The European Psychiatric Association Guidelines on Cultural Competency – Summary

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The European Psychiatric Association Guidelines on Cultural Competency

EPA guidance on cultural competence training. Schouler-Ocak, M., Graef-Calliess, I. T., Tarricone, I., Qureshi, A., Kastrup, M. C., & Bhugra, D. (2015). European Psychiatry, 30(3), 431-440. doi:10.1016/j.eurpsy.2015.01.012

 

What is Cultural Competency?

  • Cultural Competency as a skillset “that a clinician can employ to understand the cultural values, attitudes and behaviors of patients, especially those whose cultural background differs from that of the mental health professional”
  • Cultural Competence includes an awareness of the impact of the psychiatrists’ own ethno-cultural identity on their patients
  • Cultural Competence is a concept that captures the capacity to provide appropriate care for diverse patients, overcoming socio-cultural differences and other systemic challenges to reduce disparities with regard to mental health care provision
  • Cultural Competency is about respecting differences and making sure that these are bridgeable in order that they do not negatively impact upon the diagnostic and therapeutic process

 

Why is Cultural Competency needed?

  • Cultural Competence is necessary in clinical practice whereby the psychiatrist sees each patient in the context of the patient’s culture as well as their own cultural values and prejudices
  • mental health specialists regularly come into contact with patients from different cultural backgrounds
  • immigrants’ health, including mental health, is seriously affected by their trajectory and/or the social conditions in which they live in the receiving country
  • the ability to understand and be aware of cultural factors in the therapeutic interaction between the therapist and the patient
  • culture plays an important role in the symptom presentation of distress and illness
  • idiom of distress in which patients communicate with psychiatrists can vary considerably from culture to culture and many languages do not have equivalent words to describe various mental disorders
  • minority patients are not the only ones who have differing cultures. All patients and staff are shaped by their own cultures with respect to ethnicity, religion, professional world etc., which can be very different from those of the patients.
  • patients are not the only ones with culture. institutions have their own cultures as well which can produce barriers of various kinds, and minority groups may well face strong barriers to health care access
  • patients who are illegal or undocumented immigrants, asylum seekers, or refugees have a “fragile existence” which raises additional issues about clinical management best addressed by culturally competent therapists.

 

How does Cultural Competence play out in clinical management?

These are some of the culturally adapted interventions suggested:

  • the cultural values of the immigrant patient should be incorporated into therapy
  • if possible immigrant patients can be paired with therapists of the same cultural or ethnic group
  • mental health interventions should be easily accessible and targeted to immigrant patients’ circumstances
  • support resources available within an immigrant patient’s community, extended family members, and tradition should all be incorporated into therapy interventions
  • Interventions conducted in patients’ native or primary language
  • the incorporation of psychologically trained interpreters or culture broker into the treatment process
  • review the cultural formulation interview in DSM-5 in which a major effort was made to recognize the influence of cultural factors on psychiatric symptoms and disease entities

 

What are the benefits of Cultural Competency?

  • culturally knowledgeable therapists influence changes in attitudes and behaviors in patients
  • therapists who show multicultural competence receive higher ratings than therapists who do not show multicultural competence
  • Cultural Competence training presented to psychiatrists in the context of clinical practice and with organizational support can lead to progress made in decreasing ethnic disparities in care

 

What are some suggested methods of developing Cultural Competency?

  • using cases and case note reviews
  • participant observation
  • cultural consultation where members of staff present cases and experts can advise them on specific cultural issues
  • Interactive lectures and role play along with small group work can help staff understand the most effective ways of doing things and engaging patients
  • listening carefully to the patient
  • eliciting the psychopathology in a culturally appropriate manner
  • assessing needs and suggesting changes in management while looking at the outcome
  • therapist acknowledging their own personal prejudices and try and deal with them
  • avoiding assumptions and stereotyping to develop higher levels of empathy will produce better therapeutic engagement
  • cultural empathy can transcend language barriers as most of the communication occurs at a nonverbal level
  • Outcome indicators may be one way forward for measuring cultural sensitivity and Cultural Competency in an organization

 

In conclusion:

“Competent treatment of minority patients requires that mental health professionals are open to understanding the similarities and differences between more traditional and modern Western approaches. It is important to understand and emphasize that Cultural Competence is not a static phenomenon but a developmental process, which represents a continuum. It must be remembered that Cultural Competency should be tempered with what has been termed ‘‘cultural humility. Attaining a level of cultural proficiency indicates a level of Cultural Competence but this is not absolute and will need ongoing development.” And “individual learning is not enough to guarantee a sensitive approach to diversity at the organizational level”, “institutional Cultural Competence requires not only the recognition of the barriers that exist to quality care at a systemic, organizational, and institutional level but also the elimination of these”.

 

Récits de pratique d’intervenants en ligne

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L’équipe METISS vous présente sa dernière publication intitulée

Récits de pratique d’intervenants dans des organismes d’aide aux nouveaux immigrants. Guide d’animation.

Ce guide présente une série de récits de pratique recueillis par Catherine Montgomery, professeure au Département de communication sociale et publique de l’UQAM, et son équipe, auprès d’organismes communautaires oeuvrant auprès d’une clientèle immigrante. Ces récits servent à la fois à la valorisation des actvités de ces organismes et à la formation des bénévoles, stagiaires et futurs intervenants qui entrevoient côtoyer cette clientèle.

Ce guide est également disponible en ligne : http://www.sherpa-recherche.com/partage-des-savoirs/publications/

Bonne lecture!

Andréanne

Andréanne Boisjoli
Agente de mobilisation des connaissances
Équipe METISS

www.equipemetiss.com
Centre de recherche SHERPA
CSSS de la Montagne (CLSC Métro)

 

Services de prévention en petite enfance auprès des familles vulnérables : quelle accessibilité pour les mères immigrantes?

Entre-vues, le bulletin de l’équipe METISS, vous présente ce mois-ci les travaux de Ghayda Hassan, professeure en psychologie à l’UQAM, sur les critères d’admissibilités au programme SIPPE pour les mères immigrantes.

Entre-vues_vol4_no8_octobre2013_en_ligne

Vous trouverez tous les numéros d’ Entre-vues gratuitement sur le site Web du CSSS de la Montagne :

www.culturementalhealth.com/?attachment_id=3797

 

Dr. Cécile Rousseau on how identity affects mental health

Désolé, cet article est seulement disponible en Anglais Canadien. Pour le confort de l’utilisateur, le contenu est affiché ci-dessous dans une autre langue. Vous pouvez cliquer le lien pour changer de langue active.

The CBC speaks with Dr. Cécile Rousseau about psychiatry’s move toward integrating culture in training and psychiatric practices. Listen here for a fascinating dialogue about how this important aspect of identity is impacting the Canadian mental health context.  Dr. Rousseau is a professor in the Division of Social and Transcultural Psychiatry at McGill University in Montreal where she directs the Transcultural Child Psychiatry Clinic. She is also a member of the MMHRC steering committee.