Language, Culture and Mental Health

The increase in cultural and linguistic diversity of contemporary societies poses major challenges to mental health services across the world. Is it possible to work in ways that respect cultural and linguistic difference in multicultural societies? In this paper we focus on the difficulties raised by the use of interpreters in the diagnosis of depression. We use a simple thought experiment in the form of two fictitious vignettes to highlight important features of language-games, an idea introduced by Ludwig Wittgenstein in his late work, Philosophical Investigations. The thought experiment draws attention to the importance of culture and contexts in understanding the meaning of what people say when they feel sad. This is even more important in understanding the help that people expect under these circumstances. This has implications not only for how we understand the role of interpreters in clinical settings, but more generally it draws attention to the importance of respecting the many different understandings of sadness and unhappiness that are a prominent feature of non-Western cultures. We conclude attempts to impose Western biomedical interpretations of sadness and suffering on people from non-Western societies has no ethical basis, and is to be avoided.