Abstract
Cultural diversity poses a challenge to mental Health care systems in many settings. Specialized cultural consultation services have been developed in a number of countries as a way to supplement existing services. The objective of this paper is to compare and contrast cultural consultation services in Montreal, London, and Paris to determine how culture and society have shaped the evolution of these services to meet local sensitivities and imperatives. Historical contexts of the sites, their descriptions and origins, how they categorize cultural, ethnic, and linguistic diversity, and their intake procedures are compared and contrasted according to a standardized template of themes. Data came from site visits and participant observation at each site. For historical, political, and cultural reasons, categorization of diversity and intake procedures differ markedly by site: Montreal focuses on language categories and language proficiency; London enumerates ethnic diversity according to officially mandated categories; and Paris does not gather ethnic data on its patients in any form. The process of cultural consultation, specifically its triage and intake procedures, is profoundly influenced by local histories and social norms that are maintained by professional cultures of psychiatry in each setting. To properly place their patients in context, cultural psychiatrists must not only aim to understand the culture of the other, but also must consider the culture of the mainstream society and how it shapes the delivery of services.
Similar content being viewed by others
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). Washington: American Psychiatric Publication.
Ascoli, M., Palinski, A., Owiti, J.A., De Jongh, B., & Bhui, K.S. 2012. The culture of care within psychiatric services: tackling inequalities and improving clinical and organizational capabilities. Philosophy, Ethics, and Humanities in Medicine, 7:12.
BBC London News 2011 Census 2011: Gypsies and Irish Travellers Get a Box, March 30, http://www.bbc.co.uk/news/uk-england-12914877, accessed October 6, 2016.
Beauchemin, C., C. Hamelle, and P. Simon 2010 Trajectories and Origins: Survey on Population Diversity in France. INED & INSEE, https://www.ined.fr/en/publications/document-travail/trajectories-and-origines-survey-on-population-diversity-in-france-initial-findings-en/, accessed April 24, 2018.
Beauchemin, C, Hamel, C, & Simon P. 2016. Trajectoires et origines: Enquête sur la diversité des populations en France. Paris: INED.
Bennegadi R, Bourdin M-J, & Paris C. 2008. Les apports de l’anthropologie médicale clinique dans la relation soignant-soigné en situation interculturelle. Revue du Soignant en Santé Publique, 5(34):14-16.
Bhui KS, Ascoli M, & Nuamh O. 2012. The place of race and racism in cultural comptetence: What can we learn from the English experience about the narratives of evidence and argument? Transcultural Psychiatry, 49 (2), 185-205.
Bhui KS, Owiti JA, Palinski A, Ascoli M, De Jongh B, Archer J, Staples P, Ahmed N, & Ajaz A. 2015a. A cultural consultation service in East London: Experiences and outcomes from implementation of an innovative service. International Review of Psychiatry, 27(1): 11-22.
Bhui KS, Ullrich S, Kallis, C, & Coid JW. 2015b. Criminal justice pathways to psychiatric care for psychosis. BJP, 207(6):523-9.
Bhui, K., Warfa, N., Edonya, P., McKenzie, K., & Bhugra, D. (2007). Cultural competence in mental health care: a review of model evaluations. BMC health services research, 7(1), 15
Boni-Claverie, I. 2015 Trop noire pour être française. Video documentary, ARTE, http://www.arte.tv/guide/fr/050748-000/trop-noire-pour-etre-francaise. Accessed 2015–2016.
Bouchard, G. & Taylor, C., 2008. Building the Future: A Time for Reconciliation, Abridged Report. Bibliothèque et Archives Nationals du Québec: Ville du Québec.
Bowen, J.R. 2017 French Republicanism and Pluralism: Can They Co-exist? Global Centre for Pluralism, https://www.pluralism.ca/wp-content/uploads/2018/03/France_EN-2.pdf. Accessed 4 Oct 2019.
Brisset, C., Y. Leanza, E. Rosenberg, B. Vissandjée, L.J. Kirmayer, G. Muckle, S. Xenocostas, and H. Laforce 2014 Language Barriers in Mental Health Care: A Survey of Primary Care Practitioners. Journal of Immigrant and Minority Health 16(6): 1238–1246.
