Conference Proceedings and Resources
6-7 February 2008
Kindly funded by the Australian Research Council Asia-Pacific Futures Research Network (ARC-APFRN)
Gordon Greenwood Building (32), Room 207, The University of Queensland, St Lucia, Brisbane, Australia.
The ‘Mental Illness and Contemporary East Asian Communities: Responding to Culture’ workshop brought together researchers, professionals and community and industry representatives engaged in the field of mental health to examine contemporary understandings of mental illness in East Asian communities in both indigenous and migrant settings. The impact of these understandings on the experience of mental illness in East Asian communities and the means by which health and allied services take into account these understandings were explored across a range of disciplinary perspectives. Conceptions of mental illness, including stigmatic conceptions, vary across cultures and it is important that workshops like this examine the issue from a range of contributing viewpoints.
At a time when the dominant paradigms that have informed Western understandings of and responses to mental illness are under challenge, it is equally important to seriously examine those that inform a distinct and influential part of our local region, East Asia. Through bringing together local and international researchers from the humanities, social sciences and health sciences, and health professionals, community and industry representatives engaged in service delivery to East Asian communities in Australia, the workshop has set the groundwork for a more rich, interdisciplinary understanding of mental illness and its attendant stigma in contemporary East Asian communities, which can usefully inform future research collaborations and health delivery practice.
Below are the details of the workshop program with presenters brief bio; downloadable presentations for your perusal and other related resources. Further information can be obtained from Dr Guy Ramsay (conference organiser): guy.ramsay@uq.edu.au
Dr Guy Ramsay, Ms Caroline Lenette and A/Professor John Traphagan
WORKSHOP PROGRAM
Wednesday 6 February 2008
Morning session:
Associate Professor John W. Traphagan, Professor of Religious Studies and Anthropology at the University of Texas at Austin
Presenter Bio: John W. Traphagan, Ph. D. is Associate Professor of Religious Studies and Anthropology at the University of Texas at Austin. He is the author of Taming Oblivion: Aging Bodies and the Fear of Senility in Japan (State University of New York Press, 2000) and The Practice of Concern: Ritual, Well-Being, and Aging in Rural Japan (Carolina Academic Press, 2004), and co-editor of Imagined Families, Lived Families: Culture and Kinship in Contemporary Japan (State University of New York Press, in press), Demographic Change and the Family in Japan’s Aging Society (State University of New York Press, 2003) and Wearing Cultural Styles: Concepts of Tradition and Modernity in Practice (State University of New York Press, 2006). His work has appeared in many scholarly journals, including Alzheimer Disease and Associated Disorders, Research on Aging, Ethnology, the Journal of Cross-Cultural Gerontology, the Journal of Anthropological Research, and the Journal of Adult Development.
Local governments in Japan use a variety of contexts and media to construct and disseminate a public discourse on aging which situates senility within a conceptual frame that ties individual well-being to collective well-being and ideas about the social good. A variety of government-run facilities and programs—such as senior centers and senior activity programs—have been developed as contexts in which older people can engage in care of self and through that, it is hoped, avoid or delay the onset of senility. This is not only seen as being individually beneficial, but also as a social responsibility of older people. Well-being is achieved through self-discipline and self-cultivation, which are viewed as central in maintaining an integrated self. The collapse of this integrated self, evident through the onset of senility, is not only a problem for the well-being of the individual and his or her family, but is problematised as challenging the integration, and thus the well-being, of the social whole. This presentation considers the politics of senility in Japan, with a focus on how a discourse of non-use has emerged in relation to the recently promulgated national Long-Term Care Insurance (LTCI) program. Older people are encouraged to engage in self-discipline and self-cultivation through government (and other) organized facilities and activities in order to avoid using LTCI. Care of self can be understood as a central feature of a political economy of growing old in Japan in which the onset of senility is, in part, constructed in terms of burdening limited care resources.
View Associate Professor Traphagan's presentation (In Parts 1, 2 & 3 due to size):
Related Links and Resources:
Article by Associate Professor Traphagan: "Suicide"
Associate Professor Harry Minas, Director of the University of Melbourne’s Centre for International Mental Health and the Victorian Transcultural Psychiatry Unit
Presenter Bio: Associate Professor Harry Minas is the Director of the Centre for International Mental Health, School of Population Health, University of Melbourne, and the Victorian Transcultural Psychiatry Unit. Professor Harry Minas graduated in medicine and surgery, and medical science, from the University of Melbourne, and was elected a Fellow of the Royal Australian and New Zealand College of Psychiatrists in 1985. In 1988 he was invited to take up the position of foundation director of the VTPU. He has served as a member of the Executive of the Mental Health Council of Australia and on numerous state, national and international boards and committees, and has been a member of state and national ministerial advisory groups. He has led the development of research, teaching and service development activities in the area of transcultural mental health and in the field of international mental health development. He has been a consultant to the Commonwealth Department of Human Services, the International Organization for Migration, and the World Health Organization, and leads a WHO Collaborating Centre for Mental Health and Substance Abuse. Professor Minas was recently appointed to the WHO International Panel of Experts on Mental Health and Substance Abuse.
