Social Theory & Health

, Volume 16, Issue 4, pp 396–413 | Cite as

Revisiting Goffman: frames of mental health in the interactions of mental healthcare professionals with diasporic Muslims

  • Elise RondelezEmail author
  • Sarah Bracke
  • Griet Roets
  • Caroline Vandekinderen
  • Piet Bracke
Original Article


Despite indications that the mental health of diasporic Muslims is under pressure, some evidence suggests that they are under-represented in established mental healthcare services. Studies indicate that, although diasporic migrants are at higher risk for mental health problems, they do not find their way to established mental healthcare services. This issue has been identified, conceptualised, and approached from a variety of perspectives. Existing scholarship nevertheless provides no in-depth, dynamic understanding of what happens in the interactions between mental healthcare professionals and diasporic Muslims. In this contribution, we discuss and analyse the perspective of professionals providing mental healthcare services in Flanders (the Dutch-speaking part of Belgium). Based on snowball sampling, we conducted 31 in-depth qualitative interviews. We analysed our data according to a directed approach to content-analysis. Inspired by the work of Goffman, and with the objective of revisiting Goffman’s theory on frames in the light of several theoretical sensibilities that inform our empirical material, we attempt to disentangle the frames that professionals use when approaching diasporic Muslims with mental health problems. We discuss the most prevalent frames and identify a biomedical, a resocialisation, and a cultural-difference frame.


