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Minorities are almost part of every society and today minority exists in different forms like religious, cultural, ethnic, tribal, racial, linguistic, national, refugees, sexual and immigrant. Singh et al. (2009) pointed that, in most pluralistic societies social groups vary on a number of overlapping dimensions such as religion, caste, language, tribal / non tribal and geographical and so on and so forth.
Issues of cultural, linguistic, religious, and ethnic differences have taken renewed and increased importance in many countries, institutions and local contexts (Brug, 2007). Recognizing and accommodating diverse ethnicities, religions, languages, and values is “an inescapable feature of the landscape of politics in the 21st century” (United Nations Development Programme, 2004).
Mutatkar (2005) has pointed that, in most pluralistic societies social groups vary on a number of overlapping dimensions such as religion, caste, language, tribal / non tribal and geographical and so on and so forth. Berween, (2006) has reported that almost all societies are composed of at least two groups that differ in race, nationality, language, religion, class, or regional cultures. These societies are usually ruled by a dominant group or a coalition or alternatively by one determined minority that has a monopoly over the means of force. He described two main types of minority: Substantial (or permanent) minorities and Mechanical (or non-permanent minorities).
In social psychological literature, majority and minority groups usually are defined in terms of size (Leonardelli & Brewer, 2001), power and/or status (Blanz, Mummendey, Mielke, & Klink, 1998; Sachdev & Bourhis, 1991). Further more, Blanz, Mummendey and Otten (1995) avowed that the terms majority and minority reflect positive or negative social conditions and treatment. Minority denotes negatively stigmatized, ostracized, oppressed, and outcast individuals, whereas majority denotes positively valued or high status groups (Tajfel, 1981).
The widely acceptable definition for minority was given by Capotorti (1991) who defined “minority” as “a group numerically inferior to the rest of the population of a state, in a non dominant position, whose members being nationals of the state possess ethnic, religious or linguistic characteristics differing from those of the rest of the population and show, if only implicitly, a sense of solidarity, directed towards preserving their culture, traditions, religion or language”. Deschênes (1985) also defined criterion of citizenship for minorities as: “A group of citizens of a state, constituting a numerical minority and in a non dominant position in that state, endowed with ethnic, religious or linguistic characteristics which differ from those of the majority of the population, having a sense of solidarity with another, motivated, if only implicitly, by a collective will to survive and whose aim is to achieve equality with the majority in fact and law”. Eide (1993) also includes non-nationals in the concept of minorities in his final report to the UN Sub-Commission. He stated that: “minority is any group of persons resident within a sovereign state which constitutes less than half the population of the national society and whose members share common characteristics of an ethnic, religious or linguistic nature that distinguish them from the rest of the population”. These considerations are also relevant to the definition of United Nations (UN Department in Geneva. Geneva, July 1992, which states that there is such description of this concept, which one is widely used, namely “the minority is a national, ethnic, religious or language group distinguished from other groups on the terrain of a sovereign state”.
In literature specific minority like ethnic, racial and sexual minority mental health issues continue on focal point, while other form of minorities especially religious minority relatively obtain a less attention. Although it can be clearly attained from minority definitions that declaration of minority is not based on single trait, indeed it is based on non dominant position whose members vary from rest of the population on certain features and these features varies across societies. In Pakistani society, the declaration of minority is based on religion, though ethnicity exists but does not comes under regime of minority in Pakistan. Regarding minority and majority distribution of population in Pakistan, Census Organization of Statistics Division of Pakistan (1998) declared population of Pakistan more than 140 million (although at present informally is estimated up to 180 million). Census Organization of Statistics Division, 1998 (It was last and recent census conducted in Pakistan) officially figured religious demography of Pakistani population as approximately 96 percent of the population or 148.8 million people in Pakistan are Muslim who are considered as majority or dominant group, while 2.02 percent or 2.44 million people to be Hindu, 1.69 percent or 2.09 million to be Christian, and 0.35 percent to be “other,” including Ahmadis, Sikhs, Parsi, and Baha’i etc. In Pakistan Non Muslims are officially declared, considered and labeled as minority on the basis of having their non dominant position in all spheres of life, dissimilar in many characteristics like values, languages, customs, traditions, religious belief and practices.
