Cultural impacts on psychiatric care for pre- and post-diagnosed patients and their respective health outcomes

Carina Lam; Marim Ibrahim; Houssein Chahrour; Aqsa Shoaib; Muhammad Muiz-uddin  Ghauri

doi:10.33178/SMJ.2025.1.14

Authors

Carina Lam School of Medicine, University College Cork, Cork, Ireland
Marim Ibrahim School of Medicine, University College Cork, Cork, Ireland
Houssein Chahrour School of Medicine, University College Cork, Cork, Ireland
Aqsa Shoaib School of Medicine, University College Cork, Cork, Ireland
Muhammad Muiz-uddin Ghauri School of Medicine, University College Cork, Cork, Ireland

DOI:

https://doi.org/10.33178/SMJ.2025.1.14

Keywords:

Psychiatry, Cultural Barriers, Cultural minorities, Mental Health, psychiatric disorders, Medication compliance, Diagnosis

Abstract

Given the cultural influences and perceptions surrounding psychiatry, this has led to hesitancy and delays in seeking mental health services and treatment. Even the process of being diagnosed is affected by cultural perceptions and physician bias, as symptomatology differs between various minority groups, resulting in misdiagnoses and further delays. Compounded with pre-existing disparities and a perception that mental health conditions are inferior to other medical conditions, cultural minorities have experienced poorer health outcomes and a reduction in quality of life. Only with a better understanding of the cultural impacts on pre- and post-diagnosis and treatment can psychiatry better serve its patients and provide effective care.

References

Mental health disorder statistics. Johns Hopkins Medicine. (2024, June 20). https://www.hopkinsmedicine.org/health/wellness-and-prevention/mental-health-disorder-statistics#:~:text=An%20estimated%2026%25%20of%20Americans,substance%20use%20and%20anxiety%20disorders

Aggarwal NK, Pieh MC, Dixon L, Guarnaccia P, Alegría M, Lewis-Fernández R. Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review. Patient Education and Counseling. 2016 Feb;99(2):198–209. doi:10.1016/j.pec.2015.09.002

Ahad AA, Sanchez-Gonzalez M, Junquera P. Understanding and addressing mental health stigma across cultures for improving psychiatric care: a narrative review. Cureus. 2023 May;15(5). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10220277/

Kirmayer LJ, Fung K, Rousseau C, Lo HT, Menzies P, Guzder J, McKenzie K. Guidelines for training in cultural psychiatry. Canadian Journal of Psychiatry. 2012 Mar 1;57(3):1-6. Available from: https://journals.sagepub.com/doi/full/10.1177/0706743720907505

Gearing, R. E., Washburn, M., Brewer, K. B., Cabrera, A., Yu, M., & Torres, L. R. (2024). Pathways to mental health care: Latinos’ help-seeking preferences. Journal of Latinx Psychology, 12(1), 1–17. https://doi.org/10.1037/lat0000237

Abeysundera H, Khanna H. “Ghost on the Coast”: Persistent hallucinations through the prism of cultural concepts of distress. Industrial Psychiatry Journal. 2021 Jul 1;30(2):353-5. Available from: https://journals.lww.com/inpj/fulltext/2021/30020/_ghost_on_the_coast persistent_ hallucinations.26.aspx

Shim RS. Dismantling structural racism in psychiatry: a path to mental health equity. American Journal of Psychiatry. 2021 Jul;178(7):592-8. Available from: https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2021.21060558

Wong, E. C., Collins, R. L., Cerully, J., Seelam, R., & Roth, B. (2017). Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges. Rand health quarterly, 6(2), 6

Karasz, A., Gany, F., Escobar, J., Flores, C., Prasad, L., Inman, A., Kalasapudi, V., Kosi, R., Murthy, M., Leng, J., & Diwan, S. (2019). Mental Health and Stress Among South Asians. Journal of immigrant and minority health, 21(Suppl 1), 7–14. https://doi.org/10.1007/s10903-016-0501-4

Lin, K. M., & Cheung, F. Mental health issues for Asian Americans. 50, Psychiatric Services . (1999):774–780.

Faber, S. C., Khanna Roy, A., Michaels, T. I., & Williams, M. T. (2023). The weaponization of medicine: Early psychosis in the Black community and the need for racially informed mental healthcare. Frontiers in psychiatry, 14, 1098292. https://doi.org/10.3389/fpsyt.2023.1098292

Diaz E, Woods SW, Rosenheck RA. Effects of ethnicity on psychotropic medications adherence. Community Mental Health Journal. 2005 Oct;41(5):521–37. doi:10.1007/s10597-005-6359-x

Schnittker, J. (2003). Misgivings of Medicine?: African Americans’ Skepticism of Psychiatric Medication. Journal of Health and Social Behavior, 44(4), 506–524. https://doi.org/10.2307/1519796

Lanouette, N. M., Folsom, D. P., Sciolla, A., & Jeste, D. V. (2009). Psychotropic medication nonadherence among United States latinos: A comprehensive literature review. Psychiatric Services, 60(2), 157–174. https://doi.org/10.1176/ps.2009.60.2.157