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Title: Culture and psychopathology: An introduction to mental illness in a cross- cultural perspective
Keywords: Mobile population
Migration
Mental health
Anthropology
Country: Norway
Institution: Norway - Centre for International Health, Universitetet i Bergen
Course coordinator: David Lackland Sam
Date start: 2024-03-18
Date end: 2024-03-22
About duration and dates: One preparatory week before the staring date and one week to work on perspective assignment (student investment time).Regarding admission, please visit here: http://www.uib.no/en/cih/71970/courses-cih (annual application date 1 November)
Classification: advanced optional
Mode of delivery: Distance-based
Course location: Centre for International Health,
Aarstadveien 21, Bergen, Norway
ECTS credit points: 4 ECTS credits
SIT: TOTAL SIT = 110 hours, comprising of:
• 40 hours of preparatory reading and performing an interview in week 1
• 10 hours of lectures
• 10 hours presentations and discussions in class
• 20 hours group work discussions
• 30 hours individual assignment
Language: English
Description: At the end of the course, the student should be able to:
• Design and promote mental health care sensitive to specific cultural contexts, and/or for different ethnic groups
• Propose a culturally based hypothesis on the aetiology of different forms of mental illness
• Use the acquired knowledge to appraise differential prevalence, expression, course, and prognosis of mental illness across cultures
• Identify which aspects of mental illness symptomatology are cultural general, and which aspects are culture-specific (i.e., etic vs. emic)
Assessment Procedures: The marking has a max. sum of 100, the grading scale is A-F:
A = 80 or higher; B = 70 – 79; C = 60 – 69; D = 50 – 59; E = 40 – 49; and F > 40 (to pass you must have 40 points or more).

The total assessment is based upon:
1. Interview exercise with report (about 500 words); max 20 points (assignment 1)
2. Two short essays, with assigned essay topics (about 500 words each). General feedback will be given on the first of the short essays for the purpose of improving the quality of later essays (assignment 2-3) Max 40 points
3. One self-defined essay (2 500 words)– max. 40 points (assignment 4)

Submitted essays will be check for plagiarism.

Assignment 1 will be evaluated based on:
(i) the quality of the interview
(ii) the extent the interviewer manages to tease out indigenous meaning of “madness” and
(iii) how the information is contrasted with the student’s own cultural group understanding of madness.

Assignment 2 and 3 (essays) will be evaluated based on:
(i) The understanding of the topic
(ii) The extent of utilizing suggested reading
(iii) The extent to which the student has found additional reading
(iv) The extent to which the essay is based on the student’s own wording
(v) Clarity of writing

The self-defined topic will in addition be evaluated based on:
(i) The centrality of the chosen topic for the objectives of the course
(ii) The understanding of the chosen mental illness
(iii) The extent to which the cultural explanations are being considered

If the student fails, it will be possible to resit for exam by resubmission of interview report and assignments, in the same semester (minimum 3 weeks after the first exam).
Content: Like all systems of healing, biomedicine is a cultural product arising from Western industrialised countries. Yet, the practice of medicine has to a large extent shown very little cognisance of cultural and social factors that affect people’s health. Biomedical conception of health and its practice are often transported from one part of the world to another in packages of “absolute truths”. Notwithstanding great results, they have sometimes proven to be ineffective and even detrimental to the receiving group of people. Central to this problem is failure on the part of biomedicine to consider culture’s influence on people’s attitudes, belief systems, conception of illness and disease, disease aetiology, and mental health care. In addition, while certain health problems (e.g., culture-bound syndromes) are difficult to understand using imported biomedical models from the West, they are readily understood within the cultural societies where they are manifested. The crux of this course is to examine mental illness, their manifestations, diagnosis, treatment, and prognosis in different cultural societies.
The following areas of topics will be addressed during the 5-days of lectures.
• Culture and mental illness: Concepts, issues, models, and theories
• Classification/grouping of mental disorders in diagnostic manuals: culture and methodology
• Review of some common mental illness (anxiety, mood, somatoform disorders and schizophrenia from a cultural perspective
• Culture-bound syndromes, cultural validations, and their possible links with mental illness in the classification manuals
• Migration, acculturation, multicultural health and cross-cultural and multicultural psychotherapy Help-seeking behavior, treatment, and prognosis
Methods: The students will:
-Be assigned written material to read for self-reflection on mental disorders from their own society
-Perform an interview with people from different cultures about how mental disorders are defined, identified, and treated in their society; and make an assignment from this interview (500 words, delivered to the course leader online)
-Have formal lectures (2 hours face to face teaching sessions for 5 days)
-Have interactive group discussions, debates, and presentations in class; present themselves, present their interview results in class
-Have group work during the on-campus week, discussing literature and selected topics (new in every course, focused on relevant topics at the time)
-Debate in class on whether modern day society is over pathologizing everyday behavior
-Write essays of 500 and 2 500 words-
Prerequisites: Students admitted to a master’s degree programme in global health or related topics may join this course.
Good working knowledge of English (TOEFL score of at least 550 points paper-based or 213 points computer-based, or an equivalent approved test)
Attendance: Maximum number of students: 40 (no limit on numbers of tropEd students among these 40)
Selection: Priority:
Master students enrolled at the University of Bergen and master students from institutions within tropEd will be registered before others
Fees: No fees
Scholarships: None
Major changes since initial accreditation: The requirements for exams and assignments are now made clearer.
This course used to be run together with a similar course offered to psychology students at the University of Bergen (i.e., PSYK 302g). Because of major differences in educational backgrounds and level between the psychological students and the students following this course, the two courses are now run separately. This change from our point of view has been a wise one.
The TropEd students are more mature, as ask well thought through questions, and discussion with them is at another level. Moreover, as an elective, students are more engaged and know why they are taking the course.
Student evaluation: The experience gained from the 2020 and 2021 courses and feedback from students have been very instrumental in working on this re-accreditation.
The one point with the discussions is that it is easy to get all the students to contribute, and we will continue these.