‘Chinese-Australians and Mental Illness: Knowledge, Popular Conceptions and Cultural Attributions’.
East Asian communities throughout Australia use public mental health services at substantially lower rates than do the Australian-born and European immigrant communities. There is no adequate explanation for this robust finding although there is considerable speculation concerning possible contributing factors. Among the possible contributors that have been consistently suggested are issues to do with popular conceptions of mental illness among such communities, cultural attributions for experiences of distress and dysfunction that are different to those of the dominant community and of health services, and lack of knowledge of ‘Western’ conceptions of mental illness. In this presentation an outline is given of PhD work carried out in Melbourne by Dr Fei-Hsiu Hsiao, who is now Assistant Professor, College of Nursing, Taipei Medical University, Taipei. The results of the work are considered in the context of the observed under-utilisation of public mental health services by the China-born population of Victoria as a basis for discussion of possible contributors to such under-utilisation by all East Asian communities and reflect on his vast experience in research into and service delivery to East Asian communities both within and outside Australia.
View Associate Profossor Minas' presentation: Minas
Related Links and Resources:
The Centre for International Mental Health
Related Articles
Hsiao et al.( 2006) "Cultural Attribution"
Hsiao et al. (2006) "Folk Concepts"
Klimidis et al. (2007) "Chinese Knowledge"
Midday session:
Greg Turner, State Liaison and Policy Co-ordinator, Queensland Transcultural Mental Health Centre
Presenter Bio: Greg has worked with the Queensland Transcultural Mental Health Centre for the past nine years and is currently the State Liaison & Policy Coordinator. For seven years Greg was the Education Coordinator with QTMHC and in that time developed numerous courses on transcultural mental health, delivering over 500 workshops, training sessions and conference papers across Australia. He is a registered psychologist with many years experience in mental health including operating a private practice and providing consulting services across Australia. Greg is also a lecturer with the University of Queensland, School of Medicine. In 2006 Greg developed a one-day workshop on Supporting the Emotional Wellbeing of International Homestay Students and has maintained an interest in this topic.
In this globalised new millennium the concept of the Boarding School has taken on an international perspective. Children and young people can be sent across the globe to receive their education while at the same time learn a new language and experience a new culture. While this can be an exciting learning experience it does also come with risks to mental health and emotional wellbeing. Migration to a new culture brings with it a range of potential mental health issues particularly related to acculturative stress. Temporary migration can bring a range of additional issues associated with the context of that migration and when these issues are being faced by unaccompanied children and young people there is a need to be vigilant to the potential mental health risk factors. The Homestay program enables children and young people to attend school in Australia while living with a host family. This presentation focuses on Japanese homestay students and explores how culture shock, acculturative stress, loss of language, living away from family, friends and homeland and other psychosocial stressors can lead to mental health problems for these young people concurrently experiencing adolescent development. These issues are explored within a developmental context and in consideration of temporary migration.
View Mr Turner's presentation: Turner
Related Links and Resources:
Queensland Transcultural Mental Health Centre:
www.health.qld.gov.au/pahospital/qtmhc/
Dr Tomoko Aoyama, Senior Lecturer in Japanese at The University of Queensland
Presenter Bio: Tomoko Aoyama is a Senior Lecturer in the School of Languages and Comparative Cultural Studies at the University of Queensland. She has published a number of journal articles and book chapters on topics ranging from male homosexuality in women’s texts, Japanese parody, the Russo-Japanese War literature, father-daughter relationships. Her monograph Reading Food in Modern Japanese Literature will be published by University of Hawaii Press in 2008. Her current research project (ARC DP) involves a series of studies of the representations of young women in Japanese literature.
The presentation focuses in particular on the notion of ‘liberation treatment’ that plays a significant role in the novel of Yumeno Kyūsaku (1889-1936) entitled Dogura magura. One of the main points of interest is the power of subversion Yumeno attaches to his representations of mental illness. The discussion includes socio-historical and cultural contexts of the novel with reference to the work of the pioneering Japanese psychiatrist Kure Shūzō (1865-1932).
View Dr Aoyama's presentation: Aoyama
Related Links and Resources:
With the kind permission of Professor Akira Hashimoto (Aichi Prefectural University), I have included some of his slides in my presentation.
