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Ethnography and the role of culture in mental healthcare

Published online by Cambridge University Press:  20 August 2025

Piyush Pushkar*
Affiliation:
Clinical lecturer at the University of Manchester, UK, and a higher trainee in forensic psychiatry with Greater Manchester Mental Health NHS Trust, Manchester, UK. For his doctoral research he did ethnographic fieldwork with political activists campaigning against cuts and privatisation in the National Health Service (NHS), as well as the managers and politicians charged with administering the health service. His current research focuses on guilt and shame among mentally unwell people who have been convicted of a criminal offence.
*
Correspondence Dr Piyush Pushkar. Email: piyushpushkar@doctors.org.uk

Summary

This article responds to Wells & Giacco’s discussion of the theoretical frameworks that guide qualitative research. In addition to the methods they explore, I describe ethnography, focusing on the anthropological investigation of culture. I use examples from the research literature to highlight the unique values of ethnography. I describe what ethnography entails, before outlining illustrations of how ethnographic research has contributed to psychiatric clinical practice. Although it is difficult to generalise from the findings of ethnographic research, its focus on how social processes work and how people perceive them in a particular context makes it useful for advancing improvements in clinical care.

Information

Type
Commentary
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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Footnotes

Commentary on… Theoretical frameworks used to inform qualitative mental health research. See this issue.

References

Aggarwal, NK (2025) Cultural factors, social structures, and social determinants of health: the need for clarity in assessing psychopathology. Harvard Review of Psychiatry, 33: 5466.10.1097/HRP.0000000000000407CrossRefGoogle ScholarPubMed
Armstrong, N (2024) Collaborative Ethnographic Working in Mental Health: Knowledge, Power and Hope in an Age of Bureaucratic Accountability. Routledge.Google Scholar
Berwick, D (2013) A Promise to Learn – a Commitment to Act: Improving the Safety of Patients in England. Department of Health and Social Care (https://www.gov.uk/government/publications/berwick-review-into-patient-safety).Google Scholar
Berwick, D, Dixon, J, Ham, C (2016) Improving Quality in the English NHS: A Strategy for Action. King’s Fund (www.kingsfund.org.uk/insight-and-analysis/reports/quality-improvement).Google Scholar
Carpenter-Song, EA, Schwallie, MN, Longhofer, J (2007) Cultural competence reexamined: critique and directions for the future. Psychiatric Services, 58: 1362–5.10.1176/ps.2007.58.10.1362CrossRefGoogle ScholarPubMed
Cerwonka, A, Malkki, LH (2007) Improvising Theory: Process and Temporality in Ethnographic Fieldwork. University of Chicago Press.10.7208/chicago/9780226100289.001.0001CrossRefGoogle Scholar
Francis, R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. TSO (The Stationery Office).Google Scholar
Kleinman, A (1980) Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. University of California Press.10.1525/9780520340848CrossRefGoogle Scholar
Kleinman, A, Benson, P (2006) Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Medicine, 3: 1673–6.10.1371/journal.pmed.0030294CrossRefGoogle ScholarPubMed
Metzl, JM, Hansen, H (2018) Structural competency and psychiatry. JAMA Psychiatry, 75: 115–6.CrossRefGoogle ScholarPubMed
Mosse, D, Baker, D, Carroll, M, et al (2023) The contribution of anthropology to the study of Open Dialogue: ethnographic research methods and opportunities. Frontiers in Psychology, 14: 1111588.10.3389/fpsyg.2023.1111588CrossRefGoogle Scholar
Santiago-Irizarry, V (2001) Medicalizing Ethnicity: The Construction of Latino Identity in a Psychiatric Setting. Cornell University Press.10.7591/9781501718458CrossRefGoogle Scholar
Savage, J (2000) Ethnography and health care. BMJ 321: 1400–2.10.1136/bmj.321.7273.1400CrossRefGoogle ScholarPubMed
Shanley, O (2024) Independent Review into the Care and Treatment Provided by Greater Manchester Mental Health NHS Foundation Trust: Final Report, January 2024. NHS England.Google Scholar
Wells, I, Giacco, D (2024) Theoretical frameworks used to inform qualitative mental health research: a focus on positivism, interpretivism and critical realism. BJPsych Advances, this issue (Epub ahead of print: 31 Oct 2024). Available from: https://doi.org/10.1192/bja.2024.66.Google Scholar
Whittle, HJ, Kiely, E, Millard, I, et al (2024) The relational institution: an ethnographic study of recovery orientation and relational engagement on a psychiatric rehabilitation ward in London. BMC Psychiatry, 24: 738.10.1186/s12888-024-06140-0CrossRefGoogle Scholar
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