Boston Globe Examines Need For Cultural Competency In Medical Care

Main Category: Mental Health
Also Included In: Public Health;  Primary Care / General Practice
Article Date: 26 Mar 2008 - 8:00 PDT

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The Boston Globe on Monday examined a "national push to offer more culturally sensitive mental health care to immigrant groups, often in small clinics in urban areas."

Since a 1999 surgeon general's report found that the "impact of culture has been 'historically underestimated,'" particularly among minorities with mental health illnesses, a "growing number of clinics focused on immigrants' needs have opened," the Globe reports. Health professionals who work with such patients often blend traditional practices of the patients' home countries with conventional Western treatments.

In recent years, mental health professionals in Massachusetts have launched a number of initiatives aimed at improving psychiatric care for immigrants, the Globe reports. For example, the Massachusetts Department of Mental Health has partnered with a team of researchers to educate primary care physicians about what physical symptoms could likely be signs of mental disorders in immigrants. Another effort by the Cambridge Health Alliance uses computerized educational programs in Portuguese, Spanish and Creole to show how physical ailments such as fatigue and intestinal problems, as well as emotional ailments such as homesickness or loneliness, can be signs of depression.

Devon Hinton, a psychiatrist at Arbour Counseling Services in Lowell, Mass., said each immigrant group has a different way of perceiving and explaining how their bodies work. For example, patients with English and German backgrounds often discuss "heart-focused" aliments when conveying anxiety, Latin American cultures refer to attacks of "nerves," and many Cambodians believe in the importance of wind, which they believe must exit regularly through their feet and hands, Hinton said.

Francis Lu, a cultural diversity specialist with the American Psychiatric Association, said U.S. health professionals might find it difficult to understand the different cultural needs of each patient. Lu said, "We don't know all the intricacies of hundreds of cultures, but that doesn't mean we throw up our hands," adding, "There's a certain body of knowledge that we're collecting. And at least we should know what we don't know" (Wen, Boston Globe, 3/24).

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