The effect of cultural dislocation on the perception of mental health treatment in Ghanaian

这项民族志研究旨在探讨文化错位的问题，即伦敦北部的加纳社区如何看待有效的心理健康治疗。文化错位的定义是“将一个人从一套特定的文化习俗组织的地点转移到另一套完全不同的文化习俗组织的地点”（Dajani，2018，1）。通过在北伦敦和加纳进行多地点的研究，我将分析从一个共享的文化体系中产生的这种身体和情感上的错位对加纳人从他们的精神卫生保健中所期望的影响，以及从家庭到东道主环境的信仰的连续性和变化的想法。我将采访英国和加纳的精神科医生和患者，并比较和对比两个领域关于心理健康的想法。在英国的加纳侨民在21世纪世纪的规模翻了一番，达到113，000多人，最近的一项研究发现，超过一半的人患有心理社会压力（Awuah等人，2018）。在英国退欧后，积极推动敌对环境政策以及与少数民族有关的压力，为移民培养了一种不稳定的状态和情境诱发的压力因素，这增加了发生心理健康问题的风险，并使治疗遇到的挑战更加复杂。这种治疗也受到缺乏文化意识和英国医疗保健中制度化种族主义证据的影响，其中黑人根据《精神卫生法》被拘留的可能性是其他人口的四倍（Singh等人，2014年）。这项研究将探讨：a）英国的心理健康政策和社会保障; B）移民如何影响对心理健康和自我感知的态度;（3）家庭和收容机构中的精神疾病概念。基于医学人类学家亚瑟·克莱曼（Arthur Kleinman）提出的“疾病叙事”方法，克劳斯（Krause）随后在对伦敦加纳人的研究中使用了这种方法，我将通过散居者的个人心理健康经历来探索英国社会和医疗保健提供的背景。叙事民族志是一种通过讲故事的方式探索对话者的经历，从而更深入地与对话者接触的手段。通过详细介绍具体案例，本研究将借鉴家庭和医疗多元化的东道国社区内明显的主题，并将这些经验与英国移民心理健康规定中明显的更广泛问题联系起来。

This ethnographic study aims to explore the issue of cultural dislocation in how Ghanaiancommunities in North London perceive what constitutes effective mental health treatment.Cultural dislocation is defined as 'the removal of a person from a location organized by aparticular set of cultural practices and placing them in another location organized by asubstantially different set of cultural practices' (Dajani, 2018, 1). By undertaking a multisitedethnography in North London and Ghana, I will analyse the effects of this physical andemotional dislocation from a shared cultural system upon what Ghanaian people expect fromtheir mental health care, and ideas of continuity and change in beliefs from home to hostcontexts. I will interview psychiatrists and patients in both the UK and Ghana and compareand contrast ideas around mental health in both spaces.The Ghanaian diaspora in the UK has doubled in size in the twenty first century to over113,000 people and a recent study found that over half suffered from psychosocial stress(Awuah et al. 2018). The active promotion of a hostile environment policy alongside stressesrelated to being an ethnic minority in post-Brexit Britain has fostered a state ofprecariousness and situationally-induced stress factors for migrants which has heightenedthe risk of mental health issues occurring and made the challenges encountered withtreatment even more complex. This treatment is also affected by a lack of cultural awarenessand evidence of institutionalised racism within UK healthcare, in which black people are fourtimes more likely to be detained under the Mental Health Act compared to the rest of thepopulation (Singh et al. 2014).This research will explore: a) mental health policy and social provision in the UK; b) howmigration affects attitudes towards mental health and self-perception; and c) conceptions ofmental illness in home and host context institutions. Building on the 'illness narratives'approach developed by medical anthropologist Arthur Kleinman and used subsequently byKrause in her study of Ghanaians in London, I will explore the UK context of social andhealthcare provision through individual experiences of mental health in the diaspora.Narrative ethnography is a means of engaging with interlocutors in more depth by exploringtheir experiences through modes of storytelling. By detailing specific cases, this study willdraw on themes evident within home and host communities of medical pluralism andcontextualise these experiences within the wider issues evident in UK mental healthprovision for migrants.