Sudha Chavda. Hillingdon
Part 4

Asian patient and cultural belief

Since then I have come across many cases as such. Obviously one could not change their cultural views and beliefs in split seconds. I have learnt to respect their religious background and cultural beliefs at the same time giving gradual education on mental health and mental illness. Due to the stigma attached and lack of education, patients are not referred to us in the early stages of illness. It is twice as difficult and time consuming when assessing the Asian patients. First of all family members do not realise that the person is suffering from mental illness and are not open about their family relationship and dynamics to a total stranger. On my first visit, I am led to believe that everything is perfect in the family and they could not understand why this person is behaving in an unacceptable way. The impression will be given that they have everything they want, e.g. a house, a job, children and money. I wonder sometimes why somebody is referred to our service then! There must be something wrong somewhere. What about their interpersonal relationship? I end up doing detective work by gently asking questions on issues not openly mentioned but which I read between the lines during their conversation with me. I have to build a rapport with them, which is based on trust, assurance and confidence, which would allow them to divulge their innermost disturbing feelings with ease and comfort. When I get to the bottom of it, I usually sense that they are sitting on time bombs, which could explode anytime.
When I get a referral, which says the patient is suffering from depression and anxiety, it could be due to various reasons e.g. Bereavement, loss of job, rape, mugging, sexual abuse, physical abuse, incest, lack of finance, accommodation, conflict with in laws- husband- children- neighbours- work, unable to conceive or produce a son, phobia and so on. I never know what people are going to off load on to me. Sometimes I hear such sad, tormenting stories that it does affect me, especially when young innocent children are involved, but luckily I have learnt over the years to separate my work and home-life. When I leave work, I leave all the distress and stress of the work behind.

Asian attitude to Mental illness Asian patient and cultural belief Gujarati Referrals
Arranged marriage Incompatibility

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