Cultural Consultation Service - South Shore (Longueuil, Quebec)
Don Quang Tran, MD
Imen Ben Cheikh, MD
The CCS – South-Shore is a third-line psychiatry clinic that offers mental health evaluations for adults, youths, and their families with a focus on cultural consultation. We are staffed by an adult psychiatrist and a child psychiatrist. The clinic is located in Hôpital Charles LeMoyne, itself affiliated with the Université de Sherbrooke. A teaching program for psychiatry residents is in the process of being set up.
Website | info [at] scc-rivesud.com (Email)
The Ottawa Newcomer Health Centre (Ottawa, Ontario, Canada)
Azaad Kassam MD, FRCPC
Assistant Professor, University of Ottawa
At Ottawa Newcomer Health Centre, we provide health care services, mental health services, navigation and language support to refugees and immigrants. We have a number of programs to support individuals during their initial settlement period in Ottawa, but also offer services for individuals who have lived in here for years.
Mental health services include cultural psychiatric consultation, psychotherapy and collaborative management with primary care. We link with the Ottawa Local Immigration Partnership, including a range of local agencies who serve diverse and marginalized populations. We aim to foster pluralism in our approach to mental health care.
New Beginnings Clinic - CAMH (Toronto, Ontario, Canada)
CAMH's New Beginnings Clinic offers psychiatric consulting, care provider consulting and culturally sensitive interventions to newly arrived refugees.
Mount Sinai Hospital Ethnocultural Assertive Community Treatment Team (Toronto, Ontario, Canada)
The focus of Mount Sinai Hospital Assertive Community Treatment Team (ACTT) is on the use of ACTT models in research, assessment and treatment to:
- help those we serve to improve their quality of life;
- help them integrate into family and community;
- help them find fulfilling roles in society.
To accomplish this we attempt to work in a manner which values individuals and their rights to be treated with dignity, compassion and without discrimination.
- Asian and South East Asian community
- Aboriginal community
Canadian Centre for Victims of Torture (Toronto, Ontario, Canada)
Hunter New England Mental Health (HNE MH) Cultural Consultation Program (Australia)
Bipin Ravindran MD, FRANZCP
Senior Staff Specialist, HNE Mental Health, Newcastle, NSW
bipin.ravindran [at] health.nsw.gov.au (Email)
HNE MH cultural consultation program provides consultation, support and training to the local health district in NSW, Australia.
It includes a clinic providing assessments for persons from culturally diverse and refugee backgrounds which works in a collaborative model with local health and community services. The key aspects of the program and clinic are:
1. Flexible referral process aimed to improve barriers to access health services and facilitate inter-service partnerships.
2. Assessments done at home or the patient’s preferred environments providing a whole of family approach to assessment and case formulation.
3. Collaborative assessment, formulation and care with refugee health and multicultural service and state based trauma service, STARTTS (NSW service for treatment and rehabilitation of torture and trauma survivors).
4. Collaboration with state based program, mental health community living supports for refugees and asylum seekers (CLSR).
5. Program has a clinical lead and collaborates with mental health specialities including child and adolescent psychiatry, Dual Diagnosis and liaison psychiatry in providing clinical assessments and ongoing support.
6. Teaching program covering domains of social and cultural psychiatry for psychiatry trainees. The program collaborates with local refugee and trauma services in providing training to health care providers in areas of cultural psychiatry and refugee mental health.
Cultural Consultation Service (Bologna, Italy)
Vincenzo Spigonardo, MD
Asp Città di Bologna
Via del Pratello 55
servizioconsultazioneculturale [at] gmail.com (Email)
The Cultural Consultation Service of Bologna (SCC-Bo) is an outpatient clinic which provides psychiatric and psychological support to asylum seeker and refugees hosted in the local network of SIPROIMI - ASP città di Bologna
The SCC-Bo works also as liaison service for the Department of Mental Health of Bologna as well as for local general doctors. The SCC-Bo is part of the International Protection Service of the municipality of Bologna.
The SCC-Bo provides a cultural psychiatric and psychological assessment as well as a long term psychological support based on the assumption of the ethnopsychiatric theory.
After the period of evaluation (three/four clinical encounters) we provide therapeutic strategy as well as suggestions to caregivers, social workers or clinicians involved.
The SCC-Bo organizes a monthly clinical and theoretical training in cultural psychiatry and medical anthropology.
Cultural Consultation Service - Indigenous Health Ambulatory (Brazil)
Brazil – University of Brasilia / UnB
Denise Osório Severo, PhD
Renato Antunes dos Santos, MD, PhD
Maria da Graça LuderitzHoefel, MD, PhD
gracahoefel [at] gmail.com (Email)
The University of Brasilia has a Cultural Consultation Service, the Indigenous Health Ambulatory (ASI), focused on the health of the Indigenous populations from several different cultures spread in many states of the country.
Considering the clinical, educational, and research vocation of this service, its main objective is to establish a bridge between the westernized health treatments and the Shamanic comprehension of health.
