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Introduction “Culture comprises of shared beliefs values, and practices that guide a group’s members in patterned ways of thinking and acting. Culture can also be viewed as a blueprint for guiding actions that impact care, health, and well-being” (Leininger & McFarland, 2006). “Culture is more than ethnicity and social norms; it includes religious, geographic, socio-economic, occupational, ability-or disability-related, and sexual orientation-related beliefs and behaviors. Each group has cultural beliefs, values, and practices that guide its members in ways of thinking and acting.

Cultural norms help members of the group make sense of the world around them and make decisions about appropriate ways to relate and behave. Because cultural norms prescribe what is “normal” and ‘abnormal,” culture helps develop concepts of mental health and illness” (Varcarolis & Halter, 2010). Discussed further will be the mental health of Filipino Americans as well as mental health information from The Philippines. Mental Health Needs “A strong belief that spirits are a cause of physical and mental illness is prevalent throughout the Western Pacific Region, including the Philippines.

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The strong influence of religion on the Filipino people has however, generated a strong and positive sense of spirituality, which is considered a source of strength in the individual. Since this spirituality is actively acknowledged and practiced in communities, it is recognized as a major coping mechanism in times of social deprivation and disadvantage, crises, political upheavals, and natural and man- Running Head: FILIPINO MENTAL HEALTH CULTURE PAPER 3 made disasters. Psychosocial intervention programs during these times often integrate a psycho-spiritual approach.

It is though that the rate of successful suicide is low because taking one’s life is considered a sin (Conde, 2004). ” Family Support “The family is the basic unit of society. It is still considered to be very important and there is active consciousness in the majority of Filipinos to preserve this despite the many social conditions that threaten its structure and the roles within it. While the nuclear family is evolving in the rapidly expanding urban areas, extended families are still prevalent.

Families are clos-knit and influenced by tradition. Major decisions are not made unless parents are consulted and have given their approval. Family support is crucial as a basis of community support in times of need” (Conde, 2004). “Mental illness is dealt with through the help of family and friends and faith in God. One’s mental affliction is identified as the family’s illness and is associated with shame and stigma. The open display of emotional affliction is discouraged in favor of social harmony.

Assistance is often sought from relatives and peers before approaching professionals. Decisions, including health care practices and preferences, advance directives, and consent for procedures and treatment, are commonly made in consultation with the family” (Sanchez & Gaw, 2007). “Some families view children with mental illness as “bringers of good luck”. Filipinos willingly interact with persons with mental illness, but they may not accept them as cohabitants or employees.

The rejection is based on the belief that persons with mental affliction are Running Head: FILIPINO MENTAL HEALTH CULTURE PAPER 4 dangerously unpredictable. Filipinos generally unconditionally sacrifice time and vocation to accept and care for their disabled family members” (Sanchez & Gaw, 2007). Access to Mental Health Care “Among Asian American ethnic groups, Filipinos have the second largest representation (behind their peers of Chinese ancestry) within the total Asian American Pacific Islander population of approximately 10 million people (U. S. Census Bureau, 2002). ”

“Although Filipino Americans are generally categorized within the aggregated “Asian American: group, Asian Americans are not a homogenous group with respect to mental health status. ” In a study comparing Asian ethnic groups and Asian-specifically Filipino Americans have been found to have one of the highest levels of depressive symptoms of all Asian ethnic groups in the United States, second only to Korean Americans. Although the need for psychiatric treatment exists, Filipino Americans were found to underutilize public outpatient mental health services (Baello & Mori, 2007).

“It would seem that Filipino Americans, perceived as the most westernized of the Asian Americans, would be more apt to adapt to the American culture. However, they remain among the most mislabeled and culturally marginalized of the Asian Americans. Increased time of residence in the United States may not necessarily reflect an increase in the adoption of American lifestyle and culture” (Sanchez & Gaw, 2007) The Philippines have a National Mental Health Policy.

