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Why does transcultural consultation matter?

Published online by Cambridge University Press:  13 August 2021

A. Quintão*
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
C. Santos
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
M.D. Urzal
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
I. Donas-Boto
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
F. Azevedo
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
M.M. Lemos
Affiliation:
Psychiatry Department, North Lisbon Hospital Center, Lisboa, Portugal
F. Coelho
Affiliation:
Psychiatry Department, North Lisbon Hospital Center, Lisboa, Portugal
J. Vian
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

Psychiatrists should be aware of the new challenges and needs that globalization poses.

Objectives

To highlight the need for a culturally sensitive approach to mental health.

Methods

Non-systematic review of “cultural consultation” on PubMed.

Results

Most people assume a direct connection between pathophysiology and clinical symptoms. However, evidence shows that the translation of pathophysiology and psychopathology into specific symptoms is mediated by cognitive processes and social interactions, which reflect models/practices specific to our culture. Patients focus on specific aspects of being sick, reinforced by cultural narratives or to fit expectations. Thus, people from different cultural backgrounds might have trouble communicating; cultural idioms of distress can be misinterpreted. The role of structural violence bestowed upon cultural minorities, which leads to discrimination and social exclusion, has extensively been studied as a risk factor for mental illness. Furthermore, ignoring cultural differences and diversity has been shown to contribute to healthcare disparities, hampering access to care and diminishing the quality of care received. In Canada, the Cultural Consultation Model provides cultural expertise, either by evaluating patients (preferably accompanied by the referring doctor, a translator and cultural mediator) for 1-3 sessions, providing recommendations to the referring doctor; or providing consulting to a referring doctor or organisation, through general guidance or discussion of specific cases.

Conclusions

In an evergrowing globalization process, we will inevitably have more contact with patients from culturally distinct backgrounds. To provide the best care, we must be aware of the ways in which culture can shape symptom expression, and take into account cultural explanations and preferences.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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