Cross-cultural psychiatric assessment

Different cultures vary in their perceptions of mental illness (Karno & Edgerton, 1969), which can affect their utilisation of orthodox psychiatric facilities (Padilla et al, 1975;Sue, 1977). Mental health services may be seen by ethnic minorities as challenging the value of traditional support systems, reflecting dominant Western cultural values and harbouring implicitly racist psychological formulations. The clinician-patient interaction may become fraught with misunderstandings if the two parties come from different cultural backgrounds and bring distinct cultural expectations to the encounter. The concept of a core disease process with concentric rings of illness behaviour is a useful one, allowing the clinician to make sense of a diversity of surface phenomena which may all be related to a narrower range of disease categories. Thus, while the patient suffers from an 'illness', the clinician diagnoses and treats a 'disease' (Eisenberg, 1977;