GLOBALIZATION AND MENTAL HEALTH

Difficult to Assess Impact

Mental Illness Is a Global Health Burden

    12% = 15-44 Year Olds in Developing Nations
    8% of Lost Years of Quality Life

Likely Causes
    
    Economic Inequalities
    Changing Individual and Collective Identities
    Urbanization > Rootlessness > Anxiety + Depression

        Breakdown of the Family
        Overcrowding/Inadequate Housing
        Domestic and Neighborhood Violence
        Poverty and Lack of Opportunity

Depression

    Culture Mediates Experience and Expression

        Psychological/Emotional vs. Physical/Somatic

    Cause of Death Worldwide
        
        5th among Women
        12th among Men
    
    Predictions
        
        2010 = 2nd Cause of Death Following Heart Disease
        Leading Disease Burden in Developing World

Cross-cultural Data
        
    Confounds    

        Awareness/Stigma
        Role of Physician
        Pathways to Care
        
    WHO Study of Depression

        14 countries
        26,000 adults
        
    Cross-national Collaborative Group - Depression
            
        Comorbidity

            Substance Misuse
            Anxiety Disorders (e.g., OCD, panic)

    Community Surveys of Mental Illness
        
        Mumbai (India) Slum Dwellers – 25%
        Rio de Janeiro (Brazil) Slum Dwellers – 46%
        Santiago (Chile) Slum Dwellers – 45%
        
Depression and Somatization

    Common Presenting Symptom – 69%
    
    Western Dualism Differentiates Symptoms
    
    Traditional Cultures: Mental and Physical Unity
    
        Experience vs. Expression
        Metaphorical Speech
        “Depression” Absent from Many Languages

A Note on Suicide

    Rates in Industrial vs. Developing Societies

        Between- and Within-Group Variability

    Social and Cultural Sources of Stress
    
    Protective Cultural Factors

DISCUSSION:

➢    If globalization is responsible for cultural and personal dislocation, is it also responsible for the consequences of such dislocation, such as depression and substitute forms of integration (e.g., addiction, gangs)?

➢    Is addiction criminal, medical, and/or sociopolitical?  Based on your view, how should the "War on Drugs" be waged?