Professor Hashimoto's presentation “Home Custody of Mental Patients in Modern Japan” is available at:http://www.lit.aichi-pu.ac.jp/~aha/New%20Delhi%20conference%202006.pdf
Afternoon session:
Professor Tian Po Oei, Director of The University of Queensland School of Psychology and the CBT Unit at the Toowong Private Hospital
Presenter Bio: Professor Oei was born and raised in Indonesia and educated in the Western world with a BA degree from Queens’ University in Canada, a Masters of Clinical Psychology degree from The University of New South Wales and a Phd degree from Newcastle University. His research interests are mainly in the areas of addictive behaviours, Mood and Anxiety disorders. He is one of the earliest researchers to study Group Cognitive Behavior Therapy (GCBT), and to study the role of specific and non-specific processes in influencing outcomes, in particular with Asian populations. He has more then 280 refereed publications in international and national journals and has contributed in all areas of assessment, theory and practice of clinical psychology. In the past 10 years, the focus of his research has shifted from outcome research to processes of change research. This is important because understanding the change processes allows us to do better CBT and thus will help reduce suffering among those with mental illness in a cost-efficient way.
In addition, Prof Oei acts as consultant to many universities around the world; for example he was a technical assistant consultant to the World Bank for the Faculty of Psychology, University of Indonesia, and was appointed as an Honorary Professor at the University of Flores in Buenos Aires. Professor Oei is a former (1992-2002) member of the editorial board of Behavior Research and Therapy. At present he is Professor of Clinical Psychology at the University of Queensland, a Fellow of the Australian Psychological Society and a member of the editorial board of the Journal of Anxiety Disorders. He was the founder of the Asian CBT conference where the 1st Asian CBT conference was held in Hong Kong in 2006. Professor Oei has also been an enthusiastic teacher and supervisor through out his career; winning the University of Queensland award for Excellence in research higher degree supervision in 2004 and the Carrick Awards in Excellence for teaching and learning in 2006 and 2007.
This presentation evaluates the validity of Cognitive Behaviour Therapy (CBT), now widely used in Asia; in particular Beck’s cognitive theory. This is important given that it remains unknown whether the Beck cognitive theory of depression can be used in Asian populations.
View Professor Oei's presentation: Oei
Related Links and Resources:
Dr Ahmed Munib, Principal Psychiatry Registrar, Barwon Health-The Geelong Hospital, Victoria
Presenter Bio: Dr. Ahmed Munib is presently Principal Psychiatry Registrar at Barwon Health, The Geelong Hospital, Victoria. Dr. Munib completed his PhD in the Department of Psychiatry, The University of Melbourne, Victoria in 2006. He also acquired an MPhil degree in Psychiatry from the University of Dhaka, Bangladesh (his country of origin), where he has previously worked as a psychiatrist. Dr. Munib’s research interests include Transcultural and Social Psychiatry as well as psychopharmacology. He has presented at numerous seminars, symposia and conferences, including the 2007 World Psychiatric Association Congress in Melbourne.
This PhD research project explores the relationship between postmigration experiences and psychological well-being within the Indian and Bangladeshi communities in Melbourne, Australia. This study aimed to examine personal accounts of adjustment and acculturation in a foreign society and the impact on mental health. The study focused on coping strategies and psychosocial protective mechanisms impacting successful and unsuccessful resettlement, and the concomitant effect on emotional well-being. The researcher conducted individual in-depth interviews with thirty-eight adult Australian permanent residents/citizens born in India and Bangladesh. The personal experiences of South-Asian migrants and the psychological consequences of resettlement in Australia were qualitatively explored, with identification of multiple interrelated themes and sub-themes. The qualitative results were complemented by correlation analysis, focusing on the discussion salience of themes/sub-themes described by participants. The results indicated that social isolation, alienation, non-recognition of professional skills, experiences of racial discrimination, cultural incongruity and disconnection, and inadequate English language competency, all contribute to psychological distress, adjustment difficulties and even repatriation to the country of origin. Co-ethnic density, social support/networking, intra-family cohesion, and retention of religious/cultural values/norms were associated with hybrid acculturation, acclimatization and successful resettlement in the host country. Networking with the local Australian society and acceptance of migrants were identified as promoting sociocultural integration, and exerting a protective effect against psychological distress in South-Asian migrants. The findings highlight that complex cultural and cross-cultural processes, in addition to psychosocial factors, are important in relation to post-migration psychological distress, and in determining the outcome of relocation and settlement in a new country.