Positive mental health is a value in its own right; it contributes to the individual’s well-being and quality of life; and also contributes to society and the economy by increasing social functioning and social capital. Positive mental health refers to human qualities and life skills such as cognitive functioning, positive self-esteem, social and problem solving skills, the ability to manage major changes and stresses in life and to influence the social environment, the ability to work productively and fruitfully and to make contributions to the community, and a state of emotional, spiritual and mental well-being (Hosman, 1999; WHO, 2001). In general, mental illness affects wide life aspects, ranging from internal world to external world, of people from all social, economic, geographic, age, gender, religious, and occupational groups. People with certain behavioral and emotional problems have been recognized by the societies in which they live as differing significantly from the general population (Thompson, 2007).
World Health Organization (WHO) has included mental well-being in the definition of health. WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” and has defined mental health as “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 or her community” (WHO, 2001). Although the regime of mental health is massive but certain ingredient like self esteem and depression are highlighted frequently and are considered as important indicators of well-being. Variables like self esteem and depression continued to be prime concern for researcher where the element of anger is relatively overlooked in studies. Additionally in mental health literature, multiparty studies of these three variables are not considered thoroughly.
Mental illness is considered as the product of a complex interaction among biological, psychological, social, and cultural factors. The role of any one of these major factors can be stronger or weaker depending on the disorder (U.S. DHHS, 1999). The evidence on the personal, social, and environmental factors associated with mental health and mental illness has been reviewed by a number of authors (HEA 1997; Lahtinen et al. 1999; Wilkinson & Marmot 1998; Eaton & Harrison 1998; Hosman & Llopis 2004; Patel & Kleinman 2003). Researchers have sufficiently demonstrated that discrepancies in health are intimately associated with differences in social, economic, cultural, and political circumstances (Bloom, 2001; Rogers, 1997).
Social divisions and inequalities are observable features of advanced societies and their study has been one of sociology’s main preoccupations. Many minority ethnic groups are subject to forms of social exclusion and marginalization (Ahmad & Bradby, 2008). The study of minority influence has a long tradition in social psychology (Crano & Seyranian, 2007; Moscovici, 1985; Mugny & Perez, 1991; Wood, Lundgren, Ouelette, Busceme, & Blackstone, 1994).
Bourguignon, Seron, Yzerbyt, and Herman (2006) have stated that human beings are prone to create hierarchies that relegate some groups to the bottom of the social ladder. Being part of a so-called low status group is not a pleasant experience because it is associated with prejudice and discrimination in all aspects of daily life.
According to Wittkower & Dubreuil (1968), social groups also become vulnerable to mental disease when they are reduced to positions of inferiority. Such seems to be the case for minority groups which have been ‘colonialized’ by a more powerful majority group. It has been suggested that colonialized groups suffer from a complex of depersonalization; that is, many persons perceive themselves in accordance with the stereotypes which the dominant group entertains about them. This complex of depersonalization undermines and confuses their ego identity and quo.
Belle & Doucet, (2003); Sidanius & Pratto (1999) have inscribed that; dispassionate analysis of discrimination reveals that members of subordinate groups lag behind dominants on many societal indicators. They earn less money, are more often unemployed, and have lower diplomas and poorer health than high status group members. All these aspects (Chakraborty & McKenzie, 2002; Klonoff, Landrine, & Campbell, 2000) should logically impact on their psychological well-being and, indeed, studies generally show that stigmatized group members have a higher prevalence of psychiatric disorders than their dominant counterparts. House, Landis & Umberson (1988) have also reported that people who are more socially isolated and people who are disadvantaged have poorer health than others. Cross & Phagen-Smith, (2001) and Kim, (2001) stated that minority groups based on ethnic are often deemed inferior to the dominant group and stress associated with such stigma can negatively impact individuals who are in the ethnic minority. Minority groups (Kusat, 2001) categorized by race, nationality and religion generally suffer from the prejudices of majority groups and especially from political authorities. Because of their stigmatized social status, minorities are believed to encounter discrimination at greater frequencies than non-minorities (Kessler et al., 1999).
