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Culture and Mental Health. A Comprehensive Textbook. Edited by Kamaldeep Bhui & Dinesh Bhugra. Hodder Arnold. 2007. 376pp. £99.00 (hb). ISBN 9780340810460

Published online by Cambridge University Press:  02 January 2018

Oye Gureje*
Affiliation:
University College Hospital, Ibadan, PMB 5116, Nigeria. Email: [email protected]
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Abstract

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Copyright © Royal College of Psychiatrists, 2008 

All of medicine and medical conditions have to be considered within the context of culture: the culture in which patients and their families live; the culture that has produced the healthcare providers; and the culture in which the doctor–patient encounter is negotiated. From a consideration of lifestyles, sociocultural values and ideas of health, to acceptance of and adherence to medical interventions, both physical and mental health issues are intricately tied to the culture in which health or ill-health is experienced. However, culture has a particular salience for mental health not least because of the fact that many mental disorders are still defined relative to an implicit or explicit cultural norm.

Given its importance to mental health, it is surprising that the traditional way of considering culture often does not go beyond a discourse on ‘culture-bound syndromes’ or on ‘masked’ depression or ‘somatisation’. Typically, an insufficient focus on the various contextual factors that may produce differences in the experience and expression of psychological distress leads to the hood being taken for the monk: differences that have their origin in poverty or in the ways health systems are organised are ascribed to the broader culture in which patients live.

This book represents a departure from that beaten track. A textbook on culture and mental health that has chapters on epidemiological method and mental health law is truly unique. This book is not about the reification of ‘culture-bound’ syndromes nor is it constrained by a narrow definition of culture. Rather, it presents evidence, much of it from legitimate cultural representatives, for why the experience of psychiatric syndromes and the treatment for such have to be considered within the context of the culture of the patients experiencing such syndromes.

The result is an impressive opus that lives up to its promise of being comprehensive. The first part of the book has chapters dealing with basic sciences and provides a much-needed grounding for readers who want to be able to critically review what they read in the literature regarding, for example, cross-cultural studies. The second part has chapters, of varying lengths and details, dealing with cultural aspects of mental health in various regions of the world. However, the section flips between nations (Russia, South Africa, etc.) and regions (West Africa, South Asia, etc.), thus, perhaps, losing some consistency of organisation. That notwithstanding, this part of the book is a treasure trove, drawing on local experiences and sensitive analysis of the ways in which culture, in the broadest sense, shapes the experience of mental disorders and the delivery of services to those affected. An informed discussion of culture in the context of mental health must avoid inflation of differences as much at their deflation. This book strikes the right balance and deserves wide readership among practitioners and trainees.

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