'This house believes that the concept of culture has outlived its usefulness for psychiatry'

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Consider this description:

"The connections between culture and mental health are as varied as they are profound. Culture affects the expression, experience, interpretation, course, and outcome of the various mental disorders. Further, culture modulates individual resilience, coping mechanisms and social response which are crucial for recovery from mental health problems. In addition, mental health practice in terms of assessment and diagnosis frequently involves the meeting of at least two cultural worlds−the clinician's and the patient's−and negotiating this encounter is essential to good clinical practice and accurate diagnosis." (Rashed, du Plessis, & van Staden 2016: 487)

In recent times, this view of the connections between culture and mental health has become accepted in psychiatry. Starting in the DSM-IV and, more explicitly, in the DMS-5, attempts have been made to include culture as an important element in diagnosis and treatment. The DSM-5, for example, has a section on cultural formulation and cultural concepts of distress. This state of affairs was the outcome of decades' worth of research in medical anthropology, and is considered a hard-won achievement.

The benefits of attending to culture are well known, and summarised in the quote above. The problems of using the concept of culture include the following:

• The proliferation of other markers of identity and difference which in some cases are more important such as gender, political and sexual orientation.
• Culture tends to become an add-on to bio-psychological models rather than a central aspect of pathogenesis
• Its inclusion in diagnosis and practice promotes the view that culture is always elsewhere, and not equally part of modern diagnostic models and scientific understandings of mental distress.
• Difficulties defining culture: either understood as ethnic or religious group (and hence reifying and exclusive) or understood as symbols and meanings (and hence dissolves into language).