The minority status stress model describes the unique or excess stress, as compared to general stress, to which individuals in oppressed groups are exposed as a result of their minority status in society (Allison, 1998; Meyer, 2003). Sociological and psychological researchers have promoted the conceptualization that groups occupying multiple disadvantaged social categories (e.g., race, ethnicity, gender, socioeconomic status, particularly stigmatized minority groups, are exposed to multiple risk factors and stressful social environments that may increase their vulnerability to the effects of stress and compromise their health (Allison, 1998; Meyer, 2003; Williams et al., 1994). Investigators have argued that minorities like ethnic experience stressors associated with their minority status, in addition to the daily life stressors that non minorities face, and that this heightened stress places them at increased risk for health and mental health problems (Allison, 1998; Harrell, 2000; Turner & Avison, 2003; Williams et al., 1997). Children in socially disadvantaged families are more likely to be exposed to multiple stressors, increasing their susceptibility to mental health problems (McLeod & Shanahan, 1996).
Further more, members of minority status groups tend to be well aware of their group’s devalued status (Jones et al., 1984) and recognize that they are likely to be seen and evaluated in terms of their devalued group membership (Goffman, 1963). Consequently, they live with the constant threat of becoming targets of prejudice (Crocker, Major, & Steele, 1998), at the same time as they tend to receive inferior treatment due to their group’s devalued status (Swim, Hyers, Cohen, & Ferguson, 2001; Swim, Hyers, Cohen, Fitzgerald, & Bylsma, 2003).
Exclusion from groups as a function of ethnicity (i.e. ethnic minority) contributes to depression and low motivation in adults (Baumeister, Twenge, & Nuss, 2002). Siegrist’s (2000) reported that exclusion from core social roles and from participation in society’s ‘structure of opportunities’ creates conditions that account for health disparities.
The Psychological Costs of Exclusion a sense of belongingness and attachment to others appears to be a universal need. Indeed, numerous theorists have argued that humans are motivated to seek inclusion and avoid exclusion (Michael T. Schmitt et al. (2003); Baumeister & Leary, 1995; Brewer, 1997; Maslow, 1968; Rosenberg, 1979; Williams & Sommer, 1997). Because ‘finding one’s place’ in the social world is necessary to subjectively experience one’s existence as meaningful (Simon, 1999), being rejected is likely to harm self-esteem and other markers of psychological well-being. Indeed, empirical research has found that being rejected by others causes psychological harm by increasing anxiety (Baumeister & Tice, 1990; Bowlby, 1973) and depression (Frable, 1993); lowering self-esteem (Leary, Tambor, Terdal, & Downs, 1995), and creating the feeling that one’s existence lacks meaning (Williams, Shore, & Grahe, 1998). Furthermore, literature suggests that, “The relationship between social exclusion and mental illness is complex, with many of the elements of ‘exclusion’ (low income, lack of social networks, joblessness) being in different circumstances both causal factors and consequences of mental illness” (Brown & Harris, 1978; Jahoda, 1979; Link et al, 1997; Perkins & Repper, 1996; Department of Health, 1999; Sartorius, 2000; Sayce, 2000).
However, it is a truism to state that people actually diagnosed with a significant mental illness are among the most ‘excluded’ in society (Sayce & Measey, 1999; Sayce & Morris, 1999; Sayce, 2000). Social exclusion may is a multidimensional process of progressive social rupture detaching groups and individuals from social relations and institutions (Power & Wilson, 2000). People, because of predetermined characteristics in life like caste, gender, religion etc. are faced with very different opportunities in life. They thus differ in schooling they get, education, health status, economic and social mobility, and capacity to influence social and political institutions affecting them. These various types of disadvantages are generally interlinked. Disadvantage in one dimension is reinforced by disadvantage in other dimensions. Social inequalities and injustices may mar individual and group potential (Singh, Pandey, Tiwari, Pandey, and Maurya, 2009).
When a minority group with a separate and distinct culture exists in a larger environment that is strongly influenced by a majority culture, the situation could provide an abundant source of potential problems. There might be conflicting attitudes, beliefs, and values; and differences in language, dress, behaviors, and traditions. Because of these cultural conflicts, it is often assumed that minority adolescents may have a particularly difficult time, since they can be caught between parents and older relatives who have deep roots in the minority culture, and teachers and peers who reflect the majority culture (Oetting, E. R. & Beauvais, F, 1991).
