Cross-cultural psychiatric assessment

Migration and asylum occur for a range of personal and geopolitical reasons. In an increasingly globalized world, migrants, refugees and asylum seekers show higher than expected rates of mental illness. Cultures and cultural identities strongly influence presentation, help-seeking and therapeutic alliance. Minority ethnic groups have higher than expected rates of psychiatric disorders, and their idioms of distress and pathways to care often vary compared with the majority population: thus, they need particular consideration in terms of their mental healthcare. Clinicians dealing with minority ethnic groups must use a culturally sensitive and appropriate approach. This paper highlights some of the factors that clinicians need to be aware of and take into account while planning therapeutic interventions. The authors make recommendations regarding assessment and management. Assessment must incorporate factors including primary language, religion, cultural identity and, where applicable, migration history. ‘Cultural competence’ must be a priority in developing and delivering services.