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
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.