Ecological factors in psychological acculturation

The COVID-19 pandemic significantly changed the lives of a majority of the world's population. People have been encouraged to implement social distancing behaviors enforced by governments, and have experienced loss of employment or changes to their usual working environment. In the mental health sector, psychologists and psychiatrists have been forced to alter the standard care of patients without compromising safety. This article documents the experiences of the authors-mental health professionals in four countries, Canada, Russia, Australia and Japan-at the time of the COVID-19 pandemic, and offers recommendations on how clinical, training, and research practices may need to be adjusted to deal with lockdown situations. Clinicians adapted their usual best practices by learning new skills and updating their knowledge base. Mental health clinicians noticed that the pandemic led to symptomatic changes in some of their patients. Most clinicians moved towards providing telemental health services, such as conducting assessments and treatments remotely. Those who continued seeing patients in person employed personal protective equipment with various impacts on the clinician-patient relationship. The dilemmas of mass quarantines need to be carefully examined, as their effects on numerous health and psychosocial variables appear to be farreaching.

Testable assessment and therapy adaptations for Russians were outlined based on integrating clinical and cultural psychology perspectives.

Objectives-This study assessed cultural consultants' impression of the utility of an expanded version of the DSM-IV Outline for Cultural Formulation in cultural psychiatric consultation and identified ways to improve the usefulness of the cultural formulation. Methods-A structured interview and questionnaire on the use of the cultural formulation was administered to 60 consultants working for an outpatient Cultural Consultation Service (CCS).Results-Most consultants (93%) found the cultural formulation to be moderately to very useful. More than half (57%) had little or no familiarity with the cultural formulation before working with the CCS. The main suggestions for improvement of the cultural formulation were to expand sections on migration experience and include sections on religious and spiritual practice.Conclusions-Although many consultants had little previous familiarity with the cultural formulation, most found it useful in organizing their assessment and preparing consultation reports. The cultural formulation is a useful tool for nonmedical consultants and culture brokers, as well as for clinicians.Clinical work with diverse populations requires assessment and treatment planning that are sensitive to ethnocultural background and social context (1-3). To assist clinicians in identifying clinically relevant aspects of patients' cultural background, DSM-IV introduced an outline for cultural formulation (4,5). The cultural formulation has not been widely incorporated into standard clinical practice; however, and despite a report that identified the refinement of cultural formulation as a high priority in preparation for DSM-V (6), there are no published evaluations of its utility. This study assessed the usefulness of the DSM-IV Outline for Cultural Formulation from the perspective of consultants working for a Cultural Consultation Service (CCS) in an outpatient psychiatry department of a general hospital in Montreal, Canada (7). Disclosures CIHR Author Manuscript CIHR Author Manuscript CIHR Author Manuscript MethodsThe CCS is based in an urban area where 45% of the population comprises immigrants and refugees (8). The service receives requests for assistance from primary care providers and mental health professionals throughout the region who are facing difficulties with the assessment or treatment of ethnically diverse patients. The CCS has a clinical coordinator and a network of interpreters; cultural consultants, who are clinicians; and culture brokers, who are nonclinicians with specific cultural knowledge and who assist a CCS clinician in conducting the assessment.The CCS developed and uses an expanded version of the DSM-IV-TR (9) Outline for Cultural Formulation, which has specific questions on migration history, citizenship status, multiple cultural backgrounds and identities, and extended family network (the expanded version is available at www.mcgill.ca/ccs). Additional areas explored in this expanded version of the cultural formulation include details on migration trajectory (origins, re...

Background: Cross-cultural studies find that culture shapes people’s understanding of mental illnesses, particularly Depression and Schizophrenia. Aims: To compare individuals’ beliefs and attitudes toward Depression and Schizophrenia in Russia and the United States. Method: Participants ( N=607) were presented with vignettes of two diagnostically unlabeled psychiatric case histories and then answered questions regarding mental health literacy (MHL) and attitudes toward the person and the illness. Results: Our findings indicate that Depression was most often attributed to psychosocial stress while Schizophrenia was thought to be caused by biological factors. People from both countries considered those suffering from Schizophrenia to be unpredictable and dangerous. US participants were more likely to endorse lay and professional help for both disorders than their Russian counterparts. Russian participants reported being less likely to turn to someone they trust and more likely to deal with problems on their own. Russian participants were also more likely to view those with Depression as ‘weak-willed’ and leading an ‘immoral lifestyle’. Conclusion: Our findings further inform cultural understandings of these mental illnesses in an often neglected national group. Patterns suggest that both groups may benefit from exposure to corrective information about Depression and Schizophrenia.