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LETTER TO EDITOR
Year : 2019  |  Volume : 7  |  Issue : 2  |  Page : 75-76

The use of explanatory model interview catalog in mental illness research


Department of Social Work, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India

Date of Submission08-Apr-2019
Date of Acceptance20-Jul-2019
Date of Web Publication02-Jan-2020

Correspondence Address:
Prof. Chittaranjan Subudhi
Department of Social Work, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIHS.JIHS_14_19

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How to cite this article:
Subudhi C. The use of explanatory model interview catalog in mental illness research. J Integr Health Sci 2019;7:75-6

How to cite this URL:
Subudhi C. The use of explanatory model interview catalog in mental illness research. J Integr Health Sci [serial online] 2019 [cited 2020 Feb 29];7:75-6. Available from: http://www.jihs.in/text.asp?2019/7/2/75/274524



Dear Sir,

Cultural influences on mental illness are ever gray area of research in the field of anthropology, psychiatry, sociology, and other allied social sciences. However, indigenous understating is highly necessary to understand the mental illness and its metaphors. Hence, culture plays an imperative role in presenting and managing mental illness. Cultural influences on practices have a high degree of influence on all the domains of mental illness, which include determinants, diagnosis, management, and help-seeking behavior. Every culture has a set of beliefs around illnesses, and these tenets explain what causes a particular illness, how it can be cured, how and from whom to seek help, how the victims respond to a specific therapy, and who should be involved in the process. Due to this cultural construction and complex phenomenon of mental illness, the researcher requires explanatory model interview catalog (EMIC) to do the research on this sphere. The paper discusses the use of EMIC in mental illness research.

Cultural relativists pointed out that the narration of mental illness and the person's social and cultural context cannot be stay isolated.[1] The concept of mental illness is a multifaceted one with the change of culture and time.[2] Glick has hypothesized that knowing a couture's chief sources of power (social, political, mythological, religious, and technological) allow to one's predict its beliefs about the etiology of illness and how to treat illness.[3] Cultural dynamics play an important role in health-care system.[4] Therefore, every culture determines its own society's health-care system.

In this regard, the explanatory model (EM) helps to understand the importance of culture and the cultural meaning to mental illness. The concept of “EM” was introduced by Kleinman, which is used to examine the health and sickness from a medical anthropological perspective.[5] EM indicates, “notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process.“[5],[6] It is very important to know a person's own ideas about his/her illness. This perspective helps us to determine the local concept of mental illness; how a person constructs his experiences about his illness; and help-seeking for these problems. Weiss has mentioned “consider people's own judgments about their susceptibility and the severity of their illness with references to benefits of and barriers to treatment as determinants of illness behavior and help-seeking.”[7]

EM is basically meant for the cultural study of the illness. It helps the researchers to collect the information in emic perspective. The term “emic” and “etic” are two different approaches which is widely used in anthropology. Through the emic approach, the researcher can collect information on local concepts of mental illness, includes perceived etiology, expected behavior of the mental illness, and reason behind to resort a particular healers/healing practices indepthly.[5],[8],[9] The EM of illness is different from general beliefs about illness. The lay perceptions EM of illness disclose the significance of a given health problem along with the treatment decision. It draws the beliefs systems about the particular illness. EMs model interrelate the illness beliefs, norms, experience, and treatment procedures which is called “hierarchy of resort” and “structure of relevance.” This EM also guides the healer to follow the certain treatment procedure also. EM of the mental illness encompasses a person's idea about the nature of their problem, its cause, severity, prognosis, and preferences for the treatment, including the history of the illness.[10]

EM of patient's and healers are the central component of every health-care system. The patient's EM deals with the emic approaches were the healers EM deals his own understanding about the illness and treatment procedure. Existing studies also highlighted that the choice of treatment is highly prejudiced by the EM of illness of the patient, family members, relatives, and community people.[11],[12],[13]

These different EM deals with five major components with small variations: etiology, onset symptoms, pathophysiology, course of illness (including both degree of severity and type of sick role-acute, chronic, and impaired), and treatment. This Kleinman has stated eight questions to measure the patient's EM of illness[5]: (i) what do you think has caused your problem? (ii) Why do you think it started when it did? (iii) What do you think your sickness does do you? (iv) How severe is your sickness? (v) What kind of treatment do you think you should receive? (vi) What are the important results you hope to receive from this treatment? (vii) What are the chief problems your sickness has caused for you? and (viii) What do you fear most about your sickness?

