Attributions of Mental Illness: An Ethnically Diverse Community Perspective

Abstract

Although the prevalence of mental illness is similar across ethnic groups, a large disparity exists in the utilization of services. Mental health attributions, causal beliefs regarding the etiology of mental illness, may contribute to this disparity. To understand mental health attributions across diverse ethnic backgrounds, we conducted focus groups with African American (n = 8; 24 %), Asian American (n = 6; 18 %), Latino/Hispanic (n = 9; 26 %), and White (n = 11; 32 %) participants. We solicited attributions about 19 mental health disorders, each representing major sub-categories of the DSM-IV. Using a grounded theory approach, participant responses were categorized into 12 themes: Biological, Normalization, Personal Characteristic, Personal Choice, Just World, Spiritual, Family, Social Other, Environment, Trauma, Stress, and Diagnosis. Results indicate that ethnic minorities are more likely than Whites to mention spirituality and normalization causes. Understanding ethnic minority mental health attributions is critical to promote treatment-seeking behaviors and inform culturally responsive community-based mental health services.

Beliefs and perception about mental health issues: a meta-synthesis

“…Kolstad and Gjesvik46 found that participants believed that depression is a minor mental health problem and used this normalization strategy to describe the mental illness. Normalizing and underestimating symptoms of mental issues were also revealed by Bignall et al47 and further discussed and described mental health issues in terms of trauma and stress. Similarly, other studies2,40,44 described mental health issues in the context of stress and poor coping.…”

“…Mental disorders were interpreted as a result of the wrath of God, curses, and evil spirits 51. People attributing them to spirits was found in a number of studies 41,44,47,51,52. Within a spiritual and supernatural domain, there was some distinction as these aforementioned studies attributed mental health issues to negative forces or the result of the anger of God, while other studies revealed the beliefs of people attributing mental health problems to some blessings and spiritual connection with God and getting special attention from nature 44,53…”

“…Treatment with psychotherapeutic and psychiatric medicines, and hospitalization following medical treatment, was discussed in many studies 2,47,52. However, there were some findings pointing only to psychiatric and medicinal treatment and not psychological treatment 2,15,44.…”

“…Stigma of madness was the most significant barrier to seeking mental health help 5,42,48. Lack of knowledge and awareness about mental health treatment was the second most occurring barrier 15,42,44,47,48,59. Some economic and legal and linguistic barriers were also identified 44,52.…”

“…Studies such as this provide the grounds to work on awareness-raising regarding mental health perceptions where myths are believed rather than scientific explanations. Likewise, in some other studies,41,42,44,47,51 despite the discussions of psychosocial and medical causes, spiritual phenomenon and supernatural causes are believed to be the major causes of mental health problems, and similar remedies were recommended.…”