Psychiatry and social values: the American Psychiatric Association and immigration restriction, 1880-1930

Editorial: Steps towards the Renovation of Acculturation Research Paradigms: What Scientists’ Personal Experiences of Migration Might Tell Science

Acculturation refers to cultural learning and adjustment in the context of continuous cross-cultural experience. Plato, in his ‘Laws’, considered cross-cultural imitation to be a risk arising from foreign commerce. In the 19th century, European theorists wrote of the amalgamation processes by which diverse peoples were culturally unified for the purposes of the nation-state. In the 20th century, acculturation research first focused on the cultural changes of conquered and dispossessed native peoples, and later on the cultural adaptation, assimilation, or integration of immigrants and other minorities. Native peoples and immigrants were stereotyped as genetically and culturally inferior and prone to diseases and mental illness. Thus, in most research, improved health became the criterion of successful acculturation, and further confusion came from the good intentions to advise public policy. A century of such research has come to no confident conclusions and has produced little useful information. Acculturation research paradigms need renovation. As one step forward, four acculturation researchers have here reflected on their own research in the light of their own acculturation experiences. Their self-observations and insights point to new questions and constructs, and eventually to new research paradigms.

Should "acculturation" be a variable in health research? A critical review of research on US Hispanics

Acculturation has become a popular variable in research on health disparities among certain ethnic minorities, in the absence of serious reflection about its central concepts and assumptions. Key constructs such as what constitutes a culture, which traits pertain to the ethnic versus "mainstream" culture, and what cultural adaptation entails have not been carefully defined. Using examples from a systematic review of recent articles, this paper critically reviews the development and application of the concept of acculturation in US health research on Hispanics. Multiple misconceptions and errors in the central assumptions underlying the concept of acculturation are examined, and it is concluded that acculturation as a variable in health research may be based more on ethnic stereotyping than on objective representations of cultural difference.

Psychiatric morbidity among housemaids in Kuwait. III: Vulnerability factors

BACKGROUND

Housemaids are a relatively homogenous immigrant subgroup in terms of their gender; ethnic origin; and socio-cultural, educational and occupational background. Psychiatric morbidity among housemaids is two to five times higher than the native female population.

AIMS

To determine the possible pre-immigration risk factors for prospective psychiatric breakdown among the housemaids.

METHODS

The sample consisted of all the housemaids (N = 197) hospitalised during the two-year study period. The controls comprised all the newly arrived housemaids (N = 502). The measures obtained included demographic characteristics and previous history of physical illness, psychiatric illness, hospitalisation and family history of psychiatric disorder.

RESULTS

More than a quarter of the hospitalised group broke down within one month of their arrival. The hospitalised group had a significant excess of Sri Lankan housemaids; non-Muslims; those with less than four years of education and those with a previous history of physical illness, psychiatric illness or hospitalisation.

CONCLUSIONS

A number of potential risk factors results in premature repatriation of housemaids on mental health grounds. Preventive measures involving recruitment procedures and pre-departure orientation courses are needed to minimise the expatriate failure among the housemaids.

Increasing access and building equity into mental health services: an examination of the potential for change

This article explores the use of mental health care services by ethnoracial people in Canada and distinguishes between the reasons for underutilization of services by ethnoracial groups and the barriers which prevent ethnoracial groups from accessing services. Research focusing on Canadian race relations is reviewed to reveal how they are paralleled in the functioning of mainstream mental health care organizations. Existing policies and attitudes are then considered in relation to how they support or impede interventions to increase accessibility to services. Finally, frameworks for organizational change based on multiculturalism and anti-racism are presented, and the advantages and disadvantages of both are articulated.