Mental health social work in the Eastern context

Abstract

Mental health social work (MHSW) puts great emphasis on contextual factors. In parallel, contextual factors have shaped MHSW practice in different populations. Key underpinning factors include differences in illness behaviour and family structure. Mind/body connection and somatization are universal phenomena. However, due to a collective-oriented culture, somatization tendency is a prominent feature of illness behaviour in the East. Somatic discomforts are the socially legitimate channel for soliciting attention. Rooted in an ancient Confucian culture, traditional Chinese medicine (TCM) adopted a strategic integrative approach to engage persons in distress. TCM categorized common mental disorders under internal medicine. Typically, TCM firstly offers quick symptom relief, and, if patient is ready, follows by psycho-behavioural interventions. Inspired by TCM’s wisdom, we operationalized TCM stagnation syndrome (similar to depression) into a psychological construct useful to all mental health practitioners. We studied self-focused versus others-focused illness coping patterns, and examined the mindfulness construct grounded on the original discourses in Buddhism. In severe mental illness, we studied family expressed emotions (EE) as a risk factor in schizophrenic relapse. Due to differences in family structure, what constitutes to EE (criticism, hostility and emotional-over-involvement) are rather different from that in the West. Practice implications will be depicted.