Note from the editor

CrossCurrents

Several weeks ago I visited a therapist for an interview. When I arrived, I noticed that her door was slightly ajar. Taking this as a sign that she was free, I knocked quietly. The therapist came to the door and told me she was finishing up with a client. She later explained that the client was a male Orthodox Jew, in whose culture a man should avoid being alone with a woman who is not his wife unless other people are in earshot and have access to the room. This is an example of cultural competence in mental health care – services that are sensitive to and responsive to cultural differences.

In recent years, Canada has witnessed a mind-boggling expansion in the ethnocultural diversity of its population. According to Statistics Canada projections, about one in five people in Canada will be a member of a visible minority by 2017.

Despite our multicultural character, availability and accessibility of relevant, culturally competent health care is still lacking. Yet nowhere is the importance of culturally competent care greater perhaps than in the delivery of mental health services, where cultural issues and communication between client and care provider are a critical part of the services themselves. Indeed, culture plays a large role in shaping health-related values, beliefs and behaviour – how people seek help, communicate and interact with one another, how symptoms get manifested and what roles family and community supports play.

At the clinical level cultural competence means providing services that respond appropriately to a person’s unique cultural differences. But cultural competence extends far beyond the clinical encounter. It involves addressing broader, systemic issues such as disparities in health care engendered by racism and oppression.

This issue of CrossCurrents urges health care providers to embrace cultural diversity in their day-to-day practice and to help move cultural competence from the margins into the mainstream.

CAMH’s deputy chief of nursing practice, Rani Srivastava, opens with a call to action to health care providers, arguing that cultural competence is not merely a practice in itself, but that it should be a core component of any service. Sarah Hamid-Balma draws from her personal experience to discuss the importance of understanding cultural expressions of mental health issues. Kim Goggins discusses why quality interpretation services must be more accessible to clinicians and clients.

This issue also emphasizes the need for cultural competence at the systemic level. Anne Ptasznik’s article about Hong Fook, an ethno-specific mental health agency in Toronto, discusses some of the ongoing barriers to accessing mainstream mental health services. Avril Roberts’ article about racism and mental health challenges the mental health system to embrace an anti-oppression framework. Kim Goggins discusses how mainstream mental health and addiction services can partner with traditional faith communities and healers to improve client care. Finally, the Last Word column argues that incorporating Aboriginal traditions into mainstream mental health and addiction services will improve the quality of care for Aboriginal clients.

Enjoy this stimulating issue. Send us your comments and ideas. It is your input that furthers the dialogue around mental health and addiction issues.

Hema Zbogar
tel 416 595-6714
hema_zbogar@camh.net

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