Culture Medicine and Psychiatry最新文献

The global mental health movement has brought much-needed attention to the vast burden of mental illness worldwide, yet its overwhelming reliance on Western psychiatric models has generated critical debate regarding cultural relevance and effectiveness. This commentary examines the limitations of exporting Western diagnostic categories and treatments to diverse settings, highlighting the risks of cultural mismatch, medicalization of social suffering, and marginalization of indigenous healing systems. Drawing on recent evidence from task-shifting, community-based interventions, and hybrid models, we demonstrate that locally grounded approaches such as Zimbabwe's friendship bench and collaborative programs between traditional and biomedical practitioners can be highly effective, culturally resonant, and sustainable. However, the unchecked predominance of Western paradigms has sometimes led to increased stigma, over-reliance on pharmaceuticals, and the erosion of community trust. To address these challenges, this paper recommend a pluralistic and participatory approach to global mental health, emphasizing culturally adapted care, local leadership, equitable research funding, and respectful integration of multiple healing traditions. The future of global mental health depends on humility, partnership, and a commitment to social justice, ensuring that mental health services are not only scientifically sound but also meaningful and accessible to all communities. Achieving effective and equitable mental health care globally requires moving beyond Western models to embrace pluralism, cultural adaptation, community engagement, local leadership, and equity.

The "mental health crisis" has become the dominant framework for understanding student distress in US higher education. Drawing on interviews with 35 mental health professionals working with college students, this paper examines how practitioners themselves understand and critique this crisis narrative. Rather than accepting or rejecting the crisis framing wholesale, professionals articulated five distinct and often competing ways of understanding what is happening in college mental health: (1) a mental health crisis emphasizing increasing student psychopathology; (2) a developmental crisis attributing distress to disrupted adolescent development from technology use and changing parenting practices; (3) an access crisis focusing on overwhelmed institutional capacity; (4) a crisis of meaning highlighting the semantic instability of diagnostic language as it circulates in vernacular usage; and (5) a crisis of higher education locating the problem in structural conditions and achievement culture. Each framing renders certain aspects of the situation visible while obscuring others, authorizes particular forms of expertise, and implies fundamentally different interventions. Building on critical scholarship that treats "crisis" as a framing device that performs political work, this paper argues that the multiplication of crisis narratives represents both a symptom of conceptual complexity and practitioners' efforts to make visible what dominant framings obscure. Ultimately, professionals face the task of addressing patients' needs while dealing with multiple simultaneous pressures and working with a limited capacity to address upstream causes of distress.

This study examines climate change-related emotional responses among young adults engaged in climate activism and an intergenerational group of non-activists through an ecofeminist lens, which highlights interconnected oppression within patriarchal societies. The objectives were to understand how environmental decline influences young adults' climate engagement, thoughts, actions, and behaviors and to describe the emotional and psychological impacts of the climate crisis on both young adults and the intergenerational group. The study comprised two phases: young adult activists created digital stories, and an intergenerational focus group of non-activists viewed these stories and participated in a discussion. Thematic analysis constructed key themes: among activists, youth environmental awareness, psychoterratic syndromes, and activism; among non-activists, climate change perspectives and intergenerational injustice. Both groups expressed concern, anxiety, sadness, and grief, although activists reported experiencing these emotions more frequently and expressed worry about human health. Activists also conveyed hope for climate action, similar to older non-activists, whereas younger non-activists reported feelings of hopelessness and lack of motivation, and older non-activists showed little interest in collective action. Despite emotional burdens, young activists remained hopeful and motivated through collective efforts. Both groups underscored the disproportionate responsibility placed on young people to address climate change, calling for greater support and equitable distribution of responsibility.

