The history and future of cross-cultural psychiatric services

Abstract

With cultural issues prominent in the United States today and with ongoing rapid changes in health care management and delivery, this paper discusses the shift from a genetic-type psychiatry (i.e., assuming that humans the world over are no different, and will react to given stressors in life in the same manner) to one recognizing that cultural beliefs, mores, peer pressure, family expectations, and other ingredients operate in unique combinations in various cultures and ethnic groups. These social and cultural factors can and will impact treatment modalities and outcomes. Literature reviewed herein illustrates the progressive stages of awareness and incorporation of cultural differences and the many ways they impact treatment. Unfortunately, the rise in managed, rationed health care threatens the future of this progression. It is essential that culturally-based managed care programs be developed and funded to ensure the availability of cost-effective treatment, through an integrated system of services, to patients of all cultural and economic backgrounds.

Towards culturally competent practice in child and adolescent mental health

“…These are consistent with other work which critiques the historical development of cross-cultural services and offer a model of service organization and development designed to meet the needs of ethnicminority families (Bhugra, 1999;Bhugra and Bahl, 1999;Moffic and Kinzie, 1996). Ethnocentric and particularly Eurocentric explanations of emotional and psycho-social development are not inclusive enough for the development of diverse ethnic-minority children.…”

Culturally competent protection of children's mental health

“…These are consistent with other work which critiques the historical development of cross-cultural services and offer a model of service organization and development designed to meet the needs of ethnic minority families (Moffic and Kinzie, 1996;Bhugra, 1999;Bhugra and Bahl, 1999). Ethnocentric, and particularly Eurocentric explanations of emotional and psychosocial development are not inclusive enough to encompass the developments of diverse ethnic minority children.…”

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

“…Those investigators found evidence of strong simultaneous belief in both systems. Other research on the effects of the penetration of the Western medical system into traditional societies indicates that with time, these two models eventually reach a level of acceptable integration (Beiser, 1985;Bilu & Witztum, 1994;Lewis-Fernandez & Kleinman, 1995;Kleinman, 1978;Kortmann, 1987;Moffic & Kinzie, 1996;Unschuld, 1976). However, given that acculturation is a lengthy process, it might be expected that full integration might encompass several generations.…”