According to Kartini Kartono (1989), so-called mental

disorders are a form of disorder and mental function disorder

or mental health caused by failure to react the adaptation
mechanisms of mental functions to external stimuli and
tensions to appear functional disorders or structural
disorders of one part, one organ, or mental psychiatric
system.
Three factors that affect mental disorders
according Kartono Kartini (1999), namely :
1. Internal factors
2. External factors
3. Intrapsychic process is wrong
WHO further specified that mental health is “ a state
of well-being in which the individual realizes his or
her own abilities, can cope with the normal stresses
of life, can work productively and fruitfully, and is
able to make a contribution to his her community
Community education and outreach programs are needed to
increase mental health service utilization in older ethic
minority population (Jang, Kim, Hansen, & Chiriboga, 2007)
Although mental health nurses care for cliens of all age
groups and all cultural groups, the current and future trends
in population projections do have major implications for
transcultural nursing and mental health services in the United
States.
 Consumers want an active role in the decision
making about their own mental health care and they
use numerous resources to make those decisions.

Offering support and clear communication can

be key to bringing about favorable outcomes for all
patients, but support and clear communication can
be more challenging for those patients, families, and
significant others from diverse cultural
 Diagnoses can be applied to patients that may
be inaccurate and if the cultural behavior were
understood and interpreted within the context of the
specific culture, a different diagnosis might be made
with different treatment or no diagnosis at all.
Inaccurate mental health labels can be applied
that will have a negative impact on an individual and
family for years and may not be congruent with the
values, beliefs, practices, and some of the patient’s
culture.
 Culturally competent nursing care for
patients from diverse cultures becomes crucial
in caring for patients with mental health
needs.
Nurses can become familiar with the
values, beliefs, and practices of the culturally
diverse groups to whom they do provide care.
This will enable them to acknowledge and
recognize common cultural needs of all
patients with mental health care needs.
A. Communicating with each patients is
important in caring for clients in
acculturally congruent and competence
manner.
B. Empathy is one of the most important
communication skills that transcultural
mental health nurses and other health
care providers can use with patients form
diverse cultural backgrounds.
 Such as schizophrenia, bipolar disorder,
psychosis, hallucination, and delusions. Transcultural
mental health nurse care for patients who have
diverse cultural values, beliefs, meanings, and
practices many of which are grounded in spiritual and
religious beliefs.
Spiritual and religious practices can play a very
influential role in enhancing mental health and
emotional stability. Taking into account of the
cultural values, beliefs, meanings, practices,
expression, and cultural norms of specific cultures
takes knowledge, experience, and patience in
acquiring these skills.
 It is important for nurses to explore
and reflect on their own cultural values,
beliefs, practices, expressions,
meanings, and own cultural norms in
order to identify and begin to
understand personal biases, prejudices,
and other barriers to caring for patients
in a culturally competent manner.
 Gordijn, Koomen, and Stapel (2001)
studied whether an individual’s level of
knowledge of cultural stereotypes about
minority groups was universal or whether
that knowledge was influenced by that
individual’s level of prejudice. Findings
indicated that an individual’s level of
prejudice was related to that individual’s
level of knowledge about cultural
stereotypes with minorities.
 In a study by Palmer et al. (2008) on
somatic complaints, mood and self-rated
health as predictors of arm pain, mental
health as found to be a strong predictor of
complaints of arm pain in adults from
British community. Beliefs about causation
and prognosis of arm pain were also
associated with persistence of symptoms.
 In mental health nursing, the
patient’s experience of pain can be
manifested in many different ways.
Unlike other somatic symptoms
frequently associated with mental health
issues, pain has a component that
includes emotional elements.
Psychosocial factors have been found to
influence pain.
Some question we can ask to help with a
cultural and social assessment are:

a. What is your primary language? Would you like

a translator?
b. How would you describe your cultural
background?
c. Who are you closed to?
d. Who do you seek in times of crisis?
e. Who do you live with?
f. Who do you seek when you are medically ill?
Mentally upset or concerned?
 REFERENCES
Andrews, Margaret M and Joyceen S. Boyle. 2008.
Transcultural Concept in Nursing Care. Fifth Edition.
China : Wolters Kluwer Health & Lippincott Wiliams &
Wilkins.
Sunaryo. 2004. Psikologi untuk Keperawatan. Jakarta:
Buku Kedokteran EGC.
Andrews, Margaret M and Joyceen S. Boyle. 2012.
Transcultural Concept in Nursing Care. Sixth Edition.
China : Wolters Kluwer Health & Lippincott Wiliams &
Wilkins.