Brutel, C. 2014 Recent Immigrants to France—Increasingly European Immigration. INSEE (Institut national de la statistique et des études économiques) PREMIÈRE, No. 1524, https://www.insee.fr/en/statistiques/1283872, accessed April 25, 2018.
Centre médico-psychologique Françoise Minkowska (2014) Rapport d’activité 2014. Paris: Association Françoise et Eugène Minkowski.
Clarke, D. E., Colantonio, A., Rhodes, A. E., & Escobar, M. (2008). Ethnicity and mental health: Conceptualization, definition and operationalization of ethnicity from a Canadian context. Chronic Diseases in Canada, 28(4), 128-147.
Commission nationale de l’informatique et des libertés (CNIL) 2007 Mésure de la diversité et protection des données personnelles. Madame Anne Debet, Rapporteur. DOC Projet Diversité Mise à jour: 16/05/2007 08:40 DECO/IRC, https://www.cnil.fr, accessed October 6, 2016.
Eurostat 2018 Asylum Statistics, http://ec.europa.eu/eurostat/statistics-explained/index.php/Asylum_statistics, accessed April 29, 2018.
Fassin D. 2000. Les politiques de l’ethnopsychiatrie. La psyché africaine, des colonies africaines aux banlieues parisiennes. L’Homme, 153 :231-250.
Fassin D, & Rechtman R. 2005. An Anthropological Hybrid: The Pragmatic Arrangement of Universalism and Culturalism in French Mental Health. Transcultural Psychiatry, 42(3)347-366.
Fassin, D. & Simon, P. (2008) Un objet sans nom. L’introduction des discriminations raciales dans la statistique française. L’Homme 3, p. 271-294.
Fraser, Graham 2009 Official Languages Commissioner as Quoted in the Hill Times, August 31, 2009, p. 14.
Goulbourne H. 1998. Race Relations in Britain Sine 1945. Palgrave Macmillan: UK.
Government of Canada, 1985 Official Languages Act. Minister of Justice, http://laws-lois.justice.gc.ca. Accessed 2011.
Jarvis, G.E., Toniolo, I., Ryder, A.G., Sessa, F., & Cremonese, C., 2011. High rates of psychosis for black inpatients in Padua and Montreal: different contexts, similar findings. Soc Psychiatry Psychiatr Epidemiol, 46:247-253.
Jarvis, G.E. 2015 Field Notes (unpublished), September 1, 2015.
Jenkins, C., A Brief History of France: People, History, and Culture. Philadelphia, Running Press, 2011.
Kirmayer, L. J. (2012). Rethinking cultural competence. Transcultural Psychiatry, 49: 149-164.
Kirmayer LJ. (2019). The politics of diversity: Pluralism, multiculturalism and mental health. Transcultural Psychiatry, 56(6):1119–1138.
Kirmayer LJ, Groleau D, Guzder J, Blake C, & Jarvis E. (2003). Cultural Consultation: A Model of Mental Health Service for Multicultural Societies. Can J Psychiatry, 48:145-153.
Kirmayer LJ, Guzder J, & Rousseau, C. (2014a). Cultural Consultation: Encountering the Other in Mental Health Care. Springer: New York.
Kirmayer LJ, Jarvis GE, & Guzder J. 2014b. The process of cultural consultation. In Cultural Consultation: Encountering the Other in Mental Health Care. Laurence J. Kirmayer, Jaswant Guzder & Cecile Rousseau, Editors. Springer: New York.
Kirmayer LJ, & Jarvis GE. (2019). Culturally responsive services as a path to equity in mental health care. Healthcare Papers, 18(2), 11–23.
Kivisto P. (2002). Multiculturalism in a global society. Oxford, UK: Blackwell Pub.
Larchanché S. in press Cultural Anxieties. Managing Migrant Suffering in France. New Brunswick, NJ: Rutgers University Press.
Larchanché S. 2015a Clinical Medical Anthropology and Its Contribution to Integrating Cultural Diversity in Psychotherapy: the Experience of the Minkowska Center. Presented at the SFU Summer School, July 20, 2015.
Larchanché S. 2015b Health Spaces: Representations of French Immigrant Youth in Mental Healthcare. In The Children of Immigrants/Second Generation Youth. Caroline Brettel and Faith Nibbs, eds. Nashville: Vanderbilt University Press.
