Attitudes about depression and its treatment among mental health professionals, lay persons and immigrants and refugees in Norway

Background: Internationally, depression is a common psychological disorder whose treatment depends upon its identification by treating professionals as well as patient utilization of mental health care systems: the latter often being hampered by cultural differences between patients and health professionals. Method: The current study used vignettes of depressed patients which varied the culture and/or social circumstances of the patient to assess whether these variables influenced the conceptualization of depression and its treatment. Participants (N=722) included mental health professionals, lay people, immigrants, and refugees in Norway. Results: We found that immigrants and refugees, particularly those of non-western origin, endorsed different types of depression treatments from native Norwegians and mental health professionals, and judged who deserved treatment and who was overreacting based on the patient's culture and social circumstances, while native Norwegians did not. Limitations: While widely used cross-culturally, vignette methodology is limited in its generalizability to real clinical situations. Acculturation was not evaluated, which may have influenced the results. Conclusions: Findings support the integration of cultural competency ideals not only into treatment, but also into public health promotions of mental health services for lay people. (C) 2011 Elsevier B.V. All rights reserved.