This EM gives a better understanding in the patient's personal and family members experience about the illness along with this it gives subjective experience about mental illness in its social or local context. This framework is embodied in locally adapted EMIC. EMIC is used as instruments for cultural epidemiological study to determine the distribution of categories in experience, meaning, and behavior in selected clinic and community populations. EMIC interviews are based on the local formulation of illness, which complements the diagnostic assessment frameworks of the International Classification of Disease and the Diagnostic and Statistical Manual of Mental Disorders. EMIC is allowed the researcher for both qualitative and quantitative set of questions.[14]

To conclude, the EMIC is highly acknowledged in the cross-cultural studies in the sphere of mental illness researches. EMIC helps the researchers to adopt an eclectic methodology which helps an in-depth understanding regarding the phenomenology of mental illness among the researched population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Siewert PA, Takeuchi DT, Pagan RW. Mental illness in a multi cultural context. In: Aneshensel CS, Phelan C, editors. Handbook of the Sociology of Mental Health. New York: Springer; 1999. p. 19-36.  Back to cited text no. 1
    
2.
Macklin R. Mental health and mental illness: Some problems of definition and concept formation. Philos Sci 1972;39:341-65.  Back to cited text no. 2
    
3.
Glick LB. Medicine as an ethnographic category: The Gimi of the New Guinea highlands. Ethnology 1967;6:31-56.  Back to cited text no. 3
    
4.
Satcher D. Mental Health: Culture, Race, and Ethnicity – A Supplement to Mental Health: A Report of the Surgeon General. U.S. Department of Health and Human Services; 2001  Back to cited text no. 4
    
5.
Kleinman A. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine and Psychiatry. Berkeley: University of California Press; 1980.  Back to cited text no. 5
    
6.
Lloyd KR, Jacob KS, Patel V, St Louis L, Bhugra D, Mann AH. The development of the short explanatory model interview (SEMI) and its use among primary-care attenders with common mental disorders. Psychol Med 1998;28:1231-7.  Back to cited text no. 6
    
7.
Weiss M. Explanatory model interview catalogue (EMIC): Framework for comparative study of illness. Transcult Psychiatry 1997;34:235-63.  Back to cited text no. 7
    
8.
Kleinma A. Concepts and a model for the comparison of medical system as cultural systems. Soc Sci Med 1978;12:85-93.  Back to cited text no. 8
    
9.
Weiss MG, Doongaji DR, Siddhartha S, Wypij D, Pathare S, Bhatawdekar M, et al. The explanatory model interview catalogue (EMIC). Contribution to cross-cultural research methods from a study of leprosy and mental health. Br J Psychiatry 1992;160:819-30.  Back to cited text no. 9
    
10.
Weiss MG, Sharma SD, Gaur RK, Sharma JS, Desai A, Doongaji DR. Traditional concepts of mental disorder among Indian psychiatric patients: Preliminary report of work in progress. Soc Sci Med 1986;23:379-86.  Back to cited text no. 10
    
11.
Padmavati R, Thara R, Corin E. A qualitative study of religious practices by chronic mentally ill and their caregivers in South India Int J Soc Psychiatry 2005;51:139-49.  Back to cited text no. 11
    
12.
Shankar BR, Saravanan B, Jacob KS. Explanatory models of common mental disorders among traditional healers and their patients in rural South India Int J Soc Psychiatry 2006;52:221-33.  Back to cited text no. 12
    
13.
Thara R, Islam A, Padmavati R. Beliefs about mental illness: A study of a rural south India community. Int J Ment Health 1998;27:70-85.  Back to cited text no. 13
    
14.
Paralikar V, Agashe M, Weiss MG. Essentials of good practice: The making of a cultural psychiatrist in Urban India In: Ancis J, editor. Culturally Responsive Interventions: Innovative Approaches to Working with Diverse Populations. New York: Brunner-Routledge; 2004. p. 95-116.  Back to cited text no. 14
    




 

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