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562 Annals of Global Health, VOL. 82, NO. 3, 2016 M a y eJ u n e 2 0 1 6 : 5 3 2 – 5 7 4 New and Emerging Priorities for Global Health Funding: Indian Council for Medical Research. Abstract #: 2.071_NEP One community at a time R.J. Bischoff 1, P.R. Springer1, N.C. Taylor1; 1University of NebraskaLincoln, Lincoln, NE, USA Program/Project Purpose: Mental health conditions continue to be one of the leading causes of disability worldwide. This is largely because adequate mental health care is not readily accessible in many parts of the world, including in many parts of the U.S. These disparities in access to care are the result of a complex interplay between availability of mental health care providers, affordability of care, and additional factors that influence the perception and acceptability of mental health care (e.g., stigma, culture, policy). Solutions that work must address this complexity. The purpose of this program was to develop a community partnership model to reduce mental healthcare disparities that address the complexity of challenges faced by underserved communities, locally and globally. Structure/Method/Design: Funded through a grant from the USDA, we have developed a model for reducing mental health care disparities around the world one community at a time. We used rural towns ( 18 years old treated for HCV with ribavirin and interferon combination therapy at King Faisal Hospital in Kigali, Rwanda from January 1, 2007 to December 31, 2014. Patient’s paper and electronic charts were reviewed for data collection. Approval for the study was obtained from the University of Maryland Institutional Review Board and King Faisal Hospital K-Ethics and Research Committee. Findings: The study included 69 patients; 52% were male, and the median age at the start of treatment was 48 years (range 2569). The majority of patients had HCV Genotype 4 (61%) and d practitioner often intuitively knows that the fit is good only insofar as it is therapeutically useful and that what is left out of the slotting of experience may be more useful (and valid) than what is hammered in. In many societies a psychiatric diagnosis has significance in political and l~gal arenas. In the former, it may be a reason why someone is judged disabled and found worthy of disability-based welfare support. In the latter, 1t may alter a citizen's rights and responsibilities. The power of an official psychiatric diagnosis in the modern state derives from its formal status as the bureaucratic standard for determining everything from competence to revise a will to access to welfare benefits. Increasingly, contemporary society medkalizes social problems (De Vries et al., eds., 1983). Alcohobsm, once a sm or moral weakness, is now a disorder. This is not purely arbitrary. Genetic factors and physiological processes are involved. But those factors and processes need to be regarded in a certain wa v _ ~ay, differently from the way we usually regard blue eyes, baldness: an mtolerance of strawberries, or an addiction to pasta-before we call them a disease. The same is true of drug abuse, certain kinds of truancy and ~elinquency for which children and parents were once held legally responSible to school authorities but which are now relabeled as conduct disorder and a wide range of the experienced problems of daily living, now called stress syndromes, which to a greater or lesser degree have biological ante.cederrts, correlates, and consequents. Medicalization-whether seemingly scientifically jw;tified or not-is an alternative form of social control, inasmuch as medical institutions come to replace legal, religious, and other community institutions as the arbiters behavior. This is not always undesirable. In certain societies medicalizamay authorize useful social change that is otherwise politically unacOOJ>tal>le. For example, Stone (1984) has shown that the American disabilsystem has come to rnedicalize problems of poverty, under- and · .1:me, and that of the patient, which includes the patient's interpretation. Validity is the negotiated outcome of this transforming interaction between concept and experience in a particular context. Thus, validity can be regarded as a type of ethnographic understanding of the meaning of an observation in a local cultural field. Let us return to the diagnosis of Mrs. Lin's disorder. For her Chinese internists and psychiatrists, the disorder is neurasthenia-a putative "chronic malfunction" of the cerebral t.'Ortex associated with nervousness, weakness, headaches, and dizziness, thought to be common among ..brain workers" and to have psychosocial as well as biological causes. But it is held to he a physical illness and therefore neither conveys the marked stign1a Chinese attribute to mental illness nor implies personal accountability for the associated physical impairment or emotional distress. The way in which Mrs. Lin presents her symptoms i• also influenced by the What Is a Psychiatric Diagnosis? 13 cat~go~y n~u.rasthenia, which is not only a technical psychiatric taxonomic e~tt.ty m Chma but one widely understood in the popular culture. Mrs. Lm s perception of her symptoms selects out and lumps together those symptoms that are familiar and salient to her, namely the ones that fit the popular. blueprint of neurasthenia. This prac'\ice is reinforced by the relatives,. fnends, and practitioners to whom she tells the story of her ill~ nes..
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Mental Health
According to the three articles, the social standards have a big influence on the mental
health of the people. Thus people from different social backgrounds and cultural backgrounds
should be treated differently. The social and cultural differences have a huge impact on the
development of the health problems. In addition, different people per...


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