Culture, Medicine, and Psychiatry

, Volume 41, Issue 4, pp 630–655 | Cite as

Cultural Sensitive Care Provision in a Public Child and Adolescent Mental Health Centre: A Case Study from the Toulouse University Hospital Intercultural Consultation

  • Gesine Sturm
  • Sylvie Bonnet
  • Yolaine Coussot
  • Katja Journot
  • Jean-Philippe Raynaud
Clinical Case Study


Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139–167, 1989). Mobilizing existing resources in terms of social and family support, and encouraging creative strategies of interculturation in therapeutic work (Denoux, in: Blomart and Krewer (eds) Perspectives de l’interculturel, L’Harmattan, Paris, 1994) may be helpful in order to enhance resilience. Drawing from experiences in the context of French transcultural and intercultural psychiatry, and inspired by the Mc Gill Cultural Consultation in Child Psychiatry, we developed an innovative model, the Intercultural Consultation Service (ICS). This consultation proposes short term interventions to children and families with complex migration experiences. It has been implemented into a local public health care structure in Toulouse, the Medical and Psychological Centre la Grave. The innovation includes the creation of a specific setting for short term therapeutic interventions and team training via shared case discussions. Our objectives are (a) to improve outcomes of mental health care for the children through a better understanding of the child’s family context (exploration of family dynamics and their relatedness to complex migration histories), (b) to enhance intercultural competencies in professionals via shared case discussions, and, (c) to improve the therapeutic relationship between children and professionals on the basis of the work with the family and the dialogue with the team. In our paper, we present the rationale and functioning of the ICS and illustrate our work with a case study. The presentation of the case uses the Mc Gill B-version of the Cultural Formulation, combined with a relational and process oriented reflection on the intercultural dynamics that unfold during the encounter with a family.


Culturally sensitive child mental health Hyperdiversity Intersectionality Interculturation Cultural formulation 



We thank the team of the CMP for our close and stimulating cooperation, and give a special thanks to all families who shared trust, scepticism and many insights with us. Thank you also to Mme Nasr, Vice President of the DRCI (Head Office of Research and Innovation of the CHU Toulouse), for having kindly informed us about the legal framework concerning the publication of case-studies in France: in application of the loi Jardé, the Institutional Review Board does not need to intervene. We also thank Adil Qureshi and Emily Anne Shults for their careful reading and the inspiring comments.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Laboratoire LCPI (EA4591)Université de Toulouse Jean JaurèsToulouseFrance
  2. 2.CMP, SUPEA (service universitaire de psychiatrie de l’enfant et de l’adolescent)CHU de ToulouseToulouseFrance
  3. 3.Faculté de médecine de ToulouseUniversité Paul SabatierToulouseFrance
  4. 4.SUPEA (service universitaire de psychiatrie de l’enfant et de l’adolescent), Inserm URM1027CHU de ToulouseToulouseFrance

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