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Cultural variations in the experience and diagnosis of mental health issues

Article outlining cultural differences in attitudes to mental health issues and the danger of cultural bias in diagnosis.
© Coventry University. CC BY-NC 4.0

One of the reasons that definitions of abnormality differ significantly from culture to culture is that there are differences in the way people experience mental disorders.

Some key cultural variations

According to research, mental health issues may not be diagnosed and experienced in the same way among different cultures, for example:

  • Non-western cultures, for instance, do not necessarily conceive of internal emotional experiences as separate from bodily experiences and may focus more on physical ailments than psychological distress (McLeod 2018). Thus, a person who has grown up in a Chinese cultural environment may complain of a stomach-ache rather than depression.
  • Some groups and sub-cultures value showing their emotions, whereas others emphasise being more restrained
  • Some cultures emphasise the religious or spiritual aspects of a mental health issue. For example, a person from an Afro-Caribbean cultural background might seek a religious solution to a psychological problem (Introductory Psychology 2007).
  • Some cultures treat religiously induced trance-like states as acceptable spiritual experiences, while others may see the same behaviour as a symptom of a mental health issue
  • One main barrier to seeking help is when asking for help from a mental health practitioner may be seen as a sign of weakness. Some cultures, consider that problems should be dealt with in the family and it would be disrespectful to discuss personal and family problems with a stranger.
  • Many cultures have a much more fluid view of the self and of reality. For example, a native American who hears the voice of a recently deceased relative calling from the afterworld would view this as a perfectly normal experience, whereas a European person may see this as a hallucination.

Cultural bias in diagnosis

When attempting to define and classify abnormality, cultural biases exist.

For instance, Puerto Ricans have a distinctive way of responding to stressful situations which includes symptoms such as heart palpitations, faintness and seizure-like episodes. These were often misdiagnosed as signs of severe mental disturbance owing to a lack of knowledge of the culture (Guaraccia et al. 1990).

Additionally, in the UK there are substantial differences in the frequency of mental disorders between different ethnic or cultural groups. There is an over representation of black (African-Caribbean) immigrants amongst those diagnosed with schizophrenia. The risk may be even greater with people from the second generation (McLeod 2018).

In Britain and the USA, black males are more likely to be treated as criminals and sent to prison rather than be diagnosed as mentally ill. If they show symptoms of alcohol and drug abuse, they are more likely to be diagnosed as psychotic, as are white males (Introductory Psychology 2007).

Cultural differences must not be confused with effects that are due to poverty or poor education.


Davey, G.C. (2017) Psychopathology. 2nd edn. Chichester: Wiley

Guarnaccia, J.P., Good, B.J., and Kleinman, A. (1990) ‘A Critical Review of Epidemiological Studies of Puerto Rican Mental Health’. The American Journal of Psychiatry 147 (11)

Introductory Psychology (2007) ‘Defining Abnormality’ [Online] available from [20th November 2018]

McLeod, S. (2018) ‘Abnormal Psychology’ Simply Psychology [online]. available from [19th November 2018]

© Coventry University. CC BY-NC 4.0
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