Guidelines for Training in Cultural Psychiatry

Kirmayer, Laurence J.; Fung, Kenneth; Rousseau, Cécile; Lo, Hung; Menzies, Peter; Guzder, Jaswant; Ganesan, Soma; Andermann, Lisa; McKenzie, Kwame

doi:10.1177/0706743720907505

Cited by 53 publications

(60 citation statements)

References 107 publications

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“…This is defined as a set of congruent behaviours, attitudes and policies that come together in a system or agency or among professionals and enabling effective working in cross-cultural situations [ 135 ]. In the context of health care, it involves understanding and appropriately responding to the unique combination of cultural variables—including ability, age, beliefs, ethnicity, experience, gender, gender identity, linguistic background, national origin, race, religion, sexual orientation and socioeconomic status—that the professional and client/patient bring to interactions [ 136 , 137 ]. The complexity of cultural sensitivity in clinical history and presentation must also be addressed.…”

Section: Main Textmentioning

confidence: 99%

Migrants’ and refugees’ health: towards an agenda of solutions

et al. 2018

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Despite the greatly increased numbers of migrants and refugees worldwide in recent years, insufficient attention has been paid to addressing their health needs. While a variety of international instruments assert the right to health, in practice, migrants and refugees—especially those awaiting clarification of their status, such as asylum seekers and those without documentation—often fall in cracks between service providers and humanitarian relief programmes at national and regional levels.This report provides a summary of the current state of knowledge regarding the health issues of migrants and refugees and of the extent to which they are being met. It highlights, through a series of case studies, the diverse approaches to policies, entitlements and services provided in different jurisdictions, ranging from regional (Europe) and country (Germany, Iran, Italy, Turkey, South Africa) levels to provinces and cities (Quebec/Montreal, Berlin). These provide evidence of successes and challenges and highlight areas requiring further effort, including in the domains of policy, service design and delivery, education and training, research and communication. They also underscore the challenges of highly neglected aspects such as mental health and the critical importance of developing cultural/transnational competence in the health professional individuals and institutions working with migrants and refugees.Results from discussions taking place in an M8 Alliance Expert Group Meeting (Rome, 23–24 June 2017) and from the literature are synthesised to develop an ‘agenda of solutions’. This agenda aims to provide a comprehensive framework, which bridges humanitarian, ethical and rights-based imperatives to provide a framework for action to tackle this crucial area.

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Section: Main Textmentioning

confidence: 99%

Migrants’ and refugees’ health: towards an agenda of solutions

et al. 2018

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“…Furthermore, migrants could have been less likely to consent to studies or some may have been excluded as fluent English was an inclusion criterion for all studies. Attentiveness to these questions helps them create reception arrangements in care centres and research protocols open to cultural diversity (Kirmayer et al, 2012). Although the object of this article is not to provide complete training for psychiatrists specializing in early management, we present several guidelines that are easy to apply for future cohorts using CAARMS.…”

Section: Make Professionals Aware Of Transcultural Issuesmentioning

confidence: 99%

Early intervention for everyone? A review of cross‐cultural issues and their treatment in ultra‐high‐risk (UHR) cohorts

Deriu

Moro

Benoit

2018

Early Intervention Psych

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This systematic review demonstrates barriers to the access to participation in early intervention research for migrants and ethnic minorities. This selection bias may result in lower validity for the CAARMS among these populations and thus in inadequate intervention programmes. Along with targeted studies, minorities' access to participation in UHR cohorts should be improved through 3 tools: interpreters at recruitment and for administration of CAARMS, a guide to cultural formulation and transcultural data collection.

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“…However, the assessment of these aspects may be laborious and time-consuming, added to the fact that it is not clear how this directly affects the treatment plan to be followed with the patient. Some of the clinical consequences of the lack of understanding of culture have been misunderstandings in clinical recommendations, incomplete assessments, misdiagnoses, lack of rapport in the doctor-patient relationship, poor adherence and improper treatment [ 60 ].…”

Section: Culture Mental Health and Ocdmentioning

confidence: 99%

“…The use of pharmacological treatments for OCD varies significantly among countries worldwide [ 73 ]. One of the differences observed among countries is that not all patients are being treated pharmacologically (44% OCD patients untreated in Brazil, 38% in Australia; in Italy, Japan and Spain nearly 100% of patients are on pharmacological treatment) [ 60 ]. In China, the search for pharmacological treatment is below 6% for most mental disorders [ 4 , 76 ].…”

Section: Pharmacological Treatment In Different Countriesmentioning

confidence: 99%

“…Among OCD patients, one-quarter receiving pharmacotherapy receive antipsychotics [ 60 , 77 ]. The country in which atypical antipsychotics for OCD are used the most, is Japan, probably with the highest Y-BOCS scores [ 60 ]. It is also important to emphasize the influence of public policies on each country regarding access to treatments, as well as subsidies for drug and interventions.…”

Section: Pharmacological Treatment In Different Countriesmentioning

confidence: 99%

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Influence of Culture in Obsessive-compulsive Disorder and Its Treatment

Nicolini¹,

Salín-Pascual²,

Cabrera

et al. 2018

CPSR

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Background: The aspects of cultural identity and its impact on obsessive-compulsive disorder (OCD) have been un-derstudied. There are different opinions, ranging from the idea that culture does not affect the symptoms of this condition to the idea that cultures with high religiosity may have more severity of OCD. Also, the concept of OCD has considerably var-ied across history and cultures, from being considered an issue related to lack of control of blasphemous ideas, and a part of anxious issues, to the description of complex neurobiological systems in its causation.Objective: The aim of this review was to address OCD as a well-characterized disorder with a proposed neurobiological ba-sis which may or may not have variations depending on cultural diversity. The question that was asked in this review is whether or not there are cultural differences in the manifestations of the OCD symptomatology and which factors of cultural diversity have a major influence on such manifestations along with the differences among some cultures regarding OCD is-sues, where the difference among countries has also been highlighted.Methods: A review of the literature was conducted that includes the following words: obsessive-compulsive disorder, cul-ture, cultural identity and religion in a period of 10 years.Conclusion: Cultural variations do not seem to differ from symptomatic clusters of OCD, which may be indicating that a se-ries of adaptive behaviors is evolutionarily evolving to be constantly altered, perhaps by well-determined pathophysiological mechanisms. Some aspects that have been related to some dimensions of OCD symptomatology are religion and religiosity, affecting the content of obsessions and the severity of manifestations. Properly evaluating the education background, access to health services, food, and the genetic structure of populations, using investigational instruments sensitive to these cultural elements, will increase our understanding of the importance of culture on OCD and its treatment.

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Guidelines for Training in Cultural Psychiatry

Cited by 53 publications

References 107 publications

Migrants’ and refugees’ health: towards an agenda of solutions

Migrants’ and refugees’ health: towards an agenda of solutions

Early intervention for everyone? A review of cross‐cultural issues and their treatment in ultra‐high‐risk (UHR) cohorts

Influence of Culture in Obsessive-compulsive Disorder and Its Treatment

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