View Dr Munib's presentation [Parts 1 -4 due to size]:
Related Links and Resources:
Dr Chohye Park, Consultant Child and Adolescent Psychiatrist, Hamilton CAAMHS, New Zealand
Presenter Bio: Chohye Park is a child and adolescent psychiatrist, currently working at Child and Adolescent Mental Health Service in Hamilton, New Zealand. Her research interests are immigrant children especially Asian children’s and teenagers’ mental health issues. She works with the Asian Mental health service in Auckland as an external supervisor and advisor.
The Asian population is the third largest in New Zealand, following the European and Maori, and the number of Asian young people has been growing rapidly since 1980. In addition, there is the transient Asian student population who choose to study in NZ. In spite of this the utilization rate of mental health services in NZ is extremely low and the presentations of Asian adolescents to child and adolescent mental health services are of an advanced stage of mental illness. This paper discusses the issues faced in looking after the Asian young population in NZ.
View Dr Park's presentation: Park
Related Links and Resources:
Dr Guy Ramsay, Lecturer in Chinese at The University of Queensland
Presenter Bio: Guy Ramsay lectures in Chinese language studies at The University of Queensland, Australia. His research interests encompass discourse analysis and intercultural communication studies, with a current interest in representations of health in Chinese communities, particularly mental illness. In 2007 Guy obtained an Australian Research Council Asia Pacific Futures Research Network grant to hold the “Mental Illness and Contemporary East Asian Communities: Responding to Culture” workshop.
This presentation demonstrates the value of written texts as a resource for exploring cultural understandings and experiences of mental illness. The author’s discourse analytic work on Chinese-language psychoeducational literature is drawn on to illustrate the extent to which such literature mediates its institutional setting of production, professionally derived content and cultural attributes of the intended audience. Differences explicated in the discursive makeup of psychoeducational literature sourced from indigenous settings (China and Taiwan) and the migrant setting (Australia) may see the communicative efficacy of the latter compromised. The author’s narrative analytic work on Chinese ‘patient’ and carer narratives reveals salient attitudes toward and responses to what are extremely problematic circumstances for Chinese families. The importance of the ‘social’ in informing these attitudes and responses is brought to light along with the tensions this produces for Chinese people with mental illness and their families. The text-based studies, therefore, can provide useful insights into the experience of mental illness for the ill individual and family caregiver alike and the salient cultural and social forces informing their experiences.
View Dr Ramsay's presentation: Ramsay
Related Links and Resources:
School of Languages and Cultural Comparative Studies, University of Queensland:
Thursday 7 February 2008
Associate Professor John W. Traphagan, Professor of Asian Studies and Anthropology at the University of Texas at Austin
This presentation focuses on some of the methodological, practical, and ethical issues that can arise when conducting ethnographic research specifically on mental health, but also more generally. The presentation explores questions such as: What constitutes a sensitive issue when collecting data in the field? How do cultural concepts and values influence the manner in which health and illness are understood and interpreted? What is the role of the "observer" in ethnographic research and how does one balance one's identity as anthropologist with that of community participant? In order to explore these questions, the presentation considers several major issues in Japanese culture, including suicide and local definitions of mental illness.
View Associate Professor Traphagan's Masterclass presentation (Parts 1 & 2 due to size):
Related Links and Resources:
Caroline Lenette, Program Coordinator, Promotion, Prevention and Early Intervention Team, Queensland Transcultural Mental Health Centre
Presenter Bio: Caroline is a second year PhD student at the Faculty of Health, QUT. Her thesis is entitled Resilience and Wellbeing among refugee women in Brisbane: an Ethnographic exploration. As her area of study suggests, she has a strong interest in gender issues, migration and refugee studies, and is keen to promote visual ethnography as a key method of qualitative research.
Caroline currently works for the Queensland Transcultural Mental Health Centre as a Program Coordinator in the Promotion, Prevention and Early Intervention team. She has worked for the Queensland Government over the past two years, mainly in multicultural affairs, as well as in developing and delivering training in cross-cultural practice.
Caroline holds a Bachelor in Human Services and a Masters in International Social Development. She has lectured and tutored students in the School of Human Services, Griffith University, and more recently, the School of Nursing, QUT, on multiculturalism, diversity and cross-cultural practice.
Caroline provides a subjective perspective on the difficulties of conducting research in the field of medical anthropology. These ranged from securing funding to the impact of community politics and frictions on her ability to conduct the project. She also broached the subject of qualitative researcher distress and highlighted the need for strong support networks for qualitative researchers to debrief on more strenuous aspects of their research. Her key message was that researchers in this field should dedicate time and effort in maintaining their own mental health in the process.
View Ms Lenette's presentation: Lenette_Masterclass
Masterclass Presenters: Ms Caroline Lenette and A/Professor John Traphagan