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ANZJP Correspondence

Mental health correlates of mental disorders should within one’s existing cultural schema
stigma and the not be taken at the expense of other (Haslam et al., 2007; Kleinman, 1980).
ingredients already known to be suc- Ultimately, we agree with Thomas
mind-body problem:
cessful at reducing stigma among (2013) that educating health-care pro-
Making the case for health professionals, like contact- viders about the biological correlates of
strategic collusion based education and a focus on recov- mental disorders may not, in itself,
Thomas Ungar1,2 and ery (Ungar and Knaak, 2013:2). overcome mind-body dualism.
Stephanie Knaak3 But we still need providers to Strategically colluding with the existing
see mental disorders as real and knowledge paradigm of health-care
1Psychiatry, North York General Hospital,
treatable in the first place. This is providers may, however, allow us to
Toronto, Canada
2Faculty of Medicine, University of Toronto, where working with and leveraging accomplish a more immediate and
Canada the existing knowledge paradigm of practical goal – improving the quality of
3Mental Health Commission of Canada, Calgary,
health professionals is likely to be care of patients with mental disorders,
Canada more productive than working reducing stigma and improving the
Corresponding author: against it. It has been our experi- experiences that patients with mental
Stephanie Knaak, Mental Health Commission ence, for example, that among physi- disorders have in their encounters with
of Canada, 320, 110 Quarry Park Blvd S.E. cians in particular, anti-stigma health-care professionals.
Calgary, Alberta T2C 3G3, Canada. interventions that focus on human-
ising mental disorders (through Funding
DOI: 10.1177/0004867413498279 contact-based approaches, for
This project was made possible through
example) tend to have low levels of funding from Opening Minds, the anti-
participation unless they also stigma initiative of the Mental Health
To the Editor include a component that teaches Commission of Canada. The work of the
about mental disorders and what Mental Health Commission of Canada is
In a recent Letter to the Editor, physicians can do to help. To this supported by a grant from Health Canada.
Thomas (2013) engages our discus- end, presenting physiological infor-
sion of mind-body dualism and its mation about mental disorders may Declaration of interest
contribution to mental health stigma help to ensure the necessary buy-in
The authors report no conflicts of interest.
among health professionals. He among physicians in the first The authors alone are responsible for the
insightfully points out that our sugges- instance, while also providing the content and writing of the paper.
tion to educate health professionals humanising component.
on the biological correlates of mental Cultural knowledge schemas are
disorders to assist them in overcom- deeply entrenched structures, resist-
ing the ‘functional vs. real’ divide does Brown T and Ka–tz B (2008) Change by Design: How
ant to change. Fields such as human
Design Thinking Transforms Organizations and
not successfully break down this dual- factors and design thinking focus on Inspires Innovation. New York: Harper Business.
ist paradigm but rather works within improving health-care quality within Haslam N, Ban L and Kaufmann L (2007) Lay con-
it. Thomas is correct: we are colluding a framework accepting of human limi- ceptions of mental disorder: The folk psychia-
with the dualist mindset. Although tations, and encourage design try model. Australian Psychologist 42: 129–137.
counterintuitive, we are doing so pur- Kleinman A (1980) Patients and Healers in the Context
affordances (i.e. designing around
of Culture: An Exploration of the Borderland
posefully and strategically. human limitations) as a way to pro- Between Anthropology, Medicine, and Psychiatry.
Thomas (2013:1) suggests that a vide more efficient and effective Berkeley: University of California Press.
more useful way to respond to the pathways to the desired result Thomas N (2013) Responding to mental
problem of mind-body dualism would (Brown and Ka– tz 2008; Vicente health’s mind-body problem. Australian
be to ‘conceptualis(e) distress in terms of and New Zealand Journal of Psychiatry.
2006). Working from an emic per-
Epub ahead of print 23 April 2013. DOI:
interactions between biological, emo- spective also finds support in cultural 10.1177/0004867413487232.
tional, cognitive, behavioural and environ- psychiatry. Inasmuch as we know Ungar T and Knaak S (2013) The hidden
mental factors’. We agree that a more that different cultural groups have medical logic of mental health stigma.
sophisticated understanding of mental different ways of explaining and mak- Australian and New Zealand Journal of Psychiatry.
disorders can be achieved by human- Epub ahead of print 12 February 2013.
ing sense of mental disorders, anti-
DOI: 10.1177/0004867413476758.
ising the experience of mental dis- stigma efforts are likely to be more Vicente K (2006) The Human Factor: Revolutionizing
tress. As we argue, educating successful if they acknowledge, the Way People Live with Technology. New York:
professionals about the organic understand and seek change from Routledge.

Australian & New Zealand Journal of Psychiatry, 47(11)

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