Mental Distress Related Beliefs and Practices among Buddhist Migrant Communities in the West

Mental health and illness research has undergone considerable change over the past decades with anthropologists gradually challenging the universality of the dominant psychiatric worldview and arguing for the cultural particularism of conceptions of mental distress. Arthur Kleinman has been particularly influential by introducing the concept of 'Explanatory Models' to refer to the ways mental difficulties are explained, understood, and experienced within a particular cultural group. Explanatory Models are strongly influenced by religion and in turn inform individuals' health seeking behaviours. Similarly, Mark Nichter's work on 'Idioms of Distress' has shown that the means by which people express distress take multiple forms (somatic complaints, religious performance, claims of spiritual possession, etc.) according to the cultural group's core values and norms. The particularistic view of mental health entails that some migrant minorities have understandings, expressions, and practices around distress that differ from the biomedical model prevailing in Western societies. These differences appear particularly pronounced where minorities hold religiously or spiritually influenced understandings of distress that are at odds with the Western medical secularism.
I thus propose to focus on Buddhist migrant minorities to explore the interplays between Western biomedical and non-Western spiritually informed ideas around mental distress. The research project will explore how interactions with the Western environment - in terms of infrastructure, medical systems, religious and health beliefs - impact on Buddhist ethno-minorities' understanding, management, and treatment of mental distress.
A qualitative methodology with comparative elements will be used. The research will focus on the Tibetan community in Switzerland and the Thai community in England. They each constitute sizeable national communities in Europe and represent two main Buddhist traditions, Mahayana/Vajrayana and Theravada. Comparing different Buddhist schools provides a better understanding of how Buddhism informs mental health beliefs and practices and the extent to which differences between schools of thought lead to variations in outcomes. Data will be gathered through semi-structured interviews and participant observation to allow the expression of beliefs and collection of data in a way that is less undermined by the researcher's cultural beliefs and preconceptions. Interview topics will include: ontologies and etiologies of mental distress, opinions on biomedical models, health-seeking strategies, pathways to care and obstacles to mental wellbeing.
While cultural conceptions of mental health among migrants are frequently researched, there is a dearth of studies about the dynamic interpenetrations of ideas relating to mental distress in a global context, i.e. how different cultural elements are combined into wider frameworks of understanding to produce new and diverse ways of approaching distress. Also, very little research has been conducted on Buddhist minorities' ideas and practices around distress, with studies focussing on larger migrant groups. Buddhist diasporas in Europe and the UK however are significant and growing. By better acknowledging their obstacles to mental wellbeing and their position in relation to dominant epistemological frameworks, social care and health policies can be improved to benefit these communities and religious minorities in general. Additionally, Buddhist ideas are of distinctive interest given their growing influence on Western mental health related policy and practice. Increased understanding of Buddhist perspectives shall improve the incorporation of Buddhist elements in Western practice, not least by involving and directly engaging with the Buddhist communities.