Non-suicidal self-harm, particularly the phenomenon of cutting, is gaining increasing academic attention. However, most existing literature approaches this topic from clinical, cultural, or historical perspectives, often neglecting an in-depth exploration of the lived experiences of individuals engaging in self-harm. Notably, within the context of mental illnesses, self-harm is often viewed merely as a symptomatic behavior and consequently addressed solely through symptomatic treatments. This article draws on data from the first and last authors' extensive projects focusing on individuals living with mental illnesses in Denmark. Over a period of four years, we closely followed 19 participants (in two different projects) in various aspects of their daily lives, including periods of hospitalization. The article also includes uncensured images of self-harm, provided by participants with their permission to publish. We aim to underscore self-harm not only as the experiential nexus of a complex relationship between the body and the world but also as a mechanism for overcoming the self. Drawing inspiration from Kierkegaard's reflections on selfhood and despair, we propose the concept of 'enacted selfhood' as an analytical framework for comprehending self-harm among individuals living with mental illness.

The smartphone has become fundamental in areas, such as leisure, sociability, and intimacy, especially for young people. Its impact has led to growing concerns about its effects, in terms of a potential addictive nature. This article approaches the articulation of abuse and self-regulation practices regarding the smartphone, and the presence of addictive explanations as a framework that links such practices to a culture of addiction. For this purpose, 24 young people (between 18 and 29 years) with different socio-demographic profiles (age, gender, occupation) and levels of problematic use of digital technologies were interviewed. The results show how respondents regulate the constant influx of smartphones into their daily lives with individual strategies that attempt to balance the perceived effects of their digital practices. Their effectiveness is modulated by aspects, such as maturity, personal context, or commitment to other activities. In many cases, their self-perceptions are permeated by popularized discourses of addiction, which coexist with ironic positions regarding their agency facing the technological designs and are aligned with logics of individual responsibility. They also highlight emergent aspects, such as the link between weekend binge or nightly practices of smartphone abuse, with their own personal sphere and self-gratification.

Possession states are a well-known but a complex clinical aspect of transcultural psychiatry. How do young clinicians react when facing such symptoms? Starting from the case of a Somali patient suffering from possession states, treated in a transcultural consultation group, we will attempt to explain the cultural countertransference experienced by young clinicians who witnessed a trance. Using the Cultural Formulation Interview, we observed an evolution of the countertransference, and therefore an evolution of the symptom's understanding and of the patient's condition. This clinical case thus highlights the necessity to take into account the cultural countertransference of young clinicians within the transcultural consultation.

The book Under the Gaze of Global Mental Health: A Critical Reflection offers a powerful critique of Euro-North American epistemology and biomedical universalism, which continue to shape global mental health policies and practices. The authors challenge the assumption that Euro-North American ways of understanding the mind and mental illness are universally valid, arguing instead that these frameworks reflect a colonial legacy with practical and epistemological consequences - particularly through the influence of international agencies.

As awareness of hikikomori has increased worldwide, the body of research has diversified, deepening our understanding of the subject. Nevertheless, qualitative studies on the subjective experiences of primary hikikomori remain limited. Within this context, this study aims to enhance understanding of the primary type of hikikomori by exploring their lived experiences through in-depth interviews. The analysis identified six interrelated conflictual themes, woven through social-existential strife. At the core of this struggle lies an intricate negotiation of self-worth and belonging amid the tension between individual vulnerability and societal expectations. An existential yearning for meaningful relatedness underscored these struggles, despite an apparent severance from the social world on the surface. The subjects appeared neither apathetic nor indifferent, but rather encapsulated in a complex web of conflicting forces, experiencing pain both when retreating from and venturing into the outside world. These experiences were deeply intersected with cultural and societal dynamics, including subtle and largely invisible pressures arising from contemporary norms of sociality. Capturing the meanings of withdrawal within the resonance of an affected person's sense of self and their view of the social world is thus crucial, given the friction inherent in contemporary pursuits of self-discovery and social connection. By linking psychological distress with structural and relational forces, this study also seeks to offer an integrative perspective on social withdrawal, yielding insights that extend beyond the Japanese context.