Cultural Competence in Evaluation: An Overview

My mission was clearly scripted: to treat the seriously mentally ill—those unfortunate individuals with schizophrenia, manicdepressive illness, depression, and serious anxiety disorders. After expending plenty of time, money, and effort learning conventional American medicine, I needed to deprogram myself from its reliance on deductive reasoning to solve medical problems while in Zimbabwe. I needed to unlock my intuitive mind, opening it to the mysterious realms of subculture and spirituality in order to work as a psychiatrist in this new culture. I didn’t have to junk those four years of medical school and another four years of psychiatric residency. I prescribed medications, performed physical examination, and made accurate diagnoses as per the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). But to go to Zimbabwe and simply apply DSM-IV and the American medical worldview would have been naïve and inaccurate. —Paul R. Linde (2001, pp. 53–54)