Transcultural mental health care issues of Ethiopian immigration to Israel

In Western societies abnormal behaviour is permitted and encouraged on specific occasions, such as Carnival and Halloween. However, in many parts in the world people are possessed by upernatural forces that speak through them, or have dreams and hallucinations that convey important messages to the community, including health perceptions and behaviours. What is an acceptable conduct for African immigrants in a Western community such as Israel and how is this interpreted? To illustrate the cultural component in mental health care and link this to mental health prevalence and patterns of mental disease, two patients who immigrated from Ethiopia are presented:(1) a young woman who tried to commit suicide, and who, on arrival at the hospital informed the physician that her situation was the result of possession by an evil spirit, the 'Zar'; (2) a 19-year-old student, who was brought by his older brother to the primary physician due to 'sensations in his head'. This article also presents unique causes and patterns for immigration of Ethiopian Jews to Israel that could have an imprint on the wellbeing of the newcomers. The conclusion is that marked sociocultural differences between immigrants and the host society and the lack of awareness of these differences by mental health professionals may influence rates and patterns of psychiatric hospitalisation even more than the immigration hardship itself. It is therefore essential that health providers make every effort to familiarise themselves with the cultural backgrounds and identities of their patients and equip themselves with the competences to engage actively and in the spirit of partnership with their patients, in order to provide them with appropriate and acceptable care.