July 24, 2010
This paper takes a cross-cultural perspective by examining the diagnosis and issues of schizophrenia in the Dominican Republic, Ethiopia, Somalia, and the United States. In particular issues related to gender, age, sexual orientation, race, and socioeconomic status are identified. In addition, the rates of occurrence, approaches to treatment, and the implications for social work practice are discussed. Cross-Cultural Perspective of Schizophrenia
Schizophrenia is defined as a disorder that lasts for at least six months and includes at least one month of active-phase symptoms of two or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000). Negative symptoms are described as a loss or decrease of normal functioning (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). For example, a person unable to express emotion such as having a flattened affect or a person not speaking, unless prompted, as seen in normal speech are negative symptoms. Schizophrenia is often misunderstood and those diagnosed with this disorder are often given labels by society. The public attitude tends to characterize people suffering from schizophrenia as dangerous, unpredictable, and unreliable. The stereotypes and stigma associated with mental disorders are frequently the main obstacles preventing early and successful treatment. Particularly in the case of schizophrenia, the burden of stigma often leads to chronic social impairment (Jackowska, 2009). Cross-Cultural Perspective
Schizophrenia affects approximately 2.4 million Americans. Taking antipsychotic medication consistently is essential to the long-term treatment of this severe, disabling disorder and is obviously more effective than taking no medicine at all (National Institute of Mental Health, 2005). Although the medications alone are not sufficient to cure the disease, they are necessary to manage it. Rates of schizophrenia are usually comparable from country to country with about .5% to 1 percent of the population being affected (“Schizophrenia facts and statistics“, 2004). Approximately 1.1 percent of the population, age 18 and older, in the U.S. is diagnosed with schizophrenia (National Institute of Mental Health, 2010). The United States of America has a modernized healthcare system that is equipped to treat disorders such as schizophrenia. Although all Americans do not have access to health insurance there are many free clinics and medical assistance (Medicaid) available to those who qualify. How do people in developing countries manage who do not have the technology, resources, and treatments available to treat medical conditions and mental disorders such as schizophrenia? The countries of the Dominican Republic, Ethiopia, and Somalia were chosen to explore how these countries treat or not treat their people that are afflicted with this disorder. The Dominican Republic
The Dominican Republic is approximately 48,442 square kilometers and has a population of 8,562,541 (World Health Organization, 2008). The people treated in outpatient facilities are primarily diagnosed with affective disorders (32%) and schizophrenia (31%), and 21-50% received psychosocial interventions in the last year which are similar to crisis intervention and short stay admission in the U.S. (World Health Organization, 2008). As of 2008 the Dominican Republic did not have a mental health policy in place but with the assistance of the World Health Organization they are in the process of developing a comprehensive plan and policy (World Health Organization, 2008). Although there is no official policy, in 2006 the Dominican Republic updated their national standards for...