THE PATIENT, A man in his early 20s, was clearly distressed, anxious. There were insects, he said, insects crawling around under his skin.
The graduate student doing the initial assessment was immediately concerned and went straight to her advisor, Dr. Brian Sharpless, a clinical psychologist and professor at Argosy University in Virginia. The patient sounded psychotic — possibly schizophrenic, she said, and she wanted to know what to do.
“Is he by any chance Nigerian?” Sharpless asked. “Yes!” she replied. “How did you know?”
“He’s not psychotic — that’s Ode Ori,” Sharpless responded. “He’s having a panic attack.”
For psychiatrists and psychologists, culture and background must be a necessary part of the picture they form of a patient in assessment, diagnosis, and treatment. If not, the potential for misunderstanding is acute.
This is precisely the thinking behind initiatives like the Cultural Consultation Service at the Jewish General Hospital in Montreal, a partnership with McGill University’s Division of Social and Transcultural Psychiatry. Dr. Andrew Ryder, a cultural psychologist at Concordia University who works on the project, explained that clinicians can refer patients with unfamiliar cultural backgrounds to the service, which will then assess the patient’s situation in a thoroughly interdisciplinary fashion, with input from anthropologists, translators, and people they call “cultural brokers,” who can help explain cultural meanings and behaviors.
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