Cultural Consultation: A Model of Mental Health Service for Multicultural Societies

Kirmayer, Laurence J.; Groleau, Danielle; Guzder, Jaswant; Blake, Caminee; Jarvis, Eric

doi:10.1177/070674370304800302

Cited by 227 publications

(108 citation statements)

References 28 publications

(2 reference statements)

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“…These themes and observations manifest in our ethnic minority patients with SPMI echo those of other cross-cultural clinicians in North America (e.g. Kirmayer et al in Montreal [10], Lu in San Francisco [31], and LewisFernandez in New York [12]). …”

Section: Direct Servicessupporting

confidence: 84%

“…These services range from increased training of the general staff in cultural competence to utilization of specially trained mental health translators and cultural brokers to ethno-specific mental health services [8,[10][11][12]. With one exception [13], matching clients with providers who speak the same language and have the same ethnic background, has been found to improve mental health outcomes [10-12, 14, 15].…”

Section: Introductionmentioning

confidence: 99%

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The Role of a Clinical Director in Developing an Innovative Assertive Community Treatment Team Targeting Ethno-racial Minority Patients

Law

2007

Psychiatr Q

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Assertive Community Treatment (ACT) is a well established, evidence-based approach for delivering psychiatric care to clients with severe and persistent mental illness (SPMI). Research shows that special populations such as refugees, recent immigrants, and persons from ethnic minorities with cultural and language barriers are among the hardest to serve and one of the most underserved groups of mental health patients. Focusing on examples of the Clinical Directors' three main task domains, this paper discusses the unique role of the Clinical Director in developing an ACT team that specifically serves ethno-racial minority patients. A program evaluation process to validate the effectiveness of the team illustrates the administrative role; a strategy to incorporate the culturally sensitive and competent "illness narrative" model in all clinical encounters of the team illustrates the direct service role; and clinical programming and research addressing the unique family psychoeducation and other needs of this special client population illustrates the clinical collaboration role. The role of the Clinical Director on this special ACT team fits well with that of a program level Clinical Director as described in literature. The role demands specialized clinical, administrative, advocacy, and evaluative skills emphasized in programs such as the Columbia University Public Psychiatry Fellowship.

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Section: Direct Servicessupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The Role of a Clinical Director in Developing an Innovative Assertive Community Treatment Team Targeting Ethno-racial Minority Patients

Law

2007

Psychiatr Q

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“…A poor use of public mental health services on behalf of immigrants has been described [9,10], which probably depends on immigrants' experience and/or perception of several barriers. Barriers may include a state of irregularity, poor understanding of local language, and differences in cultural background, which should be the target of specific strategies at individual, local and national policy levels [9,[11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Immigrants’ Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

Gramaglia

Gambaro

Rossi

et al. 2015

J Immigrant Minority Health

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A poor use of mental health services has been described in immigrants. We compared the sociodemographic, clinical and treatment features of immigrants and natives attending a Community Mental Health Centre (CMHC). 191 immigrants and 191 randomly selected natives applying to the Borgomanero CMHC between 1 January 2003 and 31 August 2013 were compared. Our sample consisted mainly of the so-called "economic" immigrant. Adjustment disorders and reaction to stress were the most frequent diagnoses; in most cases symptoms onset occurred after migration. Although treatment features overlapped in the two groups (duration, number of contacts), immigrants showed a higher frequency of treatment dropout. While it is necessary to improve access to mental health services for immigrants, for the "economic" immigrant it may be more important to focus on establishing a therapeutic relationship that can be experienced as reliable and trustworthy. The finding of similar pathways to access the CMHC in natives and immigrants is encouraging.

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“…We see a need for open, honest, and ongoing dialogue between providers and patients regarding the merits and limits of a broad range of approaches to health and well-being. This may include, for example, involving family members in treatment, use of culture-brokers, working in non-clinical settings, and collaborating with religious mentors and non-biomedical healers (Kirmayer et al 2003). …”

Section: Key Findings and Recommendationsmentioning

confidence: 99%

Reducing Disparities in Mental Health Care: Suggestions from the Dartmouth–Howard Collaboration

Carpenter‐Song

Lawson

Quimby

et al. 2009

Community Ment Health J

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This article presents recent collaborative efforts between the Dartmouth Psychiatric Research Center and Howard University to understand (and ultimately reduce) disparities in mental health care among African Americans. Researchers from Dartmouth and Howard recently formalized a longstanding collaboration through the support of a grant aimed at understanding recovery and rehabilitation for African Americans with severe mental illness. Grant-sponsored efforts have included two seminars between multi-disciplinary mental health researchers and clinicians to inform the implementation of a collaborative research and training program. This article outlines the prominent themes arising from these seminars on the issue of health disparities agreed upon by our multi-disciplinary research team. These are (1) situating disparity research in the context of social justice; (2) understanding trends in disparities; (3) promoting a sophisticated understanding of 'culture' and its role in disparities; (4) critically assessing strategies that attempt to mitigate disparities; (5) developing a reflexive research agenda.

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Cultural Consultation: A Model of Mental Health Service for Multicultural Societies

Abstract: The cultural consultation model effectively supplements existing services to improve diagnostic assessment and treatment for a culturally diverse urban population. Clinicians need training in working with interpreters and culture brokers.

Cited by 227 publications

References 28 publications

The Role of a Clinical Director in Developing an Innovative Assertive Community Treatment Team Targeting Ethno-racial Minority Patients

The Role of a Clinical Director in Developing an Innovative Assertive Community Treatment Team Targeting Ethno-racial Minority Patients

Immigrants’ Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

Reducing Disparities in Mental Health Care: Suggestions from the Dartmouth–Howard Collaboration

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