Le Monde 2014 Discriminer les habitants de zones sensibles devient illégal, http://www.lemonde.fr/societe/article/2014/01/15/le-senat-reconnait-la-discrimination-par-le-lieu-de-residence_4348684_3224.html, accessed October 6, 2016.
L’Horty, Yannick, Emmanuel Duguet, Loïc du Parquet, Pascale Petit et Florent Sari. 2011. Les effets du lieu de résidence sur l’accès à l’emploi : un test de discrimination auprès de jeunes qualifiés. Economie et Statistique, n°447:71-95. Retrieved October 6, 2016 from http://www.univ-evry.fr/modules/resources/download/default/Recherche/Les%20laboratoires/epee/wp/10-01.pdf.
Lewis-Fernández, R., Aggarwal, N. K., Hinton, L., Hinton, D. & Kirmaye,r L.J. (Eds.). (2015). DSM-5® handbook on the cultural formulation interview. Washington: American Psychiatric Pub.
Mackey, E. (2005). House of Difference: Cultural Politics and National Identity in Canada. London: Routledge.
Miles, R. and R. Torres 2007 Does “Race” Matter? Transatlantic Perspectives on Racism After “Race Relations”. In: T. D. Gupta et al. (eds.) Race and Racialization: Essential Readings, pp. 65–73. Canadian Scholars’ Press, Toronto
Ministère de L’Intèrieur 2018 Les Demandes D’Asile (Statistiques), January 16, https://www.immigration.interieur.gouv.fr/fr/Info-ressources/Etudes-et-statistiques/Statistiques/Essentiel-de-l-immigration/Chiffres-clefs/LES-DEMANDES-D-ASILE-STATISTIQUES, accessed April 24, 2018.
Morgan C, Mallett R, Hutchinson G, Bagalkote H, Morgan K, Fearon P, Dazzan P, Boydell J, McKenzie K, Harrison G, Murray R, Jones P, Craig T, & Leff J. 2005. Pathways to care and ethnicity. I: Sample characteristics and compulsory admission. BJP, 186: 281-89.
National Statistics, 2003. Ethnic Group Statistics: A Guide for the Collection and Classification of Ethnicity Data. Her Majesty’s Stationery Office, Richmond.
Office for National Statistics, 2011 Census Questionnaire. Downloaded October 6, 2016.
Office for National Statistics 2017 Migration Statistics Quarterly Report: May 2017, https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/internationalmigration/bulletins/migrationstatisticsquarterlyreport/may2017, accessed April 29, 2018.
Office for National Statistics 2018 Migration Statistics Quarterly Report, February 2018, https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/internationalmigration/bulletins/migrationstatisticsquarterlyreport/february2018, accessed April 29, 2018.
Owiti JA, Ajaz A, Ascoli M, De Johgh B, Palinski A, & Bhui, KS. 2014. Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results. Journal of Psychiatric and Mental Health Nursing, 21, 814-826.
Owiti, J. 2015 E-mail Communication with G.E. Jarvis August 14, 2015.
Powell, E. 1968 Rivers of Blood Speech.
Sargent C, & Larchanché S. 2009. The Construction of “Cultural Difference” and its Therapeutic Significance in Immigrant Mental Health Services in France. Culture, Medicine, and Psychiatry, 33:2-20.
Simon, P. 2008a Les statistiques, les sciences sociales françaises et les rapports sociaux ethniques et de « race » . Revue française de sociologie 49: 153–162. https://doi.org/10.3917/rfs.491.0153, accessed August 10, 2015.
Simon, P. 2008b French Politics. Culture & Society 26(1): 7–31. https://doi.org/10.3167/fpcs.2008.260102, accessed June 4, 2010.
Statistics Canada 2017 Montréal [Census metropolitan area], Quebec and Nova Scotia [Province] (table). Census Profile. 2016 Census. Statistics Canada Catalogue No. 98-316-X2016001. Ottawa: Statistics Canada. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/index.cfm?Lang=E, accessed June 26, 2018.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jarvis, G.E., Larchanché, S., Bennegadi, R. et al. Cultural Consultation in Context: A Comparison of the Framing of Identity During Intake at Services in Montreal, London, and Paris. Cult Med Psychiatry 44, 433–455 (2020). https://doi.org/10.1007/s11013-019-09666-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11013-019-09666-1