There is no mental health legislation and the laws that govern the provision of mental health services are contained in Running Head: FILIPINO MENTAL HEALTH CULTURE PAPER 5 various parts of written laws such as Penal Code, Magna Carta for Disabled Person, Family Code, and the Dangerous Drug Act. The country spends about 5% of the total health budget on mental health and substantial portions of it are spent on the operation and maintenance of mental hospitals. The new social insurance scheme covers mental disorders but is limited to acute inpatient care.

Psychotropic medications are available in the mental health facilities (World Health Organization 2006). There are fifteen community residential (custodial home-care) facilities that treat 1. 09 users per 100,000 general populations. Mental hospitals treat approximately 9 patients per 100,000 general populations and the occupancy rate is 92%. The majority of patients admitted have a diagnosis of schizophrenia. All forensic beds (400) are at the national Center for mental health. Involuntary admissions and the use of restraints or seclusion are common (World Health Organization 2006).

Guidelines For Treatment A culturally sensitive approach is recommended when considering treatment of Filipinos and Filipino Americans.

These guidelines include: pay attention to immigration history and regional orientation, determine the underlying reason for treatment, ensure adequate understanding of the diagnosis and treatment plan, bearing in mind that social inhibitions and nonverbal cues can mislead the practioner, use visual cues and communicate in a collaborative manner, facilitate dialogue, inquiring about physical as well as mental health complaints, utilize the family and identify the patient’s power hierarchy, allow the patient time to process any information given, respect personal space, note mannerisms without making assumptions about Running Head:

FILIPINO MENTAL HEALTH CULTURE PAPER 6 their meaning, do not be misled by the presenting affect maintain judicious use of medications, and engage the patient by actively focusing on the individual’s symptoms (Sanchez & Gaw, 2007) Conclusion Access to mental health facilities is uneven across the country, favoring those living in or near the National Capital Region.

The national mental health policy was put into operation relatively recently. Community care for patients is present, but is limited. The poor involvement of primary health care services in mental health is also a feature shared with many low and lower middle resource countries. Psychiatrists should not hesitate to assume a medical role. Increased priority to resources and a strategically coordinated network of social services that recognizes specific sociopolitical, economic, and cultural needs have to be in place when delivering mental health services to Filipinos and Filipino Americans.

It is ideal to have such services within existing medical institutions and staffed by culturally sensitive medical, psychiatric, and social service personnel. Psychiatrists need to embrace culture as a powerful factor in understanding the Filipino-American experience. A culturally sensitive and imaginative approach to the individual should be undertaken. Running Head: FILIPINO MENTAL HEALTH CULTURE PAPER 7 References Baello, J. , & Mori, L. (2007). Asian values, adherence and psychological help-seeking attitudes of filipino-americans. Journal of Multicultural, Gender and Minority Studies, 1(1), Retrieved from http://www.

scientificjournals. org/journals2007/articles/1261. pdf (Baello & Mori, 2007) Conde, B. (2004). Philippines mental health country profile. International Review of Psychiatry, 16(1-2), 159-166. Retrieved from http://www. hawaii. edu/hivandaids/Philippines_Mental_Health_Country_Profile. pdf Leininger, M. , & McFarland, M. (2006). Cultural care diversity & universality: A worldwide nursing theory (2nd ed. ). Sudbury, MA: Jones & Bartlett (Leininger & McFarland 2006) Sanchez, F. , & Gaw, A. (2007). Mental health care of filipino americans. Psychiatric Services, 58(6), doi: 10. 1176/appi. ps. 58. 6. 810.

United States Census Bureau. (2002). The Asian Population: 2000. Retrieved from website: http://www. census. gov/prod/2002pubs/c2kbr01-16. pdf Varcarolis, E. M. , & Halter, M. J. (2010). Foundations of psychiatric mental health nursing, a clinical approach. (6 ed. ). St. Louis, Missouri: Saunders: Elsevier (Varcarolis & Halter, 2010) Department of Health, Manila, The Philippines, Department of Health, Manila, The Philippine. (2006).

Who-aims report on mental health system in the philippines. Retrieved from Wold Health Organization website: http://www. who. int/mental_health/evidence/philippines_who_aims_report. pdf

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