Developing Culturally-appropriate Interventions in Mental Health Flashcards
What are the 5 definitions of ‘race’?
- Biological basis – disputed/discredited evidence
- Race science and racial hierarchies
- Visible, physical differences
- Often externally-classified
- Distinguish between large groups of people
- Highlight commonalities ‘human race’
- May also be self-ascribed
Visible, physical differences
This is known as…?
a. Culture
b. Ethnicity
c. Race
c. Race
Often externally-classified (e.g. different hair types, skin colour)
This is known as…?
a. Culture
b. Ethnicity
c. Race
c. Race
Distinguish between large groups of people
This is known as…?
a. Culture
b. Ethnicity
c. Race
c. Race
Highlight commonalities
This is known as…?
a. Culture
b. Ethnicity
c. Race
c. Race
May also be self-ascribed
This is known as…?
a. Culture
b. Ethnicity
c. Race
c. Race
Define Ethnicity
List 2 points
- Social characteristics of a group
- Common ancestry
Ethnicity can be defined as social characteristics of a group
What are the types of 3 social characteristics?
- Faith/religion
- Language
- Traditions
Ethnicity can be defined as having common ancestry as a group of people
What are common ancestries? List 2 points
- May share distinctive cultures
- Some overlap with nationality
Social characteristics of a group
This is known as…?
a. Culture
b. Ethnicity
c. Race
b. Ethnicity
Common ancestry
This is known as…?
a. Culture
b. Ethnicity
c. Race
b. Ethnicity
What are the 6 definitions of culture?
- Acquired/learned
- Non-biological
- Social aspects of human life
- Norms, Values, Beliefs, Symbols - ‘Fluid’
- Multi-cultural – societal / individual levels
- Professional cultures - Terminology e.g., ‘culturally informed’, ‘culturally sensitive’, ‘culturally appropriate’ ‘culturally-adapted’
Acquired/learned
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Non-biological
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Common ancestry
Social aspects of human life
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Norms, Values, Beliefs, Symbols
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Fluid
i.e. some people may say they belong to a group but this may change
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Multi-cultural – societal / individual levels
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
What does being ‘fluid’ mean?
Some people may say they belong to a group but this may change
Terminology
e.g., ‘culturally informed’, ‘culturally sensitive’, ‘culturally appropriate’ ‘culturally-adapted’
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
What are professional cultures?
e.g. Codes of conduct practiced between doctors, lawyers and other professionals
Languages used in the culture, not accessible or comprehensible to others outside of the cultural group
Doctors using certain terms that only other doctors understand
This is known as…?
a. Culture
b. Ethnicity
c. Race
a. Culture
Why does culture and mental health matter?
Culture and contexts shape individuals’ mental health
How does culture and contexts shape individuals’ mental health?
List 7 ways
- ‘Symptoms’, Presentation, Attribution, and Meaning
- Coping styles
- Family / community influences
- Help-seeking behaviours
- Stigma
- Insider/outsider perspectives
- Marginalisation
- Racism & discrimination
- Trust
Being marginalised is linked with ___ risk of mental health difficulties
a. Higher
b. Lower
a. Higher
‘Cultural formulation’ highlights the effect of culture on…?
List 3 points
- Symptom expression
- Definition of illness
- Treatment
How does ‘cultural formulation’ highlights the effect of culture on symptom expression?
Cultural Explanations ‘Models’ of mental Illness
How does ‘cultural formulation’ highlights the effect of culture on definition of illness?
Cultural factors related to the psychosocial environment
How does ‘cultural formulation’ highlights the effect of culture on treatment?
How can we work together with the patient to propose interventions that are deemed as acceptable?
Impact of culture/cultural identity on the clinician
patient relationship
simply = How does this person’s culture contribute to their mental health experience?
There is a(n) ______ in the incidence of psychosis and
schizophrenia among migrant and minoritised group
a. Increase
b. Decrease
a. Increase
There is an increase in the incidence of ____ and ____ among migrant and minoritised group
- Psychosis
- Schizophrenia
There is an increase in the incidence of psychosis and
schizophrenia among migrant and minoritised group
This is especially true for…?
a. White British people
b. People of Asian origin
c. People of African and Caribbean origin
d. People of Latin American origin
c. People of African and Caribbean origin
What are the schizophrenia rates (IRR) of Caribbeans compared to White British individuals?
IRR = 6.7
What are the schizophrenia rates (IRR) of Africans compared to White British individuals?
IRR = 4.1
What are the schizophrenia rates (CI) of Caribbeans compared to White British individuals?
CI = 5.4 - 8.3
What are the schizophrenia rates (CI) of Africans compared to White British individuals?
