WACP News

Statement on Covid-19 and Vulnerable Populations

From the Special Interest Group on Coronavirus of the World Association of Cultural Psychiatry 09/06/2020

Since the COVID-19 virus first manifested, in the last days of 2019 and the first months of 2020, numerous countries have taken measures at the level of national governments, states or provinces, or cities to lower the spread of infection in their populations.

At this time, it is important to point out that these measures and policies have differentially affected the mental health, physical health, and economic well-being of vulnerable populations around the world.

In Western countries, epidemiological research has shown that racialized and ethnic minorities have borne a higher burden of illness, fueled by adverse social determinants of health and mental health patterned by racism and social injustice. Not only do minorities suffer in larger numbers from coronavirus disease, but they also suffer from the greater negative impacts of the pandemic and mitigation efforts including unemployment, loss of income, food insecurity, and less access to health care.
In low- and middle-income countries, the disproportionate impact on vulnerable groups is even more severe. The measures taken by governments have left many millions of people who work in low-paid jobs without any income. State funding is often too limited to bridge the gap in income and food supply or to provide protective equipment to essential workers. We see this happening in India, Africa, and Latin America. In some cases, aggressive policing of these measures has been used as part of efforts to control low-income populations, even resulting in violence.
Measures taken without adequate scientific evidence have resulted in more infections. Examples include long lines of poor people seeking financial compensation, premature reopening of regional economies and places of entertainment without sufficient testing and access to protective equipment, and limitations of public transportation causing overcrowding of buses and trains.
Mental health care is often the last consideration in health care service planning and, with the added strain of providing care for COVID-19 cases, there is a risk of inadequate funding for mental health care.

Therefore, we call on governments at all levels to address the mental health and social impacts of the pandemic:

To rely on scientific evidence in developing responses to the pandemic. Measures can have unforeseen side effects, especially for vulnerable populations.
To focus on the most vulnerable populations, including those living in poverty who may lack resources to undertake mitigation efforts by devising policies and interventions that meet their needs.
To prioritize funding to help the most vulnerable populations, not only in their own country, but worldwide. The pandemic is widening the gap between rich and poor not only within societies but also across nations. The moment has come for a worldwide initiative to mobilize financial means to ensure basic economic support for all, whether by tax policies or through international organizations.
To address the mental health issues raised by the pandemic, both through loss of life and the effects of prolonged confinement or social distance. This includes efforts to promote social support. The impacts of grief and loss have often remained invisible due to the effects of lockdown and other restrictions on funeral rituals but may have a long-term impact on mental health.

Roberto Lewis-Fernández; Hans Rohlof; Pablo Farías; Mario Braakman; Sergio J. Villaseñor-Bayardo.

Officers of the WACP

WACP News, Conferences

A 2019 Cultural Psychiatry and Global Mental Health Conference was held in Guangzhou (China)

Jie Li, Muzi Li

Guangzhou Huiai Hospital, China

Guided by developments in the social sciences, the field of psychiatry has become increasingly aware of the importance of culture. Its centrality has become even clearer as a key component of the bio-psycho-social medical model, which argues that every human being is not only influenced by biology and psychology, but is also a social being, a cultural being. For psychiatrists and psychologists, literacy in the humanities has become a necessity. “As there is no health without mental health, there can be no psychiatry (or no medicine) without culture” (Becker & Kleinman, 2014). In particular, the rapid growth of globalization has promoted international communication and immigration. This trend has brought new perspectives to the understanding of mental health problems, including the urgent need to provide culturally adapted mental health services to people from diverse cultural backgrounds. In 2007, British scholars BHUGRA Dinesh and BHUI Kamaldeep invited over 50 distinguished colleagues from around the world to compile the first comprehensive textbook in this field, entitled The Textbook of Cultural Psychiatry. This book indicates the maturity of the field of cultural psychiatry and is a sign of its growth in Western countries.

In China, cultural psychiatry has been growing since its first development during the “Reform and Opening-up Period” under the leadership of the Section of Ethnic Psychology and Psychiatry (EPP), an affiliated group of the Chinese Society of Psychiatry. The EPP has successfully conducted numerous research studies on both theoretical and practical levels. In order to consolidate the theoretical model of cultural psychiatry for clinicians and scholars, and to equip specialists with the most up-to-date information, Guangzhou Mental Health Center (aka Guangzhou Huiai Hospital) was honored to host international experts in cultural psychiatry and psychotherapy, including Drs. Roberto Lewis-Fernández and Mario Braakman, current president and president-elect of the World Association of Cultural Psychiatry (WACP), at the 2019 Cultural Psychiatry and Global Mental Health Conference held in Guangzhou City on November 11^th-12^th2019.

This interdisciplinary conference covered topics in psychiatry, clinical psychology, cultural anthropology, and public mental health. Distinguished experts and scholars in cultural psychiatry and related disciplines from the United States, the Netherlands, and China attended the conference, which hosted more than 300 psychiatrists, public health physicians, clinical psychologists, social workers, and community mental health workers from Guangdong and Gansu provinces.

At the opening ceremony, Professor Jie Li, director of the Guangzhou Crisis Research and Intervention Center, Dr. Qiaoyang Fan, vice-director of the Department of Disease Control at the Health Commission of Guangzhou, and Dr. Hongbo He, vice-president of the Guangzhou Huiai Hospital gave presentations. The opening ceremony was hosted by Dr. Suhua Zhao, vice-director of the Community Psychiatric Department of Guangzhou Huiai Hospital. Ms. Muzi (Nina) Li from the Community Psychiatry Department served as the chief interpreter.

During the two-day conference, presentations were delivered by the current president of the World Association of Cultural Psychiatry (WACP), Professor Roberto Lewis-Fernández from the Department of Psychiatry at Columbia University, the president-elect of WACP; Professor Mario Braakman from Tilburg University; Professor Jie Li from Guangzhou Huiai Hospital; Dr. Shawn Hou, chief psychologist of the American Psychological Service Center; Dr. Yu Pang, vice-president of Beijing Huilongguan Hospital; and Professor Cheng Yu from the department of sociology and anthropology at Sun Yat-sen University, along with other scholars. Topics included the cultural classification of mental disorder, ethno-psychopharmacology, stigma and mental disorders, the application of the DSM-5 Cultural Formulation Interview in Chinese family therapy, social and cultural factors in psychological crisis intervention, and mental health and medical humanities.

The conference emphasized the need to combine public mental health services with related disciplines such as clinical psychology and cultural anthropology in order to provide better mental health care. A main topic of the conference was on disseminating the concepts of cultural psychiatry in order to address some of the limitations of focusing exclusively on biological psychiatry. An integrated approach can build a bridge between social sciences and psychiatry, highlighting the importance of humanistic care.

Conference organizers received very positive feedback after the event. Participants noted the richness of the program and the multiple opportunities for learning; the conference was felt to broaden participants’ horizons, encouraging them to pursue an interest in cultural psychiatry and humanistic care. Attendees felt better prepared to provide quality services to individuals with mental disorders, as well as to their communities and to society at large.

November 11th, 2019