Summary Almost everyone continues to develop throughout life, but at no time is development more marked than in childhood and adolescence. Culture can influence this process in many ways and mental health clinicians and researchers need to be aware of this. Everyone has some sort of family, and definitions and compositions of families are changing all the time. Children are dependent on families in many ways so the family structure needs to be taken very much into account. A third area, apart from culture and family, that must be considered is the potential cultural mismatch between young people and their carers, which may affect presentations to mental health services. The relationship between culture and mental illness has been discussed elsewhere in this volume, so here I focus on the impact of culture on the practice of child and adolescent psychiatry and the context in which this psychiatric specialty is practised.

Culture is defined by each person in relationship to the group or groups with whom he or she identifies. An individual's cultural identity may be based on heritage as well as individual circumstances and personal choice. Cultural identity may be affected by such factors as race, ethnicity, age, language, country of origin, acculturation, sexual orientation, gender, socioeconomic status, religious/spiritual beliefs, physical abilities, occupation, among others. These factors may impact behaviours such as communication styles, diet preferences, health beliefs, family roles, lifestyle, rituals and decision-making processes. All of these beliefs and practices, in turn can influence how patients and heath care professionals perceive health and illness, and how they interact with one another. (Task Force on Spirituality, Cultural Issues, and End of Life Care, 1999: p. 25.)