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When one throws the element of ethnicity into the mix, the process of diagnosis becomes even more difficult. Let us take, for instance the effect of religion on the diagnosis of a mental illness.
In some religions it is considered to be "normal" to experience visions, see ghosts, and talk to the dead. However, from a strict clinical standpoint, these things do not exist and therefore indicate a break from reality. There have certainly been people diagnosed with a serious mental illness for "hallucinating." However, it is much more difficult to determine when to label such a happening a "hallucination" or a "vision." For the person being diagnosed, the experience does not change. However, the label that is applied to the experience can mean the difference between the accepted norm and mental illness (Griffiths et al., 2006, 2).
There are differences in reactions to clinicians that are culturally based as well. For instance, in Asian cultures it is considered to be a lack of respect to disagree with a physician regarding certain symptoms or a diagnosis. Certain Middle Eastern and Asian cultures permit a certain degree of physical punishment in order to keep wives and children in line. The use of opium holds fewer societal consequences and is considered to be socially acceptable in countries such as Turkey and Pakistan. There are many more examples throughout the world where normal behavior in one culture is socially unacceptable in another.
This study focused on various factors that effect the decision to diagnose and label a person as mentally ill. As a health care professional one must be continually aware of the effects that our decisions have on the patient and the patient's family. Once the diagnosis of a mental illness is made and the person has that label, it will have an effect on them for the rest of their lives. They will always have that on their record, even after they have been successfully treated and have recovered there will still be some form of record that will have an impact on their lives. For example, employers and insurance carriers might access this information and use it as a part of their decision to employ or insure that person. Although being diagnosed with a mental illness no longer carries the stigma that it once did, there is still the feeling that a person that is diagnosed with a mental illness will be less reliable on the job than someone that has not been diagnosed with a mental illness.
As health care professionals, we must remain aware of how our own cultural biases might effect the decisions that we make on a daily basis. It is easy to say that one will make an impartial decision that is not based on biases, but this is an unrealistic expectation for anyone. We are a product of the society in which we live, our parent's upbringing and opinion, as well as recipients of the mass media and its exploitation of the mentally ill. Exposure to all of these elements, in addition to our base personality, help to shape us into the person that we are both professionally and personally. It is normal human nature to make judgments about the people and places that we encounter in our daily routines. However, one must be careful not to let personal opinions substitute for knowledge.
In consideration of all of these elements, the final analysis is that a health care professional must remember that their key role is to intervene in a manner that is in the best interest of the patient. Educating oneself about various cultures and viewpoints plays a critical role in the ability to distinguish cultural differences from real mental illness (Clark, 2007, 227). The key criteria that should be used in making a diagnosis of mental illness is that the condition must impact the life of the individual in a way that reduces their enjoyment of life, or ability to carry out the tasks that they wish to achieve. These factors are considered in DSM IV criteria and should be used as a guide in making the decision to label or not to label a person with mental illness. If one sticks to the criteria, and then considers the impact of their decision on the patient and the rest of the family, then they will be certain to take the correct action.
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