Mental health Diasporic Muslims Mental health professionals Frames Goffman 


  1. Allen, A. 1998. Power Trouble: Peformativity as Critical Theory. Constellations 5 (4): 456–471.CrossRefGoogle Scholar
  2. Appignanesi, L. 2008. Gek, slecht en droevig. Een geschiedenis van vrouwen in de psychiatrie van 1800 tot heden. Amsterdam: De bezige bij.Google Scholar
  3. Bäärnhielm, S., and M. Mösko. 2012. Cross-Cultural Training in Mental Health Care—Challenges and Experiences from Sweden and Germany. European Psychiatry 27: 70–75.CrossRefGoogle Scholar
  4. Bachrach, L. 1995a. Aspecten van deinstitutionalisering. In Rehabilitatie van de Chronische Psychiatrische Patiënt: Op weg naar een gemeenschapspsychiatrie, ed. G. Pieters, and J. Peuskens. Leuven: Garant.Google Scholar
  5. Bachrach, L. 1995b. Psychosociale rehabilitatie en psychiatrische begeleiding in de zorg voor chronische patiënten. In Rehabilitatie van de Chronische Psychiatrische Patiënt: Op weg naar een gemeenschapspsychiatrie, ed. G. Pieters, and J. Peuskens. Leuven: Garant.Google Scholar
  6. Barnes, C., G. Mercer, and T. Shakespeare. 1999. Exploring Disability. A Sociological Introduction. Cambridge: Polity Press.Google Scholar
  7. Billiet, J., and H. Waege. 2006. Een samenleving onderzocht. Methoden van sociaal-wetenschappelijk onderzoek. Antwerpen: De Boeck.Google Scholar
  8. Borah, P. 2011. Conceptual Issues in Framing Theory: A Systematic Examination of a Decade’s Literature. Journal of Communication 61: 246–263.CrossRefGoogle Scholar
  9. Borrell-Carrió, F., A.L. Suchman, and R.M. Epstein. 2004. The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry. Annals of Family Medicine 2 (6): 576–582.CrossRefGoogle Scholar
  10. Brah, A. 1996. Cartographies of Diaspora. Contesting Identities. London: Routledge.Google Scholar
  11. Bracke, S., and N. Fadil. 2008. Islam and Secular Modernity under Western Eyes. A Genealogy of a Constitutive Relationship. San Domenico di Fiesole: European University Institute.Google Scholar
  12. Braidotti, R. 2006. Transpositions: On Nomadic Ethics. Cambridge: Polity Press.Google Scholar
  13. Brickell, C. 2003. Performativity or Performance? Clarifications in the Sociology of Gender. New Zealand Sociology 18 (2): 158–178.Google Scholar
  14. Butler, J. 1988. Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory. Theatre Journal 40 (4): 519–531.CrossRefGoogle Scholar
  15. Butler, J. 1993. Bodies that Matter: On the Discursive Limits of Sex. London: Routledge.Google Scholar
  16. Butler, J. 1997. Excitable Speech: A Politics of the Performative. London: Routledge.Google Scholar
  17. Butler, J. 1999. Gender Trouble: Feminism and the Subversion of Identity. London: Routledge.Google Scholar
  18. Butler, J. 2009. Frames of War. When is Life Grievable?. Brooklyn: Verso.Google Scholar
  19. Buytaert, E., E. Vandedrinck, and G.M.D. Lemmens. 2009. Psychiatrische stoornissen bij migranten: feiten en hypothesen. Tijdschrift voor Geneeskunde 65: 1–8.Google Scholar
  20. Chakraborty, A.T., K.J. MCkenzie, S. Hajat, and S.A. Stansfeld. 2010. Racism, Mental Illness and Social Support in the UK. Social Psychiatry and Psychiatric Epidemiology 45: 1115–1124.CrossRefGoogle Scholar
  21. Crammond, B.R., and G. Carey. 2016. What Do We Mean By ‘structure’ When We Talk About Structural Influences on the Social Determinants of Health Inequalities? Social Theory & Health. Scholar
  22. Denzin, N.K., and Y.S. Lincoln. 2013. Collecting and Interpreting Qualitative Materials. Los Angeles: Sage.Google Scholar
  23. Doornbos, M.M., G.L. Zandee, J. Degroot, and M. Warpinski. 2013. Desired Mental Health Resources for Urban, Ethnically Diverse, Impoverished Women Struggling with Anxiety and Depression. Qualitative Health Research 23: 78–92.CrossRefGoogle Scholar
  24. Edgley, A., T. Stickley, N. Wright, and J. Repper. 2012. The Politics of Recovery in Mental Health: A Left Libertarian Policy Analysis. Social Theory and Health 10 (2): 121–140.CrossRefGoogle Scholar
  25. Engel, G.L. 1977. The Need for a New Medical Model: A Challenge for Biomedicine. Science 196 (4286): 129–136.CrossRefGoogle Scholar
  26. Engel, G.L. 1980. The Clinical Application of the Biopsychosocial Model. The American Journal of Psychiatry 137 (5): 535–544.CrossRefGoogle Scholar
  27. Esterberg, K.G. 2002. Qualitative Methods in Social Research. Boston: McGraw-Hill.Google Scholar
  28. Fadil, N., F.E. Asri, and S. Bracke. 2014. Islam in Belgium. Mapping an Emerging Interdisciplinary Field of Study. In The Oxford Handbook for European Islam, ed. J. Cesari. Oxford: Oxford University Press.Google Scholar
