ETHNICITY AND MENTAL ILLNESS

ETHNICITY AND M.I.

• 1. RATES

• 2. EXPRESSIONS

• 3. RESPONSES

FAMILY SUPPORT

• MANY ETHNIC GROUPS, ESPECIALLY NEW IMMIGRANTS

• GREATER SENSE OF FAMILY OBLIGATION

• LESS ADEQUATE PROFESSIONAL TREATMENT

SUMMARY

• MUCH CROSS-CULTURAL VARIATION FOR MOST M.I.

• FEW CONCLUSIONS FOR RATES IN US

• ETHNIC CULTURES AFFECT WAY PEOPLE EXPRESS DISORDERS

• ETHNIC CULTURES AFFECT DEFINITIONS, FAMILY RESPONSE, AND PROFESSIONAL HELP-SEEKING

IMPLICATIONS

• PROFESSIONALS SHOULD BE CULTURALLY SENSITIVE

• ETHNIC-SENSITIVE PROGRAMS TEND TO WORK BETTER

• PARTICULARLY IMPORTANT NOW WITH HIGH RATES OF IMMIGRATION

RECENT CHANGES

• MAJOR TOPIC OVER LAST 15 YEARS

• VAST CHANGE IN SOCIAL ROLES

• 2/3 OF MARRIED WOMEN WORK

• 60% OF WOMEN WITH SMALL CHILDREN WORK (19% IN 1960)

• 7% OF TOTAL HOUSEHOLDS HAVE WORKING FATHER AND HOUSEWIVE

QUESTIONS

• HOW ARE THESE SOCIAL CHANGES RELATED TO MENTAL HEALTH?

• DO WOMEN OR MEN HAVE MORE MENTAL ILLNESS?

• DO MEN AND WOMEN HAVE DIFFERENT TYPES OF M.I.?

• HOW IS GENDER RELATED TO THE TREATMENT OF MENTAL ILLNESS?

GENDER

• BOTH BIOLOGY AND PSYCHOLOGY FOCUS ON GENDER AS CONSTANT PROPERTY OF INDIVIDUALS

• BIOLOGY - PHYSIOLOGY, HORMONES, REPRODUCTION, ETC.

• PSYCHOLOGY - DIFFERENCES IN PSYCHOLOGICAL ORIENTATIONS

SOCIOLOGICAL

• DISTRESS ARISES OUT OF ROLES NOT PSYCHOLOGY OR BIOLOGY

• POWER, RESOURCES, AUTONOMY ASSOCIATED WITH MALE ROLES

• OPPOSITE WITH FEMALE ROLES

SOCIAL ROLES

• WOMEN IN TRADITIONALLY MALE ROLES HAVE LESS DISTRESS

• MEN IN TRADITIONALLY FEMALE ROLES HAVE MORE DISTRESS

• MEN AND WOMEN IN SAME ROLES WILL HAVE SAME DISTRESS

CULTURAL EXPECTATIONS

• NOT JUST ROLES BUT EXPECTATIONS OF MEN AND WOMEN IN ROLES

• E.G. JOBS, CHORES, CAREGIVING• UNEMPLOYED MAN VS. HOUSEWIFE• POWERFUL MAN VS. WOMAN• DISTRESS FROM COMBINATION OF

ROLES + EXPECTATIONS

SOCIAL ROLES (GOVE)

• RATES OF M.I. HISTORICALLY SPECIFIC NOT UNIVERSAL - CHANGE OVER TIME AS ROLES CHANGE

• BEFORE WWII - WOMEN’S ROLES VALUED

• RELATIVELY EQUAL RATES OF M.I.

• AFTER WWII - HOUSEWIVE ROLE

AFTER WWII

• WOMEN’S ROLES MORE STRESSFUL THAN MEN’S

• HOUSEWIVE ROLE IS FRUSTRATING, UNDEMANDING, UNREWARDED

• WORKING WOMEN FACE ROLE OVERLOAD AND DISCRIMINATION

• UNCLEAR EXPECTATIONS

PREDICTIONS

• MARRIED WOMEN HAVE MORE DISTRESS THAN MARRIED MEN

• SINGLE MEN AND WOMEN EQUAL

MARRIAGE AND DISTRESS

0

5

10

15

20

25

30

35

SM

SW

MM

MW

• SINGLE MEN AND WOMEN EQUAL

• MARRIED MEN < MARRIED WOMEN

• IMPORTANCE OF ROLES

DISTRESS, WORK AND MARRIAGE

0

5

1015

20

25

3035

40

45

50

WW NWW WM NWM

• HOUSEWIVES > DISTRESS THAN WORKING WOMEN

• WORKING WOMEN > WORKING MEN

• ROLE OVERLOAD• UNEMPLOYED

MEN WORST

ROLES ARE IMPORTANT

• SAME ROLES, SAME DISTRESS - E.G. SINGLE PEOPLE

• MALE ROLES HAVE LESS DISTRESS - EMPLOYMENT, RESOURCES, LESS OVERLOAD

• FEMALE ROLES HAVE MORE DISTRESS - NO JOBS, LOWER EARNINGS, MORE OVERLOAD

CHANGES OVER TIME

• 1960’S - HUSBANDS WITH WORKING WIVES HAVE MORE DISTRESS

• NO LONGER TRUE

• 1990’S - HUSBANDS WITH WIVES EARNING MORE THAN THEY DO HAVE MORE DISTRESS (NOW TRUE IN 1/3 OF FAMILIES)

CHANGES OVER TIME

0

5

10

15

20

25

1950

-70

1980

-90

MENWOMEN

• RATES GOING UP• WOMEN > MEN• DIFFERENCES

SMALLER NOW• BECAUSE MEN

RISING MORE RAPIDLY

LIMITS OF SOCIAL ROLE THEORY

• VERY OVERSIMPLIFIED

• HARD TO EXPLAIN MEN’S DISTRESS

• STUDIES BIASED BECAUSE ONLY USE FEMALE TYPES OF MENTAL ILLNESS – USUALLY DISTRESS/DEPRESSION