Further more; group inequality as result of cultural diversity may be threat to individual mental health. Despite the newly recognized advocacy and acceptance of cultural diversity, barriers associated with group inequality (Portes, 1996) remain entrenched and painful (Gurr, 1993; Perlmutter, 1992; Ponterroto, & Pedersen, 1993). These barriers are prime sources of various frustrations, violence, confrontations, drop-out, and stop-out rates in cross-cultural contexts (Brislin, 1981; Locke, 1992). Moreover, Trimble, Mason, & Dinges (1983) found that cultural differences are associated with isolation, passivity, increased stress, anxiety, depression, and other psychological problems.
Being a member of a minority group can have a number of psychological costs. Among members of disadvantaged or stigmatized groups, perceiving rejection by the dominant majority is likely to be psychologically costly (Schmitt, Spears & Branscombe, 2003). Membership in a minority group is frequently cited as sources of disparities. Relative to majority, members of minority groups experience poorer health status and greater disability (Institute of Medicine, 2002; Nelson, 2003). In many countries substantial disparities in health outcomes exist between ethnic minority groups (Bos et al., 2004; Davey Smith et al., 2000). Minorities disproportionately experience health problems because they are disproportionately of low socioeconomic status, and they are likely to suffer psycho physiological distress and depressive mood as a consequence (Kolody et al 1986).
Many researchers like Aneshensel & Sucoff, (1996), Brooks-Gunn, Duncan, Klebanov, & Sealand, (1993), Compas, Connor, & Hinden, (1998), Ensminger & Juon, (1998), Fitzpatrick, (1993), Fitzpatrick & LaGory, (2000), Jessor, (1992), Kandel, (1998), Loeber, Farrington, Stouthamer-Loeber, & Kammen, (1998), Resnick et al., (1997) have reported that low income and minority youth are at great risk for a wide range of problematic outcomes affecting their personal well-being. Studies indicate that children of ethnic minority groups are at risk of having more problem behavior than majority children (Bradley & Sloman, 1975; Ogbu, 1988; Pawliuk, Grizenko, Chan-Yip, Gantous, Mathew, & Nguyen, 1996; Rutter et al., 1974).
The impact of minority based on race and ethnicity on health has likewise attracted increasing attention. As with class and gender, race and ethnicity have been strongly correlated with poor health (Blake & Darling, 2000; Bolaria & Bolaria, 1994; Brancati, Kao, Folsom, Watson, & Szklo, 2000; Dana, 2002; Graham, Raines, Andrews, & Mensah, 2001; Schulz et al., 2000; Utsey, Ponterotto, Reynolds, & Cancelli, 2000). Headen, Manton, and Woodbury (2003) reported that there are racial disparities in health including mental health problems. Current epidemiologic evidence indicates significant and persistent ethnic group differences on virtually all major health status indicators in adults (NCCDPHP 2004; Williams and Jackson 2005), as well as in children (Chen et al. 2006).
Substantial research demonstrates that health outcomes are distributed unequally among diverse minority groups based on ethnicity. Choi et al. (2006) found that ethnic minority adolescents, specifically African Americans, Asian Americans, and Hispanic Americans, reported higher levels of social stress and mental distress compared with Caucasians. Rates of hypertension and related complications are significantly higher in Blacks than in non-Hispanic Whites or Asians (American Heart Association 2008). Studies have reported higher incidence rates of psychosis among ethnic minority groups in the UK as compared to dominant group (King et al. 1994; Van Os et al. 1996; Bhugra et al. 1997). Paranoia levels have been found to be consistently elevated among ethnic minority group of African Americans (Combs, Penn, & Fenigstein, 2002; Whaley, 2001a). There is a high prevalence of depression and suicide among Korean Americans (Hyun, 2001; Oh et al., 2002) than those noted by other Asian groups (Donnelly, 2001; Kim, 2002; Sung, 2005). Studies report significantly higher numbers of depressive symptoms among African Americans compared to dominant Whites (Amato, 1991; Jackson, 1997; Myers et al., 2002). There is evidence that member of certain minority groups experience higher rates of depressive symptoms (Crocker et al., 1998). Boydell et al. (2001), in the UK electoral wards within London found higher incidence of schizophrenia among ethnic minorities (Caribbean, African and all minorities).