  29. Fossion, P., Y. Ledoux, F. Valente, L. Servais, L. Staner, I. Pelc, and P. Minner. 2002. Psychiatric Disorders and Social Characteristics Among Second-Generation Moroccan Migrants in Belgium: An Age- and Gender-Controlled Study Conducted in a Psychiatric Emergency Department. European Psychiatry 17: 443–450.CrossRefGoogle Scholar
  30. Fossion, P., L. Servais, M.-C. Rejas, Y. Ledoux, I. Pelc, and P. Minner. 2004. Psychosis, Migration and Social Environment: An Age-and-Gender Controlled Study. European Psychiatry 19: 338–343.CrossRefGoogle Scholar
  31. Goffman, E. 1956. The Presentation of Self in Everyday Life. Edinburgh: University of Edinburgh Social Science Research Centre.Google Scholar
  32. Goffman, E. 1961. Asylums. Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books.Google Scholar
  33. Goffman, E. 1974. Frames of analysis. An Essay on the Organization of Experience. Boston: Northeastern University Press.Google Scholar
  34. Grosz, E. 1994. Volatile Bodies: Towards a Corporeal Subjectivity. Bloomington, IN: Indiana University Press.Google Scholar
  35. Heinz, A., and U. Kluge. 2012. Editorial. Mental Health in Different Groups of Migrants and Ethnic Minority Within Europe and Beyond: Regional and Cross-National Challenges and Approaches in Research, Practice and Training. European Psychiatry 27: 1–3.CrossRefGoogle Scholar
  36. Hilderink, I., H. Van‘t Land, and C. Smits. 2009. Drop-out onder allochtone GGZ-cliënten. Zicht op de onderliggende factoren en aanbevelingen om drop-out te verminderen. Utrecht: Trimbos-instituut.Google Scholar
  37. Hoffer, C. 2009. Psychische ziekten en problemen onder allochtonen Nederlanders: beleving en hulpzoekgedrag. Assen: Van Gorcum.Google Scholar
  38. Hsieh, H.F., and S.E. Shannon. 2005. Three Approaches to Qualitative Content Analysis. Qualitative Health Research 15 (9): 1277–1288.CrossRefGoogle Scholar
  39. Inhorn, M.C., and G.I. Serour. 2011. Islam, Medicine, and Arab-Muslim Refugee Health in America After 9/11. The Lancet 378: 935–943.CrossRefGoogle Scholar
  40. Kapilashrami, A., S. Hill, and N. Meer. 2015. What Can Health Inequalities Researchers Learn from an Intersectionality Perspective? Understanding Social Dynamics with an Inter-Categorical Approach. Social Theory & Health 13 (3/4): 288–307.CrossRefGoogle Scholar
  41. Kluge, U., M. Bogic, W. Deville, T. Greacen, M. Dauvrin, S. Dias, A. Gaddini, N. Koitzsch Jensen, E. Ioannidi-Kapolou, R. Mertaniemi, I. Pucipinos, R. Riera, S. Sandhu, A. Saravry, J.J.F. Soares, M. Stankunas, C. Straβmayr, M. Weibel, A. Heinz, and S. Priebe. 2012. Health Services and the Treatment of Immigrants: Data on Service Use, Interpreting Services and Immigrant Staff Members in Services Across Europe. European Psychiatry 27: 56–62.CrossRefGoogle Scholar
  42. Kristiansen, K. 2004. Madness, Badness, and Sadness Revisited: Ontology Control in ‘mental health land’. In Gender and Disability Research in the Nordic Countries, ed. K. Kristiansen, and R. Traustadóttir. Lund: Studentlitteratur.Google Scholar
  43. Kruispuntbank Sociale Zekerheid. 2017. Aantal personen van buitenlandse herkomst 2015—Gent. Accessed 15 September 2017.
  44. Lawler, S. 2014. Identity. Sociological Perspectives, 2nd ed. Cambridge: Polity Press.Google Scholar
  45. Lay, B., C. Laubner, C. Nordt, and W. Rössler. 2006. Patterns of Inpatient Care for Immigrants in Switzerland: A Case Control Study. Social Psychiatry and Psychiatric Epidemiology 41: 199–207.CrossRefGoogle Scholar
  46. Lodewyckx, I., A. Janssens, P. Ysabie, and C. Timmerman. 2005. Allochtone en autochtone jongeren met psychische problemen en gedragsproblemen: Verschillende trajecten naar de hulpverlening?. Antwerpen: Drukkerij Peten.Google Scholar
  47. Lorant, V., C. Depuydt, B. Gillain, A. Guillet, and V. Dubois. 2007. Involuntory Commitment in Psychiatric Care: What Drives the Decision? Social Psychiatry and Psychiatric Epidemiology 42: 360–365.CrossRefGoogle Scholar
  48. McNay, L. 2000. Gender and Agency. Reconfiguring the Subject in Feminist and Social Theory. Cambridge: Polity Press.Google Scholar
  49. Niewenhuijsen, K., A.H. Schene, K. Stronks, M.B. Snijder, M.H.W. Frings-Dresen, and J.K. Sluiter. 2015. Do Unfavourable Working Conditions Explain Mental Health Inequalities Between Ethnic Groups? Cross-Sectional Data of the HELIUS Study. BMC Public Health. Scholar
  50. Pelters, B., and B. Wijma. 2016. Neither a Sinner Nor a Saint: Health as a Present-Day Religion in the Age of Healthism. Social Theory & Health 14 (1): 129–148.CrossRefGoogle Scholar
