Cultural competence in mental health care: a review of model evaluations

BACKGROUND: Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. METHODS: A systematic review that included evaluated models of professional education or service delivery. RESULTS: Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. CONCLUSION: There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes

Careif Position Statement on Migration and Mental Health

People have moved from one place to another within the same country or across national borders for millennia. The reasons for such movements have varied, as does the duration for which people migrate. With globalisation and global connections across countries, migration has increased. The process of migration and its impact on the mental health of individuals has been and will remain heterogeneous. The responses of migrants to the process vary, depending upon a number of factors. Individuals may migrate individually, with their families or in groups. They may move to avoid political or religious persecution and seek political asylum in another country (forced migration) or migrate for personal, employment, economic or educational reasons (voluntary migration). Although these two categorisations are often a little more complex than this. Not all migrants will feel negatively affected by migration. People may migrate on a seasonal, recurrent, permanent or temporary basis. It may be within or across generations. Many migrants will never access mental health services, whilst others may use these in varying ways and with diverse requirements or presentations. The experiences and requirements of voluntary and involuntary migrants may differ. Mental health Services may need to ensure that they are accessible and appropriate to all members of society including those who have migrated. This paper makes some suggestions in relation to this

Mobile communication and refugees: An analytical review of academic literature

Over the past decade, an expanding literature has explored the ways in which refugees rely on mobile communication technologies to stay in touch with a wider community and to access relevant information and services in their new places. Nevertheless, challenges linked to (a lack of) digital literacy and accessibility among refugees, and associated risks of technology use can negatively affect their empowerment and participation in a “mediatized” society. In light of the mutually shaping processes emerging between technology and society, this article provides an overview of studies focusing on the relationship between mobile communication practices and refugee lives under different circumstances. Using the concept of affordances as an analytic tool, this article looks into ways in which existing studies address the possibilities and vulnerabilities of mobile communications, the social conditions, and the agency of refugees in engaging with mobile technologies in the different temporal and spatial dimensions of their migration trajectories. Future studies should explore more collective processes and the power dynamics involved in the appropriation of mobile technologies by different migration actors

Geopolitical determinants of mental health and global health inequities

Geopolitical determinants of health have been well recognized by the World Health Organization and are increasingly being discussed across governments, institutions, academics, policy makers, and across global health sector. Geopolitical determinants of health are events, structures, processes, and factors that influence individual health including mental health, public and population mental health both directly and indirectly. Consequently, nation’s responses to these factors will affect short-term and long-term health outcomes. Geopolitical factors are becoming increasingly more important as they influence directly and indirectly social determinants of health. These factors clearly impact both physical and mental health leading to health inequities and inequalities. It is important to factor in geopolitical determinants in resource allocation and funding as well as policy making as has been highlighted by the recent pandemic and variable access to vaccines. Geopolitical determinants would be integral when addressing all global health inequities. These play a major role in resource allocation, policy and planning to meet today’s global health challenges

Rates, risk factors & methods of self harm among minority ethnic groups in the UK: a systematic review

<p>Abstract</p> <p>Background</p> <p>Studies suggest that the rates of self harm vary by ethnic group, but the evidence for variation in risk factors has not been synthesised to inform preventive initiatives.</p> <p>Methods</p> <p>We undertook a systematic literature review of research about self harm that compared at least two ethnic groups in the United Kingdom.</p> <p>Results</p> <p>25 publications from 1765 titles and abstracts met our inclusion criteria. There was higher rate of self harm among South Asian women, compared with South Asian men and White women. In a pooled estimate from two studies, compared to their white counterparts, Asian women were more likely to self harm (Relative Risk 1.4, 95%CI: 1.1 to 1.8, p = 0.005), and Asian men were less likely to self harm (RR 0.5, 95% CI: 0.4 to 0.7, p < 0.001). Some studies concluded that South Asian adults self-harm impulsively in response to life events rather than in association with a psychiatric illness. Studies of adolescents showed similar methods of self harm and interpersonal disputes with parents and friends across ethnic groups. There were few studies of people of Caribbean, African and other minority ethnic groups, few studies took a population based and prospective design and few investigated self harm among prisoners, asylum seekers and refugees.</p> <p>Conclusion</p> <p>This review finds some ethnic differences in the nature and presentation of self harm. This argues for ethnic specific preventive actions. However, the literature does not comprehensively cover the UK's diverse ethnic groups.</p

Global mental health and climate change: A geo-psychiatry perspectiv

Climate changes affect planet ecosystems, living beings, humans, including their lives, rights, economy, housing, migration, and both physical and mental health. Geo-psychiatry is a new discipline within the field of psychiatry studying the interface between various geo-political factors including geographical, political, economic, commercial and cultural determinants which affect society and psychiatry: it provides a holistic overview on global issues such as climate changes, poverty, public health and accessibility to health care. It identifies geopolitical factors and their effects at the international and national levels, as well as considers the politics of climate changes and poverty within this context. This paper then introduces the Compassion, Assertive Action, Pragmatism, and Evidence Vulnerability Index (CAPE-VI) as a global foreign policy index: CAPE-VI calculates how foreign aid should be prioritised for countries that are at risk or already considered to be fragile. These countries are characterised by various forms of conflict, disadvantaged by extremes of climate change, poverty, human rights abuses, and suffering from internal warfare or terrorism