Main Submission Volume 3/Issue 1/2012 HealtH S cience i nquiry Volume 4 / Issue 1 / 2013 53 Questioning the assumption of universality in psychiatric approaches to mental healthcare in Canada Social Economy and Environment El-Bialy (MemorialU) Rowan El-Bialy Memorial University Mental health services in Canada are primarily based on knowledge gained in the felds of psychiatry and psychology. These felds have, in turn, emerged from a very specifc cultural and historical, that is, English-speaking and Euro-American, context. Over the past thirty years, scholars in cross-cultural psychiatry have examined the applicability of western psychiatric approaches to mental health in other cultures. This body of research views the knowledge system of psychiatry as a product of the culture in which it has emerged, and demonstrates that it is neither universal nor applicable in other cultural contexts. In this paper, I will examine some of the arguments that scholars in this area have put forward, while considering the implicatons of this research for mental health services that serve ethnolinguistc groups in Canada. In the 1980s, Arthur Kleinman, a psychiatrist and anthropologist, argued that psychiatry is a product of western culture, and thus psychiatric categories and treatments are specifc to that culture, and not universally valid. He conducted research in Asia to investgate how culture infuences how one perceives mental health and illness. 1 He argued that the biomedical view of mental illness as an individual mater emerges from a uniquely western worldview, and although it makes sense to those immersed in that culture, it cannot be extrapolated to other cultures and worldviews. 1 Since then, a robust body of research has emerged that has identfed several characteristcs of the psychiatric approach to mental health which limit its applicability in other cultures. Two such characteristcs are: the biomedical basis of psychiatry and the emphasis on mental health as an individual afair. I will briefy discuss how these two characteristcs have been problematzed in the literature. Western psychiatry is undoubtedly built upon the biomedical model that underlies western medicine. 1 A good example of this is the Diagnostc and Statstcal Manual (DSM)’s categorizaton of mental illness in terms of ‘diseases’ and ‘disorders’. 2 Similarly, the biomedical nature of psychiatry is apparent in treatments for mental illness, which ofen rely on drug-based therapies. Although many accept this biomedical approach to diagnosing and treatng mental illness, others who view mental health through alternatve cultural and knowledge lenses reject it. For example, in a study by Laura Simich and colleagues, 3 members of fve ethnolinguistc communites in Toronto expressed hesitaton over using mental health services in Canada due to their relatvely narrow, biomedical focus. One partcipant compared mental health services in Canada with those in Poland; the former focuses on ridding the individual of what is seen as a medical illness, while the later focuses on rehabilitatng the person physically, mentally, and spiritually through non-medical therapies. Similarly, scholars have argued that the medicalizaton of mental illness can trivialize the social problems that cause them. 1,4 In one study, refugee women who were interviewed about feeling depressed said that mental health ‘treatments’ should not target their individual psyches, but the structural inequalites leading to their distress. 5 These examples demonstrate how the biomedical approach to diagnosis and treatment of mental health problems limits its compatbility with alternatve understandings of mental health. The psychiatric approach to mental health is not universally applicable for another reason: it focuses almost exclusively on the individual as a locus of diagnosis and treatment. 6 In many social contexts, however, a person’s identty is not experienced so much as an individual identty, but as a part of a collectve or a group. 7 In such cases, the individualized psychiatric approach to mental health would be inappropriate because it does not address the social causes of mental health problems either in diagnosis or treatment. 5,6 In response, alternatve approaches to mental health have been developed that focus on promotng 