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Culture, Stress and Recovery from Schizophrenia: Lessons from the Field for Global Mental Health

  • Cultural Case Study
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Abstract

This cultural case study investigates one U.S. psychosocial rehabilitation organization’s (Horizons) attempt to implement the recovery philosophy of the U.S. Recovery Movement and offers lessons from this local attempt that may inform global mental health care reform. Horizons’ “recovery-oriented” initiatives unwittingly mobilized stressful North American discourses of valued citizenship. At times, efforts to “empower” people diagnosed with schizophrenia to become esteemed self-made citizens generated more stressful sociocultural conditions for people whose daily lives were typically remarkably stressful. A recovery-oriented mental health system must account for people diagnosed with schizophrenia’s sensitivity to stress and offer consumers contextually relevant coping mechanisms. Any attempt to export U.S. mental health care practices to the rest of the world must acknowledge that (1) sociocultural conditions affect schizophrenia outcomes; (2) schizophrenia outcomes are already better in the developing world than in the United States; and (3) much of what leads to “better” outcomes in the developing world may rely on the availability of locally relevant techniques to address stress.

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Notes

  1. There were two kinds of Social Security benefits available to members, based on their work history: Supplemental Security Income (SSI) and Social Security Disability Income (SSDI). If a member had a psychiatric disability and had not worked full-time for 10 years or more, he or she qualified for SSI. SSI offered a “wage” of $3.19 less per hour than minimum wage and stranded recipients below the national poverty level for 2009.

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Acknowledgments

This publication was made possible, in part, by Grant 5-T32-AT000052 from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health. Its contents are solely the responsibility of the author and do not necessarily represent the official views of the NCCAM. The author would like to thank Tanya Luhrmann and Kim Hopper for their comments on early drafts.

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    Neely Laurenzo Myers

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Myers, N.L. Culture, Stress and Recovery from Schizophrenia: Lessons from the Field for Global Mental Health. Cult Med Psychiatry 34, 500–528 (2010). https://doi.org/10.1007/s11013-010-9186-7

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