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

这个民族志研究的目的是探讨文化错位的问题，在伦敦北部的加纳社区如何看待什么是有效的心理健康治疗。文化错位被定义为“将一个人从一个由特定文化习俗组成的地点移走，并将他们安置在另一个由本质上不同的文化习俗组成的地点”（Dajani, 2018, 1）。通过在伦敦北部和加纳进行多地点的人口统计学研究，我将分析来自共同文化体系的这种身体和情感错位对加纳人对精神卫生保健的期望的影响，以及从家乡到东道国的信仰连续性和变化的想法。我将采访英国和加纳的精神病学家和患者，比较和对比这两个国家关于心理健康的观点。21世纪，在英国的加纳侨民人数翻了一番，超过113,000人，最近的一项研究发现，超过一半的加纳人患有心理社会压力（Awuah et al. 2018）。在脱欧后的英国，积极推行敌对的环境政策，加上作为少数民族的压力，助长了移民的不稳定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，并使治疗面临的挑战更加复杂。这种治疗也受到英国医疗保健中缺乏文化意识和制度化种族主义证据的影响，在英国，根据《精神卫生法》，黑人被拘留的可能性是其他人口的四倍（Singh et al. 2014）。本研究将探讨：a)英国的心理健康政策和社会保障；B)移徙如何影响对心理健康和自我认知的态度；c)家庭和东道国机构对精神疾病的概念。在医学人类学家亚瑟·克莱曼（Arthur Kleinman）开发的“疾病叙事”方法的基础上，克劳斯（krause）随后在伦敦对加纳人的研究中使用了这种方法，我将通过侨民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。叙事人种学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方法。通过详细说明具体案例，本研究将借鉴家庭和收容社区医疗多元化的明显主题，并将这些经验置于英国为移民提供心理健康的更广泛问题的背景下。

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.