Culture and diversity influence many aspects of mental health. First, culture determines what is seen as "normal" and "abnormal" within a given society. Culture also affects how individuals manifest and communicate symptoms, styles of coping, family and community support and willingness to seek treatment. Likewise, the cultures of clinicians and service provision influence the nature of health system services.
We live in a culturally interconnected world. Formerly distant people now compete for the same resources as they struggle to maintain their own cultures or fit into new ones. Dramatically different languages, religions and cultures coexist in a single country, or even single communities. Dislocation from native communities, rejection by the host community and difficulties in adapting to the cultural norms of the host society are intensely stressful, and can contribute to mental illness in those who are vulnerable.
How can we overcome the barriers of cultural difference? We need to use approaches that incorporate cultural backgrounds and beliefs, address language barriers, and create culturally sensitive forms of dialogue. We need to incorporate cultural sensitivity in training, social policy and service provision.
There are enormous challenges to developing culturally competent mental health care services. Resources for mental health are scarce; the treatment gap -- the proportion of those who need but do not receive care -- is more than 60 per cent. The rate of mental disorders and the need for care is highest among disadvantaged people -- yet these are precisely the groups with the lowest access to appropriate services. At the same time, fear of stigma leads many to avoid seeking care. The consequences are enormous in terms of disability, human suffering, and economic loss.
We have a pressing obligation to scale up care and services for mental disorders, especially among the disadvantaged, while stepping up efforts to protect the human rights of those affected. We must mobilize political will and solidarity in the entire global health community. On this World Mental Health Day, let us rededicate ourselves to this mission.