Culture and psychiatric education

While mental illness has recently been framed in largely neurobiological terms as brain disease, there has also been an increasing awareness of the contingency of psychiatric diagnoses. In this course, we will draw upon readings from medical and psychological anthropology, cultural psychiatry, and science studies to examine this paradox and to examine mental health and illness as a set of subjective experiences, social processes and objects of knowledge and intervention. On a conceptual level, the course invites students to think through the complex relationships between categories of knowledge and clinical technologies (in this case, mainly psychiatric ones) and the subjectivities of persons living with mental illness. Put in slightly different terms, we will look at the multiple links between psychiatrists’ professional accounts of mental illness and patients' experiences of it. Questions explored include: Does mental illness vary across social and cultural settings? How are experiences of people suffering from mental illness shaped by psychiatry’s knowledge of their afflictions?

While mental illness has recently been framed in largely neurobiological terms as “brain disease,” there has also been an increasing awareness of the contingency of psychiatric diagnoses. In this course, we will draw upon readings from medical and psychological anthropology, cultural psychiatry, and science studies to examine this paradox and to examine mental health and illness as a set of subjective experiences, social processes and objects of knowledge and intervention. On a conceptual level, the course invites students to think through the complex relationships between categories of knowledge and clinical technologies (in this case, mainly psychiatric ones) and the subjectivities of persons living with mental illness. Put in slightly different terms, we will look at the multiple links between psychiatrists’ professional accounts of mental illness and patients' experiences of it. Questions explored include: Does mental illness vary across social and cultural settings? How are experiences of people suffering from mental illness shaped by psychiatry’s knowledge of their afflictions?

acad.ro

Cultural competence tends to become more and more important for the clinical practice in many European countries where the recent migration flow has created bigger demographic, ethnic and cultural heterogeneity. Yet, it has been promoted especially in the countries that, already for several decades, have evolved also on the political plan, from monoculturalism to bi- or even multiculturalism, such as Australia, New Zeeland, Canada or USA. Situated in the larger context of globalization, of the economic development still unequal between North and South, of the various changes of the policies regarding the labour right in the EU Members, but also of the international armed conflict areas leading to forced migration towards zones that can provide basic surviving conditions, Romania participates to the same population flow in which immigration and emigration are more and more dynamic. It can be foreseen that both the economic migration and the forced one will create also in our country a much higher ratio of communities with different cultural and linguistic origins (CALD - Cultural and Linguistic Diversity). Under these circumstances, providing competent and efficient mental health services and equal access to medical services will involve the development of training programmes for health professionals in order to offer them the cultural knowledge, the abilities and skills necessary for communicating with patients from other cultures. In this regard, an essential role is played by the medical anthropology whose potential is still unexplored in our country. The purpose of this article is to present some debates in the scientific literature, dedicated to cultural competence and its role in the field of clinical psychiatric practice, with a special focus on some of our contributions to modelling a culturally competent approach in the case of patients suffering from various psychiatric disorders.

2010

The experience of distress and illness, let alone the utilisation of services, are not just phenomena of natural science manifest in an individual patient but patterns which interact with the patient's milieu, cultural values and the wider society, including the relationship between the doctor or other therapist and the patient, and with the doctor's own ethnicity, theoretical assumptions and the professional and political status of psychiatry itself.'' Littlewood (1991)

Advances in Psychiatric Treatment, 2004

We discuss the complicated nature of communication between people from different cultural groups, perhaps using a second language. We focus on the fact that mental health practitioners and service users often have in common neither their cultural backgrounds nor their explanatory models of illness. Communication even in a shared language can be less than optimal as words carry multiple meanings. Consequently, consultations that involve culturally grounded explanatory models of illness challenge the professional. We give examples showing that reconciling different explanatory models during the consultation is a core task for psychiatrists and mental health practitioners working in multicultural settings.

Mental Illnesses - Understanding, Prediction and Control, 2012

Why the study of culture and its clinical application is important in mental health training and service? Mental health and illness is a set of subjective experience and a social process and thus involves a practice of culture-congruent care. Series of anthropological, sociological and cross-cultural research has clearly demonstrated a very strong ground in favour of this contention. An individual's cultural background colours every facets of illness, from linguistic or

Culture, Medicine and Psychiatry, 1996

Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psychiatric history who presented at the psychiatrist's office in 1989 with a three-week history of auditory hallucinations and delusions. History of present illness. The patient was in his normal state of good health until two years prior to presentation, when he stared developing intermittent acute backaches. He went to his physician and was told that he had kidney stones. Conventional medical treatment did not provide much alleviation of his symptoms, and Mr. A. gradually lost confidence in his Western-trained physician. Mr. A.'s back pain continued to flare up intermittently. After almost two years of treatment failures, Mr. A. was willing to try treatments from China. Three weeks prior to evaluation, he started practicing Qi-gong, a Chinese folk health-enhancing practice similar to Tai Chi, which consists of controlled, synchronized breathing and body movements, and is expected to have curative effects on physical illnesses. His practice of Qi-gong was intensive. Several days after starting these practices, he developed delusional and hallucinatory experiences, while he had never experienced before. These conditions persisted and intensified, interfering with his concentration, and prevented him from working as an engineer. His auditory hallucinations consisted of voices of supernatural beings communicating with him regarding how he should practice Qi-gong and delusions that he was contacting beings from another dimension. He returned to the Qi-gong masters for help, but they were unable to provide any relief. His wife, who was a registered nurse, became increasingly concerned over his inability to work. She consulted with a Caucasian psychiatrist co-worker from their health maintenance organization (HMO) who referred her husband to a Chinese-American psychiatrist in private practice. On presentation, the patient denied depressed mood,

. I. M. Salloum & J. E. Mezzich (Eds.), Psychiatric Diagnosis: Patterns and Prospects. New York: John Wiley & Sons., 2009