Research continues to accumulate showing minority segregation based on racial and ethnic is related to poor health (Polednak 1997, Williams and Collins 2001). In this context researchers like, Suzuki, Alexander, Lin, and Duffy (2006) have also reported that, the prevalence of diagnosed psychopathology in children and youth varies depending upon racial/ethnic group membership. One of the reasons for these discrepancies may be that youth from certain racial/ethnic groups are more vulnerable to specific psychological disorders. Braveman & Egerter (2008) reported that, research indicates that socioeconomic status and race/ethnicity both contribute to disparities in health status. An analysis of nationally representative data reported (Harris, Gordon-Larsen, Chantala, & Udry, 2006) that minority adolescents and young adults in general reported worse health status, behaviors, and mental health symptoms.
Increased rates of mental illness in certain ethnic minority groups have been reported in the UK, with high community prevalence rates of depression in some South Asian groups (Nazroo,1997); high incidence rate of psychosis in African-Caribbean groups (Fearon , Kirkbride , Dazzan , Morgan , Morgan , Lloyd , Hutchinson , Tarrant , Fung , Holloway, Mallett , Harrison , Leff , Jones , Murray (2006); and higher rates of suicide in some South Asian groups (Neeleman J, Mak V, Wessely S (1997). Warheit et al (1973, 1975), reported that blacks have higher rates of psychiatric symptoms and dysfunction than whites on a number of scales e.g. anxiety, depression, phobia. Where Indian children who lives in Britain displayed higher levels of internalizing problems than did their dominant English peers (Atzaba-Poria, Pike, & Barrett, 2004).
In United States prevalence of mental health problems among different minorities Saluja et al. (2004) reported that, American Indian/Alaska Native youth (ages 11-15) are most likely to have depressive symptoms (29%) followed by Hispanic (21.7%), White American (18.4%), Asian American (16.6%), and African American (14.6%) youth. Similarly, a large body of literature indicates that Latin American (LA) youth in the United States (U.S.) report higher levels of internalizing problems than white non-Latino (WNL) youth including depressive (Joiner et al., 2001; Roberts et al., 1997; Siegel et al., 1998), anxious (Ginsburg and Silverman, 1996; Silverman et al., 1995), and somatic (PiËœna and Silverman, 2004; Varela et al., 2004) symptoms. Further more; racial minorities are more likely to experience a greater disability burden from mental disorders compared to Whites (Agency for Healthcare Research and Quality 2004; Good et al. 2003; US Department of Health, Human Services 2001).
It can be clearly insinuate from researches on mental health disparities, that minority individuals are more susceptible to mental health problem in many domains as compare to their dominant counterparts. Several studies suggest varying nature of factors that play prevailing role in minority mental health problems. To inspect dynamic impact of being minority on mental health of adolescents the present study is an attempt to investigate uncertain ties about the extent of mental illness among minority and majority religious groups.
For last few decades the phenomenon of psychological problems that emerged as a product of minority status particularly during adolescence is an attractive in the domain of social and developmental psychology. This study which compares minority and majority adolescent’s mental health problems prevalence differences may implicitly help to find out the role of social / cultural factors in development of psychological problems. Examining the role of minority position that predicts fluctuation in the mental health variables i.e. self esteem, depression and anger will provide a useful baseline for researcher and other mental health professionals. It will also serve to test assumptions revealed in the literature about difference of minority and majority adolescent’s mental heath problems.
The key focus of the study i.e. recommendations will be helpful to encourage the development of effective policies and strategies to contest racial discrimination against children of religious minorities in the areas of education, training, and employment. The factors associated and involved in making minority adolescents vulnerable to mental health problems play an important role in the development of psychopathology. The present study will also be useful for psychologists and other practitioners related to mental health discipline in order to pinpoint the causes and to prepare better strategies for prevention of such factors. Mainly it would be beneficial for the social policy makers as there is a dire need to make policies about youth issues specially minority one. In sum, researcher hope that this research work may somehow help to create understanding / awareness about core (central and peripheral) issues of mental health problems of minority youth in Pakistan in comparative context.
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