Ethnicity and Mental Health: A Cultural History of Interrelatedness Prof. dr. Darja Zaviršek University of Ljubljana Jerusalem, GAMIAN EUROPE

Culture, ethnicity and mental crises were never defined in simple neutral definitions, but were always loaded and depended from particular temporary political and social contexts and values across different countries.

Historical relatedness of ethnicity and mental health: pathologisation of ethnic minorities with the use of medical/psychiatric diagnosis; pathologisation of ethnic minorities with the use of medical/psychiatric diagnosis; political impact on the lack of ethnically competent mental health services; political impact on the lack of ethnically competent mental health services; professional limitations for resource- oriented and empowering mental health services for people of ethnic groups. professional limitations for resource- oriented and empowering mental health services for people of ethnic groups.

Pathologosation is a process when ethnic/cultural characteristics of a person/a group are seen as natural, inborn marks of a person/a group, and are described in medical terms which help to construct ethnic minorities as being prone to specific bodily and mental illnesses, pathological violence, and lesser intelligence which supposedly cause their mental inferiority. Pathologosation is a process when ethnic/cultural characteristics of a person/a group are seen as natural, inborn marks of a person/a group, and are described in medical terms which help to construct ethnic minorities as being prone to specific bodily and mental illnesses, pathological violence, and lesser intelligence which supposedly cause their mental inferiority.

Pathologisation of ethnicity Pathologisation of ethnicity

“Professional” pathologisation of ethnicity during Nacism: social workers registering the “un- healthy” Roma in Germany in the late 1930ies.

Mental health diagnosis are often a special medicalised form of social exclusion of ethnic minorities which has been well-known since the 19th Century. Mental health diagnosis are often a special medicalised form of social exclusion of ethnic minorities which has been well-known since the 19th Century.

Having ethnicity sometimes meant not having a culture. This is today still often believed by ordinary people, psychiatrists, social workers or other health workers.

Ethnicity has been externalized as relevant only to the other. “They” not “We” have ethnicity.

Roma community “Strojan Family” from Slovenia expelled from their settlement in Spring Roma community “Strojan Family” from Slovenia expelled from their settlement in Spring 2007.

A child from “Stojan family” living under a tent in Roma children in Slovenia and across eastern Europe are 10-times more often than the majority children labeled as mentally disabled and send to special schools.

In Eastern Europe like in many western countries: Ethnic minorities have less access to general mental health services, or they have no access and any proper treatment at all. Ethnic minorities have less access to general mental health services, or they have no access and any proper treatment at all.

Inter-cultural /trans-cultural competencies can be defined as the ability to communicate appropriately and successfully with persons: whose first language is different from the language of the country in which they live and/or; whose first language is different from the language of the country in which they live and/or; who have grown up with a different culture and/or; who have grown up with a different culture and/or; whose social mobility differs from that of members of the majority group on account of discrimination (Schultz 2007). whose social mobility differs from that of members of the majority group on account of discrimination (Schultz 2007). In addition to that it means avoiding any kind of Othering.

Focus of the transcultural psychiatry in different countires: language; language; acceptance of cultural diversity and a cultural and self-reflective perspective; acceptance of cultural diversity and a cultural and self-reflective perspective; understanding and addressing the consequences of traumatic life events before emigration and post-immigration stress in the host country; understanding and addressing the consequences of traumatic life events before emigration and post-immigration stress in the host country; hearing the voices of immigrants and minorities. hearing the voices of immigrants and minorities.

Ethnic minorities are less likely to receive needed mental health services and often receive poorer quality of treatment than the dominant society, even when access exists. Ethnic minorities are less likely to receive needed mental health services and often receive poorer quality of treatment than the dominant society, even when access exists.

Professionals see ethnic minorities as having more problems than the majority population, as being needy, as being dependant and as being less capable of solving the everyday difficulties: “… the stranger is always thought to be very much in need of help, even though this person has many abilities” (Dagmar Shultz 2007). Professionals see ethnic minorities as having more problems than the majority population, as being needy, as being dependant and as being less capable of solving the everyday difficulties: “… the stranger is always thought to be very much in need of help, even though this person has many abilities” (Dagmar Shultz 2007).

Strenghts perspective, resilience and resource-oriented professional practice can: encourage self-confidence and the healing motivation of the patient; encourage self-confidence and the healing motivation of the patient; positively influence the attitude of the personnel toward patients; positively influence the attitude of the personnel toward patients; challenges the personnels’ self- reflection of prejudice and stereotypical views. challenges the personnels’ self- reflection of prejudice and stereotypical views.

In Eastern Europe there is an urge for: training professional staff in trans-cultural and anti-racist practice; training professional staff in trans-cultural and anti-racist practice; cultural consultancy based on a multicultural multidisciplinary team; cultural consultancy based on a multicultural multidisciplinary team; services-led by professionals from similar ethnic backgrounds to those of clients to help people from a variety of cultural backgrounds; services-led by professionals from similar ethnic backgrounds to those of clients to help people from a variety of cultural backgrounds; advocacy to help mental health clients to deal with statutory services; advocacy to help mental health clients to deal with statutory services; guidance to clients on strategies to deal with everyday racism; guidance to clients on strategies to deal with everyday racism; incorporating resource-oriented/resilience perspective into therapy and using inter-cultural competencies in therapy; incorporating resource-oriented/resilience perspective into therapy and using inter-cultural competencies in therapy; linking psychological support to housing, economic independen ce, social integration, community development. linking psychological support to housing, economic independen ce, social integration, community development.