Promotion

14 MENTAL HEALTH PROMOTION
have problems dealing with their mental world are probably best understood as victims
of circumstance rather than adding to their problems by blaming them for their
inabilities to cope. And if society were organized differently, then it might be possible
for people to enjoy better mental health than many do at the moment.
Around the world, societies clearly are different. And in consequence the overall
level of mental health differs from one society to another (Wilkinson 1996, 2005), but
also the meaning of ‘mental health’ alters.
The fact that mental health and mental illness have been characterized by various
Western authors in essentially individualistic ways says more about their cultural
values, norms and academic orientation than it does about the reality of people’s mental
experiences. 5 In other cultures this emphasis on individualism cannot be assumed to
be the norm. In Japanese culture for example, the idea of ‘self’ is experienced as ‘one’s
share of the shared life space’ – a much more interdependent notion of ‘self’ (Markus
and Kitayama 1991).
Another example of this cultural variation is that there are times when ‘resilience’
is not appropriate – times when it is all right not to cope. And these times and circumstances
are different from culture to culture (the British ‘stiff upper lip’ is not universal).
In other cultures, the point at which resilience and coping become inappropriate will
vary. Another variation is whether things like ‘resilience’ – or even mental health in
general – is seen and experienced as a personal, social, religious or spiritual issue.
Ideas about mental health and mental illness are, according to Haque (2005: 184)
‘addressed minimally in Eastern cultures’. He observes that there continue to be
apprehensions, myths and taboos about mental illness in the East, and in this respect,
there are similarities with how it is viewed in the West. That said there are interesting
and important Eastern perspectives that need to be addressed – both in this chapter and
by mental health and mental health promotion services.
To a large extent, this variation of ideas and experience of mental health and
mental illness derives from the various religions around the world. The general belief
within Islam is that mental disorders are an outcome of abandoning or neglecting of
Islamic values. Similarly, within Christianity, true mental health is not possible without
the right relationship with God. In Islam, the idea of balance is important – the
balance between the body’s need for physical pleasure and spiritual adherence. The
belief is that movement away from God causes imbalance resulting in mental malady,
whereas purification of thought and deed leads a person closer to God and keeps them
mentally healthy. In the Quran, the state of mental health or psychological well-being
is referred to as inshirah al sadr or taqwa, and other references are made to psychological
imbalance (dhaiq al sadr); psychological stress (dhaiq nafsi); a stressed life (hayatan
dhaniqah) (Haque 2005).
Chinese culture identifies health with good emotional state. The circulation of ch’i
influences the body’s basic function and is in turn affected by the emotions. Anger
makes the ch’i rise; joy relaxes it; sorrow dissipates it; fear makes it go down; cold
contracts it; heat makes it leak out; fright makes its motions chaotic; exhaustion
consumes it; worry congeals it. Balance is again a key idea. In Chinese culture, the
individual is responsible for the society rather than the other way around. Society
cannot be blamed for one’s emotions and their influence on one’s ch’i.
In Buddhist philosophy, life is full of sufferings (dukkha) for those who crave for