Beyond patient culture: filtering cultural presentations of depression through structural terms

Abstract

There is growing global consensus for researchers to look beyond patient culture to gain a more nuanced understanding of the ways in which wider socio-structural forces influence health outcomes. In line with these critiques, this paper examines culturally diverse patients’ views about the symptoms, aetiology, and experiences of their depression, and considers how socio-structural forces are implicated in the illness experience. Analysing the transcripts of interviews with 28 Indian-Australians and 30 Anglo-Australians with depression, our results reveal cultural differences between Indian- and Anglo-Australians regarding the chronicity, perceived severity, and aetiology of their depression. Our results also show how these cultural differences are related to socio-structural forces such as time, money, and migration. We conclude by arguing that the current medicalised approach to treating depression needs to shift to a more empathetic problem-solving one; such a change would prompt greater critical consideration of the socio-structural forces that impact people’s mental health and not just focus on individuals’ culture and pathologies.

Keywords:

• Australia
• culture
• depression
• distress
• poverty
• structure

Acknowledgements

The authors acknowledge the support of the funding bodies that facilitated this study: Bianca Brijnath was supported by a fellowship from the Australian National Health and Medical Research Council [NHMRC No. GNT1036154]; Josefine Antoniades was funded to undertake this research by an Australian Postgraduate Award. We thank Ms. Nabita Singh for her assistance with the recruitment of some of the Indian-Australian participants and Dr Sara Cooper for her incisive critical commentary, which resulted in substantial improvements to the paper. Bianca Brijnath and Josefine Antoniades declare no conflict of interest, financial or otherwise.