At CTP we agree upon the following definition of Transcultural Psychiatry[1]:
"Cultural psychiatry is concerned with understanding the impact of social and cultural differences and similarities on mental illness and its treatment."[2]
We see neither culture nor mental disorders[3] as static. When a person moves to a new country he or she brings along a cultural background consisting of norms, values and specific patterns of behaviour and interaction that may differ from the new host country. The new host country however provides another framework for behaviour and interaction which leads to the creation of new patterns.
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The interlink between culture and mental disorders is described in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5):
"Mental disorders are defined in relation to cultural, social, and familial norms and values. Culture provides interpretive frameworks that shape the experience and expression of the symptoms, signs, and behaviours that are the criteria for diagnosis."
Hence, the encounter between the clinician and the migrant patient becomes of utmost importance. A patient-centered approach allows openness to facilitate mutual understanding and trust, making it possible to create a patient-clinician alliance which is necessary for successful treatment. This requires a specific framework for understanding cultural differences in the staff working with this patient group. This is commonly referred to as cultural competencies.
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The Cultural Formulation Interview (CFI) is an example of a tool developed to identify and cover the cultural issues and context of the patient.
As studies on the CFI and cultural competencies are scarce, we are conducting research aiming to provide new important knowledge about how cultural differences in the clinical encounter are understood and managed, and how they impact the treatment we offer.
[1] The concepts Transcultural-, Cultural-, and Cross-cultural Psychiatry are equated.
[2] Bhugra, Dinesh & Kamaldeep Bhui (eds): Textbook of Cultural Psychiatry (Cambridge University Press 2007).
[3] In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), a mental disorder is defined as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning."