalistic and custodial attitude that does not acknowledge issues of spirituality or alternative healing practices that are important to hospitalised patients. Modernisation of services have not led to a parallel development with regard to patient participation or in terms of appropriate cultural responses. It is concluded that until this takes place professionals will continue to ignore the personal meaning users attach to treatment resistance.