Page 161 - Hospital Authority Convention 2017

Symposiums

S13.1 Cultural Diversity 14:30 Convention Hall B

Culture and Mental Health
Bhugra D
Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK HOSPITAL AUTHORITY CONVENTION 2017
Culture is at the core of our being and functioning, influencing the way we think and the way we behave. Culture also dictates
what deviance is and how it is defined; it influences the way illnesses are identified and presented and how therapeutic
alliances are built. Cultural epidemiology looks at different rates of various mental illnesses across the globe and these
differences may be partly due to culture-specific patho-protective and pathogenic factors. Cultural competence is about
good clinical practice, where patients and their experiences are at the heart of all therapeutic interactions. Some conditions,
such as depression, are under-diagnosed in primary care all over the globe. There are many reasons for these variations,
which can be related to true differentials in prevalence rates but are also related to different explanatory models by patients
and their families. In therapeutic encounters these differences between patient and doctor, linguistic barriers and variations
in presentation can make a significant difference to clinical engagement. Such problems may also exist in secondary
mental healthcare services. Help-seeking behaviour also remains a problem, as cultures dictate what is normal and what is
abnormal. In addition, explanatory models are related to stigma associated with mental illness and to differing illness beliefs.
Psychiatric symptoms may be misdiagnosed in a number of ways as, for example, with somatic symptoms and cultural
idioms of distress in any culture. Cultural variations in response to medication and issues related to compliance are obstacles
in the pharmacological treatment of psychiatric illnesses. A novel approach to psychotherapy is also required, as cultures
can be socio-centric where the self is kinship based. Strategies such as the use of trained interpreters, raising awareness,
improved communication, a culturally sensitive approach to clinical practice, and various tools and models can help in the
diagnosis and management of psychiatric illnesses across cultures.

Wednesday, 17 May

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