Debating Transcultural Psychiatry

Gavin Miller writes: For six months of this year, eleven collaborators found themselves “Debating the First Principles of Transcultural Psychiatry”, both in person at Glasgow University, and online via a private forum. As Principal Investigator for this AHRC-funded Exploratory Award, I had the privilege of bringing together colleagues from many different disciplines (psychiatry, clinical psychology, history, medical humanities, geography, …), and encouraging them to collectively generate, and think about, fundamental questions for transcultural psychiatry, the part of psychiatry that deals with cultural factors in the cause, diagnosis and treatment of mental illness.

Part of the enjoyment of a project like this is the encounter with different disciplines, and the sense of mutual relevance that develops. Academic and professional life, at least as traditionally conceived, channel our interests and abilities narrowly. For my part, it was a pleasure to be allowed to think about what was unfamiliar to me: global mental health, cultural anthropology, human geography, … .

There was also the challenge of doing things differently. I think few of us had experience in using an online forum as a location for discussion, so there was pleasure of learning as you go along – not without its risks of course, but a change from the same old thing. In the end the forum contained over 20 000 words of discussion.

What did we find out about transcultural psychiatry? Well, our “outcomes” were – to my mind anyway – essentially Socratic: “we knew that we knew nothing”. That is: we had the wisdom to recognize how little is really understood about this complicated assembly of ideas and practices that somehow weaves through psychiatry, psychology, anthropology, post-colonialism, theology and religious studies, and a few more domains beside.

What we came up with were questions, questions, questions. How does what’s one day taken to be mental illness “flip over” into a source of collective identity, demanding recognition and even celebration (like voice hearing)? Is the well-intentioned idea of “upscaling” mental health services in poorer parts of the world merely going to trample over diverse cultures of suffering – a bit like our Western assault on ecodiversity? Is “religion” or “spirituality” just one kind of cultural difference, or does it have some kind of autonomy of its own? What should a transculturally aware clinician actually do with all this book learning about cultural difference?

If you’re interested in these questions, and more like them, our results are easy to find. Everything is downloadable from the Results Page on the project website. That’s an 8 500 word summary of the forum debates, eight shorter position papers, and four related podcasts. Use the Reply function if you’d like to post a comment – we want to hear your views.

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