• Pre-Collegiate Global Health Review

Culture’s Overwhelming Impact on Mental Disorders in the Elderly

Updated: Jul 17

By Angela Hung, University Preparatory Academy, San Jose, California, USA

The images typically conjured regarding mental disorders are often restricted to the stereotypical: therapy, psychiatrists, and depressive episodes. The shortcomings in this attitude are caused by misleading representations of mental disorders such as depression, anxiety, and schizophrenia, which increases stigma towards groups who develop these disorders. The elderly, who experience significant social isolation, undergo the ramifications to a greater degree than other groups in society (Donovan & Blazer, 2020). Cultural differences further complicate the existing taboo towards how people regard, treat, and diagnose mental disorders in the elder population globally due to differing values and norms. In Western countries, mental disorders, a natural byproduct of worsening health, are accepted as inevitable in older people as they age (U.S. Department of Health and Human Services, 2001). On the contrary, the contrasting cultural values in developing African and Asian countries influence public attitude to be less socially accepting of people with said disorders (Chaudhry, 2016). Diagnosis and treatment are more effective in areas whose cultural values prioritize following modern medical approaches, disadvantaging regions with a tendency to follow traditional medicine (Gureje et al., 2015). Considering these fundamental cultural differences and their effects on mental disorders in the elderly can lead to more constructive evaluations of mental health epidemics in impoverished, developing countries.

Mental disorders in the elderly transcend cultural and ethnic boundaries. Skepticism towards Western medicine in developing nations is greatly impacted by distinct cultures and values. Not only do many African cultures default to traditional rather than formal medical treatments for mental disorders, mental disorders are frequently under-identified where access to health care professionals who are capable of effectively diagnosing and treating mentally ill patients are limited (Alem et al., 2008). The lack of able medical professionals coupled with the negative stigma associated with mental disorders further complicates elders’ willingness to acknowledge the presence of such disorders and seek treatment. A study conducted to evaluate the differences in public attitudes toward mental illness in Africa and North America by K. O. St Louis and P. M. Roberts revealed that “In Canada (and in the USA), attitudes were generally more positive and less socially stigmatizing toward mental illness than in Cameroon,” further illuminating the existing disparities between the cultures of Cameroon, a developing African country, and Canada, an economically advanced Western country (K. O. St Louis & P. M. Roberts, 2013). Citizens of Cameroon are more prone to being disadvantaged in adopting effective Western treatments for mental illnesses as a consequence of rampant stigma and discrimination, which furthers the devastating consequences of mental health epidemics gone “unconfined.”

Developing countries in Asia reflect the effects of cultural values on the diagnosis and treatment of mental disorders due to the negative attitude citizens hold towards these illnesses, largely due to low MHK (mental health knowledge) and high stigma. Many elderly people in Asian countries prefer to consult traditional healers whenever they are unwell, in accordance with their cultural perceptions of illnesses and treatment. Traditional healers are not only accessible and popular among elderly seeking healthcare services but also “share the same sociocultural beliefs about illness and health” (Kua, 2004). In addition to cultural attitudes toward acceptable methods of mental disorder treatment, low MHK and stigma continue to push the Asian elderly away from seeking mental health institutions or general hospitals for fear of probable separation from family, a definitive end to their independence, and above all, disdain towards their decisions that are not deemed socially acceptable. Hence, the continued stigma surrounding mental illnesses in developing Asian countries must be eliminated in order to progress in providing proficient mental health experts and facilities to diagnose and treat the elderly afflicted without evoking any shame. Currently, mental disorder cases are under-diagnosed due to the deficiency of able doctors, most of whom are unfamiliar with geriatric psychiatry and consequently lack the skills to recognize the signs and symptoms of their patients’ illnesses.

Mental health is shaped by the socio-economic environment in which one resides, and successfully supporting the mentally ill and preventing the onset of such diseases requires engagement with the nuances presented by different environmental factors (Elliott, 2016). Where Western culture presents a more open perspective towards mental disorders, developing countries in the Eastern Hemisphere, which abide by different cultural values, often regard mental disorders with less social acceptance. These differences in cultural attitudes must be taken into account to effectively address mental disorder epidemics globally, as they have a monumental impact on the way mental disorders are viewed, diagnosed, and treated.


Alem, Atalay, et al. “Community-Based Mental Health Care in Africa: Mental Health Workers' Views.” World Psychiatry : Official Journal of the World Psychiatric Association (WPA), Masson Italy, Feb. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2327237/.

Afs-Usa. “Cameroon - AFS-USA.” AFS, www.afsusa.org/countries/cameroon/#afs-nav-people-and-community.

Amuyunzu-Nyamongo, Mary. “PDF.” Common Wealth Health, 2013.

Chaudhry, Tahani. “The Stigma of Mental Illness in South Asian Cultures.” Wellesley College, Apr. 2016.

Donovan, Nancy J, and Dan Blazer. “Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report.” The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, American Association for Geriatric Psychiatry. Published by Elsevier Inc., Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7437541/.

“Elderly Depression.” Pxhere, pxhere.com/en/photo/1048705?utm_content=shareClip&utm_medium=referral&a p;utm_source=pxhere.

Elliott, I. (June 2016) Poverty and Mental Health: A review to inform the

Joseph Rowntree Foundation’s Anti-Poverty Strategy. London: Mental

Health Foundation

Gureje, Oye, et al. “The Role of Global Traditional and Complementary Systems of Medicine in Treating Mental Health Problems.” The Lancet. Psychiatry, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4456435/.

Heok, Kua Ee. “Elderly People with Mental Illness in South-East Asia: Rethinking a Model of Care.” International Psychiatry : Bulletin of the Board of International Affairs of the Royal College of Psychiatrists, The Royal College of Psychiatrists, 1 Apr. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC6734966/.

Mulango, Isabelle Dibu. “Knowledge, Attitudes and Practices Regarding Depression among Primary Health Care Providers in Fako Division, Cameroon.” BMC Psychiatry, 2018, core.ac.uk/download/pdf/210592416.pdf.

PM;, St Louis KO;Roberts. “Public Attitudes toward Mental Illness in Africa and North America.” African Journal of Psychiatry, U.S. National Library of Medicine, 16 Mar. 2013, pubmed.ncbi.nlm.nih.gov/23595532/.

Small, Mario Luis, et al. “Reconsidering Culture and Poverty.” May 2010.

U.S. Department of Health and Human Services. (2001). Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

Yin, Huifang, et al. “Mental Health Stigma and Mental Health Knowledge in Chinese Population: a Cross-Sectional Study.” BMC Psychiatry, BioMed Central, 22 June 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7310154/.