Trigger Warning: Abuse, sexual abuse, children, and violence are mentioned and spoken about
Mental Illness & Culture
If you ask most Caribbean natives about mental health you will hear, “you’re mad”, “you sick” or “you nuh good in ya head.” There’s an extreme stigma towards mental health which results in many individuals struggling with mental health concerns for years, wreaking havoc on their family, friends but more importantly, themselves. It’s a taboo topic, so most of the time things get tucked away, never to be brought to the light because it will “make the family look bad”. Mental health not only effects the individual but the entire family. Rumors may spread about the family, people will talk, and the family may blame the one dealing with the mental health concerns.
According to MentalHealth.gov “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood” (2020).
It’s hard to acknowledge that we may be struggling with any mental health concerns especially if it’s culturally accepts such as being extremely organized, repeated checking, washing, etc can be diagnosed as OCD. Obsessive-Compulsive Disorder criteria are obsessions that are recurrent and persistent thoughts as well as attempts to ignore or suppress the thoughts; compulsions are repetitive behaviors in response to the obsession as well as behaviors or mental acts that help reduce the anxiety they may be experiencing; all of these are extremely time consuming (DSM-5, 2013).
Let’s take a look at the the example mentioned earlier an individual who obsesses about cleanliness and engages in behaviors to remove germs, dirt or dust need to engage in these behaviors in order reduce their anxiety otherwise the anxiety will intensify and cause the person to fixate on the obsession until their compulsions are satisfied. This is a form of OCD that might not be considered until it is confronted in therapy and the person is made to look at themselves in a mirror through reflections and rephrasing what the client has expressed.
Now let’s take a look at the numbers, “More than half of people with mental illness don’t seek help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood” (American Psychiatric Association, 2020). “People avoid or delay seeking treatment due to concerns about being treated differently…”, this indicates there are different types of stigma, which means theres difference levels of impact it can have on our mental health. Researchers suggested there are three types of stigma; public, self and and institutional. Let’s take a look at each of them:
- Public Stigma: negative attitudes or discriminatory behaviors towards those with mental illness.
- Self-stigma: negative attitude and shame towards oneself due to the mental illness(es).
- Institutional stigma: government policies and organizations that intentionally or intentionally limit opportunities for individuals with a mental illness.
Now that we know stigma has different forms we must also acknowledge that stigma doesn’t only effect the person with the mental illness but it also impacts the family. Loved ones and family members of a person who has and is struggling with a mental illness can experience stigma in the form of bringing shame to the family, negative comments or attitudes towards the family and discrimination. As mentioned earlier, the Caribbean culture tends to stigmatize mental health and in turn most individuals struggling with mental illness do not seek help because they want to avoid bringing shame to the family and/or do not want to face the backlash of bringing the family secrets to the light.
An area of controversy is abuse; physical, mental, emotional and sexual. Most forms of abuse are swept under the rug or normalized in Caribbean culture and go unprocessed for months or even years until it starts having an impact on one’s mental health and we start becoming exposed to different upbringings. There is limited research on violence in homes, domestic violence and abuse in Caribbean households but the studies suggest there is a high rate of violence in homes (Sutton & Alvarez, 2016). According to Sutton & Alvarez “Women and children suffer disproportionately from different kinds of violence than adult men — including intimate partner violence (IPV) , sexual violence, family violence, and child abuse. It is estimated that nearly one in three women in the Latin America and the Caribbean (LAC) region will experience violence in her lifetime, typically at the hands of an intimate partner” (2020).
We have all heard the term ‘sexual abuse’ but do you really know the definition of it?
“Sexual abuse involves an adult engaging a child in sexually explicit conduct, including direct sexual contact, simulation of sexual contact, or visual representation of sexual contact. The acts of sexual abuse may include rape, molestation, prostitution, child pornography, incest, or other forms of exploitation of a child for the sexual gratification of an adult” (Lawler & Talbot, 2012). With this in mind let’s remember that anyone at any age can be a victim of sexual abuse. Victims tend to be conditioned to fear their abuser and manipulated to believe that if they speak about the sexual abuse no one will believe them, which causes the victim to suffer in silence with the unprocessed trauma taking a toll on their physical and mental health.
Rape Culture Reality
- “More than half (51.1%) of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance; for male victims, more than half (52.4%) reported being raped by an acquaintance and 15.1% by a stranger.”
- “An estimated 13% of women and 6% of men have experienced sexual coercion in their lifetime (i.e., unwanted sexual penetration after being pressured in a nonphysical way); and 27.2% of women and 11.7% of men have experienced unwanted sexual contact.”
- “Most female victims of completed rape (79.6%) experienced their first rape before the age of 25; 42.2% experienced their first completed rape before the age of 18 years.”
- “More than one-quarter of male victims of completed rape (27.8%) experienced their first rape when they were 10 years of age or younger.”
- “One in four girls and one in six boys will be sexually abused before they turn 18 years old.”
- “Only 12% of child sexual abuse is ever reported to the authorities.” (NSVRC, n.d.)
The numbers are staggering and can be difficult to process. So those who have dealt or are currently still dealing with sexual abuse are terrified to speak out and their pain goes unheard. We need to normalize taking about difficult topics like domestic violence, abuse and sexual abuse otherwise people will suffer in silence and never be able to physically and/or mental have peace. Admitting trauma, processing it and healing from it needs to become the norm especially in the Caribbean. Families need to stop shushing the victims and sweeping their pain under a rug. They need a voice and a professional to talk to so justice can be achieved.
“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma.”
― Judith Lewis Herman
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychiatric Association. (2020). Stigma, prejudice and discrimination against people with mental illness. Retrieved from https://www.psychiatry.org/patients-families/stigma-and-discrimination
Lawler, M. J. & Talbot, E.B. (2012) Encyclopedia of human behavior (Second Edition),
MentalHealth.Gov. (2020) What Is Mental Health?. Retrieved from https://www.mentalhealth.gov/basics/what-is-mental-health
National Sexual Violence Resource Center (NSVRC). (n.d). Statistics. Retrieved from https://www.nsvrc.org/statistics
Sutton, H. & Alvarez, L. (2016). How safe are Caribbean homes for women and children?: Attitudes toward intimate partner violence and corporal punishment. Retrieved from https://publications.iadb.org/publications/english/document/How-Safe-Are-Caribbean-Homes-for-Women-and-Children-Attitudes-toward-Intimate-Partner-Violence-and-Corporal-Punishment.pdf