Images of culture and mental illness : South African psychiatric approaches

Abstract

This article considers ways in which the relationship between culture and mental illness is presented in some prominent South African psychiatric literature. We argue that ‘culture’ is often chosen for study for pragmatic reasons, and because the term has considerable currency both in South Africa and in mainstream psychiatry. Four major approaches situated within both interpretive and positivist models are discussed. Common to all of these is a view of ‘Black culture’ as an organic, archaic essence which is contrasted with the fragmented alienated ‘Western culture’. This view seems to dovetail neatly with dominant South African ideology, and is apparently related to a Romantic conception of the primitive. Political issues are generally ignored in the psychiatric literature. We suggest that a more critical approach to ‘Black culture’ and psychiatry is a prerequisite for an adequate contextualization of mental illness.