The connection between culture, context, mental health and human rights is addressed in Laurence Kirmayer’s chapter. He addresses three broad questions concerning the cross-cultural applicability of human rights in the domain of psychiatry: (1) Do the theory and practice of psychiatry and other mental health disciplines apply across disparate cultures? (2) Are human rights principles universally applicable? and (3) Are human rights principles applicable to mental health issues across cultures? Kirmayer notes that ‘culture’ names a process, not a thing, that cultural knowledge and institutions as part of open, fluid, dynamic systems are contested, and that a multiplicity of types of cultures are available in the contemporary world. He notes the twin dangers of endorsing cultural stereotypes and dismissing ‘culture’ altogether, rather than acknowledging its place in all our lives. Cultural context (whether local, or imported, Western and medical) potentially shapes all aspects of mental disorders and the meaning of and response to symptoms and illnesses. Psychiatry may have a liberating or debilitating role depending on how it is culturally experienced or received, and when used for involuntary treatment, may be empowering or oppressive. Kirmayer examines the meanings of relativism and universality in human rights discourse, and the contrast between Western autonomy and non-Western interdependence. Despite their anchorage in different cultural forms of life, Kirmayer advances arguments for the universality of human rights across and embedded within cultures. He discusses cultural notions of human, humanness, the humane, and dehumanization understood through cultures; comments on the right to culture and community; the potential for engaged dialogue between diverse cultures in a global society; the cultural responsiveness of mental health services; and the globalization of psychiatry as a human rights opportunity and challenge.
Chapter. 10589 words.
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