The Clinical Ethnographic Interview: opening up the diagnostic process

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“Depression questionnaires were never set up for the world’s population. They were set up in the West,” says Denise St Arnault, professor in the University of Michigan School of Nursing. For decades researchers have shown the degree to which there is cultural variation in the experience of mental illness, and yet clinicians continue to mostly ignore this fact in their practice. With a background in psychiatric nursing, Saint Arnault has developed what she hopes will be a pragmatic solution, the Clinical Ethnographic Interview. It encourages the opening up the diagnostic process so that patients can introduce the clinician to their own cultural frames and understandings. She talks us through the steps of the interview, which includes exercises to draw the patient’s social networks, map out their body and sensations, and construct a lifeline.