The course does not normally attract the largest number of students; thus, it is easy to have close interaction with each other. It also makes it easy to place emphasis on areas the students are most interested in; feedback and evaluation of the course is spontaneous and informal.
The last two times the course has been run (Spring 2020, and Spring 2021) attracted a larger number of students (obviously because the week with face-to-face teaching needed to be online due to covid-19).
The large number of students taking the course increased the cultural diversity of the students’ background and positively enhanced the cultural aspects of the discussions.
Students have also written directly to the course leader to express their appreciation for taking the course.
Lessons learned: In inviting students to pick a mental health problem and discuss the cultural dimensions has expanded the lecturer’s own knowledge level of cultural aspects of mental illness; this part of the course is clearly appreciated by the students.

This course is now a 4ECTS, and considering the amount of work involved, it is reasonable to keep the course credit the same

A change planned is to continue to integrate link the course more and more to the DSM 5 and the ICD11
tropEd accreditation:
Accredited in Copenhagen 2003. Re-accredited in Mexico, May 2010 and February 2017. Re-accredited EC Telco March 2022. Valid until March 2027.
Remarks: There will be five obligatory readings:
1. Bhugra, D., & Bhui, K (eds). (2015]). Textbook of cultural psychiatry (2nd edition) Cambridge: Cambridge University Press (selected chapters; will be decided for each course)
2. Cromby, J., Harper, D., & Reavey, P. (2013). Psychology, mental health and distress. London: Palgrave McMillian (selected chapters, will be decided for each course)
3. Tseng, W-S. (2001). Handbook of cultural psychiatry. [Selected chapters] San Diego: Academic Press (selected chapters, will be decided for each course). Although this book is old, it is the best textbook on the topic, available
4. Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553-1598.
5. Sam D.L., Moreira V. (2012). Revisiting the mutual embeddedness of culture and mental illness. Online Readings in Psychology and Culture, 10 (2), 2307-0919

Two desk reference books will be available for the students
1. American Psychiatric Association (2013). Diagnostic manual and statistical manual of mental disorders 5th edition (DSM 5). Washington: APA.
2. World Health Organization (2019). International classification of diseases- 11 for the classification of mental and behavioral disorders. Geneva: World Health Organization

Several journal papers will also be suggested for reading and will vary from year to year.
Email Address: Linda.Forshaw@uib.no
Date Of Record Creation: 2012-01-13 01:00:34 (W3C-DTF)
Date Of Record Release: 2022-10-11 10:22:33 (W3C-DTF)
Date Record Checked: 2022-03-10 (W3C-DTF)
Date Last Modified: 2023-10-09 10:39:13 (W3C-DTF)

Fifteen years of the tropEd Masters in International Health programme: what has it delivered? Results of an alumni survey of masters students in international health

L. Gerstel1, P. A. C. Zwanikken1, A. Hoffman2, C. Diederichs3, M. Borchert3 and B. Peterhans2

1 Royal Tropical Institute, Amsterdam, The Netherlands
2 Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
3 Institute of Tropical Medicine and International Health, Charite – Universit€atsmedizin Berlin, Berlin, Germany