CI = 3.2 - 5.3
The schizophrenia rates of Caribbeans compared to White British individuals are …?
a. 3.5x higher
b. 8.9 x higher
c. 5.4 x higher
d. 6.7x higher
d. 6.7x higher
The schizophrenia rates of Africans compared to White British individuals are …?
a. 4.1 x higher
b. 6.2 x higher
c. 3.9 x higher
d. 7.4 x higher
a. 4.1 x higher
What % of migrant and
minoritised groups are more likely to access care via CJS (criminal justice system)
40%
What % of Black prisoners experience schizophrenia/ delusional disorder?
37%
What % of White prisoners experience schizophrenia/ delusional disorder?
9%
Migrant and minoritised groups experience ___ x more MHA (mental health act) detentions
a. 2x
b. 4x
c. 7x
d. 5.5x
b. 4x
What are the 3 negative pathways migrant and
minoritised groups go through in terms of psychosis?
- 40% more likely access care via CJS
- 37% Black vs 9% White British prisoners
schizophrenia/delusional disorder - 4x more MHA detentions
What 6 disparities do people of minority ethnic backgrounds experience in terms of psychosis care?
- More coercive care
- Worse clinical/non-clinical outcomes
- Lack of culturally-informed care
- ‘Culturally naïve’ staff
- Lack of psychological therapies
- Often labelled ‘hard-to-reach’
In terms of psychosis care, people of minority ethnic backgrounds experience often being labelled as…?
‘Hard-to-reach’
In terms of psychosis care, people of minority ethnic backgrounds experience lack of ____ therapies
Psychological therapies
In terms of psychosis care, people of minority ethnic backgrounds experience lack of ____ care
Culturally-informed care
In terms of psychosis care, people of minority ethnic backgrounds experience ___ outcomes
Worse clinical/ non-clinical outcomes
In terms of psychosis care, people of minority ethnic backgrounds experience more ___ care
Coercive care
In terms of psychosis care, people of minority ethnic backgrounds experience more coercive care
What is the evidence for this?
They receive higher rates injectable anti-psychotic mediation than their White Counterparts
They receive higher rates injectable anti-psychotic mediation than their White Counterparts
What is this evidence for?
In terms of psychosis care, people of minority ethnic backgrounds experience more coercive care
Minorities in metal health services or care are kept for ____ x longer that their White Counterparts
2.5x longer
What are the NICE guidelines for psychosis?
List 4 points
Individualised treatment plan options:
- 16 planned sessions of CBT for psychosis (CBTp)
- Early Intervention in Psychosis (EIP)
- 10 sessions of Family Intervention (FI)
- Alongside antipsychotic medication
NICE Guidelines for psychosis recommends how many planned sessions of CBT for psychosis (CBTp)?
16 sessions
NICE Guidelines for psychosis recommends how many sessions of Family Intervention (FI)?
10 sessions
NICE Guidelines for psychosis recommends ___ intervention in psychosis
Early Intervention in Psychosis (EIP)
NICE Guidelines for psychosis recommends individualised treatment plan options alongside…?
Antipsychotic medication
List the 6 evidence for Family Intervention (FI) in schizophrenia and psychosis care
- Clinically- & cost-effective
- Reduces family tension
- Facilitates engagement & improved clinical care
- Reduces relapse/readmission rates
- Decreases lengths of stay in hospital
This is evidence for what treatment plan for schizophrenia and psychosis care?
Clinically- & cost-effective
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)
This is evidence for what treatment plan for schizophrenia and psychosis care?
Reduces family tension
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)
This is evidence for what treatment plan for schizophrenia and psychosis care?
Facilitates engagement & improved clinical care
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)
This is evidence for what treatment plan for schizophrenia and psychosis care?
Reduces relapse/readmission rates
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)
This is evidence for what treatment plan for schizophrenia and psychosis care?
Decreases lengths of stay in hospital
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)
Individualised treatment plan options:
- 16 planned sessions of CBTp
- EIP
- 10 sessions of FI
These are the NICE guidelines for …?
Psychosis care
What are the limitations of the evidence for Family Interventions (FI) in schizophrenia and psychosis care?
List 3 points
- Uptake especially low in African, Caribbean and other minoritised
groups - Limited evidence for effectiveness, acceptability, accessibility with
minoritised groups - ‘Urgent need’ to develop culturally informed care
This is a limitation of the evidence for what treatment plan for schizophrenia and psychosis care?
Uptake is especially low in African, the Caribbean and other minoritised
groups
a. Early Intervention in Psychosis (EIP)
b. CBT for psychosis (CBTp)
c. Family Intervention (FI)
c. Family Intervention (FI)