Summary

In general, most recent researchers and mental health agencies conclude that there are only minor differences in the rates of mental health diagnoses across ethnic groups in the United States.

That is not to say that ethnicity and culture does not matter for mental health. Two areas where culture factors in are within the presen­tation of symptoms and also in the seeking of services. Cultural-bound syndromes are one example of different presentation (U.S. DHHS, 2001). Cultural-bound syndromes are clusters of symptoms that appear to be more prevalent in one culture than in another. For example, some Caribbean women pres­ent with ataque de nervios, which includes occurrences of crying, trembling, and ver­bal aggression (U.S. DHHS, 2001). Such syndromes are being investigated to see if they fit within traditional DSM categories or whether they belong in unique categories. Additionally, great caution must be taken by clinicians diagnosing schizophrenia in people who come from ethnic cultures different from their own. Some of the unique characteristics of this disorder (e.g., visual and auditory hal­lucinations and delusions) are quite common in many parts of the world in the context of traditional ceremonies, religious experiences, and spiritual rituals.

Although there are limited differences in the prevalence of mental health disorders, the majority of published studies have dem­onstrated that people from underrepresented minority groups utilize mental health services less than Whites and are less satisfied with those services (Harris et al., 2005; Novins, Harman, Mitchell, & Manson, 1996). For example, Harris et al. (2005) examined a large database (more than 200,000 people) and found that American Indians had greater unmet need than Whites, while African Americans, Asian Americans, Mexican Americans, and Central Americans used mental health services less than Whites.

Despite some clear cultural differences in aspects of mental health, research is lacking in terms of identifying cultural differences in family conflict and communication. While there are clear differences in family conflict patterns across cultures (e.g., Oetzel et al., 2003), these differences have not been tied to issues of mental health very well in the litera­ture. This is a clear limitation of the literature and a need for future research. For this reason, the remainder of this review will not make large distinctions about ethnicity and culture in family conflict and communication.