  51. Pieters, G., and J. Peuskens. 1995. Inleiding: Gemeenschapspsychiatrie en rehabilitatie. In Rehabilitatie van de Chronische Psychiatrische Patiënt, ed. G. Pieters, and J. Peuskens. Leuven: Garant.Google Scholar
  52. Pilgrim, D., and T.A. Carey. 2010. Contested Professional Rationales for the Assessment of Mental Health Problems: Can Social Theories Help? Social Theory & Health 8: 309–325.CrossRefGoogle Scholar
  53. Ponzoni, E. 2016. Reframing Cooperation: Challenges in Overcoming Tensions between Professional Services and Volunteer Organizations Providing Parenting Support in Immigrant Communities. Social Service Review 89 (1): 40–76.CrossRefGoogle Scholar
  54. Rechel, B., P. Mladovsky, D. Ingleby, J.P. MacKenbach, and M. MCkee. 2013. Health in Europe 5: Migration and Health in an Increasingly Diverse Europe. The Lancet 381: 1235–1245.CrossRefGoogle Scholar
  55. Reniers, G. 1999. On the History and Selectivity of Turkish and Moroccan Migration to Belgium. International Migration 37: 679–713.CrossRefGoogle Scholar
  56. Rissmiller, D.J., and J.H. Rissmiller. 2006. Evolutino of the Antipsychiatry Movement Into Mental Health Consumerism. Psychiatric Services 57: 863–866.CrossRefGoogle Scholar
  57. Roets, G., and R. Braidotti. 2012. Nomadology and Subjectivity: Deleuze, Guattari and Critical Disability Studies. In Disability and Social Theory. New Developments and Directions. ed. D. Goodley, B. Hughes, and L. Davis, 166–178. Basingstoke: Palgrave Macmillan.Google Scholar
  58. Rondelez, E., S. Bracke, G. Roets, and P. Bracke. 2016. Racism, migration, and mental health. Theoretical reflections from Belgium. Subjectivity 9(3): 313–332.CrossRefGoogle Scholar
  59. Rondelez, E., S. Bracke, G. Roets, C. Vandekinderen, and P. Bracke. 2017. Diasporic muslims, mental health, and subjectivity: Perspectives and experiences of mental healthcare professionals in Ghent. DiGeSt 4(1): 63–84.Google Scholar
  60. Sermijn, J. 2008. Ik in veelvoud. Een zoektocht naar de relatie tussen mens en psychiatrische diagnose. Leuven: Acco.Google Scholar
  61. Siller, H., W. Renner, and B. Juen. 2015. Turkish Migrant Women with Recurrent Depression: Results from Community-Based Self-Help Groups. Behavioral Medicine. Scholar
  62. Stein, L. 1995. Systeemaanpak van ernstig zieke chronische psychiatrische patiënten. In Rehabilitatie van de Chronische Psychiatrische Patiënt: Op weg naar een gemeenschapspsychiatrie, ed. G. Pieters, and J. Peuskens. Leuven: Garant.Google Scholar
  63. Stockman, R. 2000. Van nar tot patiënt. Een geschiedenis van de zorg voor geesteszieken. Leuven: Davidsfonds.Google Scholar
  64. Stone, A. 2005. Towards a Genealogical Feminism: A Reading of Judith Butler’s Political Thought. Contemporary Political Theory 4: 4–24.CrossRefGoogle Scholar
  65. Traustadóttir, R., and K. Kristiansen. 2004. Introducing gender and disability. In Gender and Disability Research in the Nordic Countries, ed. K. Kristiansen, and R. Traustadóttir. Studentlitteratur: Lund.Google Scholar
  66. Vandeurzen, J. 2010. Beleidsplan Geestelijke gezondheidszorg Vlaanderen. Brussel: Vlaamse regering.Google Scholar
  67. Vandekinderen, C., G. Roets, R. Roose, and G. Van Hove. 2012. Re-discovering recovery: Reconceptualizing underlying assumptions of citizenship and interrelated notions of care and support. The Scientific World Journal. Scholar
  68. Vardar, A., U. Kluge, and S. Penka. 2012. How to Express Mental Health Problems: Turkish Immigrants in Berlin Compared to Native Germans in Berlin and Turks in Istanbul. European Psychiatry 27: 50–55.CrossRefGoogle Scholar
  69. Verhaeghe, P.-P., K. Van der Bracht, and B. Van de Putte. 2012. Migrant zkt toekomst. Gent op een keerpunt tussen oude en nieuwe migratie. Antwerpen: Garant.Google Scholar
  70. Vlaanderen, Zorgnet. 2011. Goede zorg bij etnisch-culturele diversiteit. Brussel: Zorgnet.Google Scholar
  71. Wade, T.D., and P.W. Halligan. 2004. Do Biomedical Models of Illness Make for Good Healthcare Systems? BMJ 329: 1398–1401.CrossRefGoogle Scholar

Copyright information

© Macmillan Publishers Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Elise Rondelez
    • 1
    • 4
    Email author
  • Sarah Bracke
    • 2
  • Griet Roets
    • 3
  • Caroline Vandekinderen
    • 3
  • Piet Bracke
    • 1
  1. 1.Department of SociologyGhent UniversityGhentBelgium
  2. 2.Department of SociologyUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Social Work and Social PedagogyGhent UniversityGhentBelgium
  4. 4.Department of SociologyGhentBelgium

Personalised recommendations