Summary

Culture influences the way people understand and experience their mental health and the way they present this in a clinical setting. No presentation is accultural.

The DSM V provides an outline for developing a cultural formulation and based on this we offer an assessment tool for gathering the relevant and required information. Assessing cultural identity, the client’s explanatory model of their illness, determining what psychosocial factors affect their health, as well as identifying the cultural elements that influence the relationship between the client and the clinician are all vital to developing an appropriate cultural diagnosis and intervention.

Other issues that affect assessment, including Western bias in testing and screening procedures, are highlighted in this section. Screening tools and tests that have some validation on a cross-cultural population in New Zealand are presented (or linked to the Resources), as well as cautions about making diagnoses based on these alone. Using cultural competency skills when conducting mental health assessments for CALD clients is critical in establishing a good rapport and achieving engagement in mental health treatment.

Grieger (2008, p.137) notes that when conducting mental health assessments it is never appropriate to ask if culture is relevant to a client, but rather to ask “how is culture relevant to understanding [my] client?”

To achieve effective cross-cultural intervention and treatment outcomes, you need to continue to gain some practical examples and skills from the CALD 9 Working in a Mental Health Context with CALD Clients course for example, gaining understanding or skills on how to:

• develop rapport
• identify supports and stressors
• provide culturally appropriate screening
• improve on under- and over-diagnosis of depression, psychosis, stress related disorders
• work with a collaborative approach
• improve outcomes taking into consideration of ethnopharmacology
• create an appropriate treatment plan
• make referrals appropriately
• seek professional consultation
• continue your cultural competency development