The global objectives of our research team are to study the impact of culture and ethnicity on mental health and illness. The team is conducting ethnographic and epidemiological studies in community, primary care and psychiatric settings to address three questions: (1) how the experience and expression of distress are shaped by cultural systems of meaning; (2) how cultural 'idioms of distress' (codes for expressing and communicating meanings) affect help-seeking behavior; and (3) how these idioms of distress affect the outcome of clinical encounters, including clinicians' diagnoses and choice of treatment modalities.
We focus on the most common mental disorders in the community and in primary care: depression, anxiety, somatoform, dissociative and trauma-related disorders (post-traumatic stress disorder) as well as psychoses. Our specific objectives are:
- to combine epidemiological and ethnographic research methods to produce more accurate and valid information on the mental health status of specific First Nations and ethnocultural communities;
- to identify the influence of culture and social factors on the pathways and barriers to care of individuals with psychiatric disorders (especially depression, anxiety and somatization);
- to examine the relationship between cultural models of illness and healing and (A) patterns of symptom expression, help-seeking and health care utilization; (B) variations in the resolution of common mental disorders and social problems; (C) variations in diagnosis and treatment by physicians;
- to examine the relationship between migration, refugee status, patterns of acculturation and (A) the prevalence and symptomatic expression of somatization, depression and anxiety, and (B) help-seeking and health care utilization;
- to examine the impact of culture and community structure on the course of psychiatric disorders including both acute and chronic disorders;
- to develop and critically examine community, institutional and practitioner models of culturally appropriate mental health care;
- to understand the conceptual, historical, and social structural underpinnings of professional knowledge and practice in psychiatry, particularly with regard to somatization, depression, dissociation and trauma-related disorders.