CULTURE AND CHILDHOOD MENTAL HEALTH

Culture and Childhood Mental Health

The Role Of Culture In Childhood Mental Health

Introduction

As the 21st century unfolds, substantial percentages of young people experience significant developmental, emotional, and behavioral problems; engage in multiple high-risk behaviors; and lack the environmental support and resources fundamental for optimal health and well-being. Despite the general prosperity of the last half of the 20th century, the percentage of children living in poverty has almost doubled, rising from 15 to 28 percent (Bianchi & Caspar, 2000), with 1 in 10 of these children likely experiencing homelessness. The increasing economic and societal pressures and uncertainties about the future place children and their families at greater risk for the development of mental health problems. Between 17 and 22 percent, or 14 million of our nation's youth, suffer from some type of mental health disorder during the course of a year; 75 to 80 percent of these children fail to receive appropriate services (U.S. Public Health Service, 2000). This paper discusses critically considers the role of culture in childhood mental health.

Discussion

These numbers underestimate the scope of the problem. They do not include a substantial number of children and adolescents who remain below the diagnostic thresholds for severity, number, or duration of symptoms but still experience adverse outcomes (increased substance abuse, school and work failure, criminal activity, teenage pregnancies, and suicide) that warrant intervention (Tolan & Dodge, 2005). A significant proportion of children do not grow out of their childhood difficulties. This failure to adjust to earlier developmental challenges may have a lasting impact on later family, occupational, and social adjustment. About 50 percent of all mental disorders in adults have an onset prior to age 14 (Kessler, Berglund, Demler, Jin, & Walters, 2005). This continuity of dysfunction across the life span heightens the necessity of early intervention, not only to reduce personal suffering but also to prevent or attenuate the direct and indirect long-term costs to society of not providing appropriate services.

Despite the high need for mental health services, families experience multiple barriers associated with participating in treatment. Among families who begin treatment, 40 to 60 percent terminate prematurely (Kazdin, Holland, & Crowley, 1997) due to factors such as socioeconomic disadvantage, minority group status, family dysfunction, difficult living circumstances, perceptions that treatment is not relevant, and a poor relationship of the parent with the therapist. Treatment success will depend, in part, on the congruence between the therapeutic interventions and the sociocultural milieu in which they are implemented (Mash, 2006). In light of the family's central importance as a social unit and transmitter of sociocultural values, an essential step in reducing barriers to treatment and meeting the mental health needs of our youth is to better understand what constitutes “family” in the 21st century. There is, however, no single immutable definition of “family.”

Each child is a member of an immediate family that itself reflects a unique configuration of structure and relationships. The family, in turn, is embedded in its own cultural and social ...