Cultural Competency in Mental Health

Individualism vs Collectivism Who you are and what you do is a reflection of yourself. Who you are and what you do is a reflection of your entire family

Cultural Patterns Individualism vs Collectivism Conceptual categories are useful for understanding cultural differences:

Individualism Collectivism Covert and Implicit Messages internalised Much non-verbal coding Reactions reserved Distinct ingroups and outgroups Strong Interpersonal bonds Commitment high Time open and flexible Overt and explicit Messages plainly coded Details verbalised Reactions on the surface Flexible ingroups and outgroups Fragile Interpersonal bonds Commitment low Time highly organised

Barriers to Seeking Help Awareness of services Language difficulties Cultural competence of health care providers Cultural mistrust Stigma

Collectivist Counselling Strategies To optimize counselling to newcomers creative adaptations of standard counselling practice are imperative. Continuous efforts to creatively and deliberately infuse collectivism and interdependence into counselling relationships will go a long way in counselling multicultural clients.

What is Cross Cultural Competence? Cross cultural competence can be viewed as a process AwarenessSensitivityKnowledge SkillsCompetence

The Cultural Competence Continuum

6 Major Dimensions to Cultural Empathy Understand and accept the context of family and community. Incorporate holisic healing practices from the client’s culture when possible. Become knowledgeable about the historical and sociopolitical background of clients. Be knowledgeable about the psychosocial adjustment Be highly sensitive to the oppression, discrimination, and racism Facilitate empowerment for clients

Seeking Help Existing community, lay healers and religious groups. Family members Family practitioner Possible referral to secondary care such as psychiatrists.

Scenario

Mental Health Across Cultures

Middle East Most medical schools in the Arab world have a rudimentary psychiatry programme. Little attention is given to teaching interviewing skills or changing attitudes toward mental illness. Clinical research is generally lacking. Clinical supervision is scarce. Little time is actually spent dealing with the patient and his/her mental issues. High Stigma attached to mental health issues

India The stigma associated with mental illness is arguably the greatest obstacle facing the mental health community in India. lack of appropriately trained mental health professionals Mistrust Religious beliefs

Asia Mental Health is influenced by emphasis on family Mental illness is often stigmatized and seen as a source of shame. Growing issue Befriending

C.r.a.s.h Model Culture: Examine your own cultural beliefs Respect: Demonstrate respect and be mindful of your gestures; e.g. not using too much of physical touch Assess: Language comprehension, health-literacy, and acculturation-level Sensitivity: Develop awareness on certain issues within a culture Humility: learn more about cultural competency, and be quick to apologize in the event of cultural mis-steps

Slow Down (Tone, Volume, Speed) Separate Questions Avoid Negative Questions Take Turns Be Supportive Check Meanings Avoid Slangs Naming Systems