Starting in 2013, the service had to stop its activities after some years of work. In 2017 the service was reopened and expanded.
Usually, patients come from distant reservations and villages being sheltered in a public facility “the house of indigenous health” (CASAI).
In each admission, both inpatients and outpatients are welcomed and followed through the consultations, hospitalization, and procedures by the members of the ASI.
Denise Osório Severo, PhD, and Renato Antunes dos Santos, MD, PhD, are long-term collaborators of the service.
Maria da Graça LuderitzHoefel, MD, PhD, is responsible for the ASI.
Cultural consultation at the Transcultural Psychiatry Program (Barcelona, Spain)
Vall d’Hebron University Hospital
Dr. Adil Qureshi, PhD
We have been actively involved in the training of both intercultural mediators and community health workers (“agentes de salud comunitarias”) in intercultural mental health care. We are currently working with an associated public health entity to support them in their community mental health work. A significant part of this project is to increase levels of culturally sensitive mental health literacy.
We are working with various 3rd sector entities (in Barcelona they are charged with frontline services by the municipality/province) that provide services to refugees/asylum seekers, sexually trafficked women, and unaccompanied minor youths. We provide supervision to the psychologists working in these entities in the broad area of “culturally competent mental health care”, always centered on the work carried out by the entities in situ. It might be worth mentioning that ex-unaccompanied immigrant minors represent a particularly vulnerable population since they tend to fall outside of standard social service protocols. We are partnering with an 3rd sector entity financed by the Barcelona City Hall which provides residential psychosocial care to this population.
We created an online course focused on cultural competence in mental health and the addictions/migration and health, and variations of these courses are available to local health care professionals.
The Geneva University Hospitals (Geneva, Switzerland)
Melissa Dominicé Dao, MD
Senior Attending Physician
Department of Primary Care Medicine
Geneva University Hospitals
1211 Genève 14 Switzerland
Tel.: +41 22 372 9584
melissa.dominice [at] hcuge.ch (Email)
The Geneva University Hospitals (Hôpitaux Universitaires de Genève, or HUG) is an 1800-bed hospital group serving a diverse population. About half of patients and half of the staff are of foreign nationality and about one in 12 patients speak no French at all (50+ languages). In this context, communication challenges are common due to social, cultural and language differences between patient and clinician.
In 2007, we created a cultural consultation (“Consultation Transculturelle” or CT) to provide direct support to HUG clinicians who encountered cross-cultural communication difficulties. Our CT is modelled on the original CCS first developed by Kirmayer and colleagues, but was adapted to fit the local needs of HUG clinicians. The CT is located in the Division of Primary Care and accepts requests from all hospital departments, as well as a small number of consultations from clinicians in private practice. There is no specific focus on mental health care, but CT requests are discussed during monthly meetings with an expanded, multi-professional team that includes mental health specialists.
In addition to providing direct support to clinicians, the CT aims to contribute to institutional cultural competence by drawing attention to the challenges of caring for diverse patient populations (research) and by identifying and addressing the training needs of clinicians (training).
For further information, please see: Dominicé Dao M, Inglin S, Vilpert S, Hudelson P. The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service. BMC Health Serv Res. 2018 Jan 11;18(1):19.
University College London: Cultural Consultation Service, Camden & Islington (London)
Dr. Sushrut Jadhav, Lead Clinician
4 Greenland Road
London NW1 0AS
Tel.: 020 3317 6590
Fax: 020 7813 8720
s.jadhav [at] ucl.ac.uk (Email)
This service aims at providing clinical consultations to all staff in Camden and Islington NHS Foundation trust. This is not a parallel out‐patient service. Instead, it will focus on consultations with clinic staff who wish to seek advice on cultural issues affecting patient care or their own clinical service. Consultation include issues that might arise from any cross‐cultural encounter between clinicians, patients, and carers. Please also note this service is not focussed on Black & Minority Ethnic patients. Referrals may well include clinicians from any Black & Minority Ethnic group who may encounter clinical challenges with patients from White European background.
Camden & Islington Clinical CCS
For further information, please access the attached intake form.
University College London CCS
For further information on University College London CCS, please access the attached article.
Cultural Consultation Service DACA, Pro Persona (The Netherlands)
Mario Braakman, MD, MA, Lead Clinician
DACA, Diagnose en AdviesCentrum Allochtonen
Postbus 545, 6800 AM Arnhem, the Netherlands
Tel: +31 26 - 312 44 48
daca [at] propersona.nl (E-mail)
DACA (Cultural Consultation Service) aims at providing culturally competent psychiatric consultations and treatment recommendations to referring mental health professionals and others both within the hospital facilities as well as beyond. Our larger goal is to enhance culturally competent mental health care among professionals in the Netherlands as well as improving government, institutional and professional policies in adapting mental health care facilities for ethnic groups.
DACA is part of Pro Persona, a large Mental Health Service in the east of the Netherlands. Pro Persona (3500 employees) has large inpatient general mental health clinics in four cities, six locations for specialised inpatient care, and extensive out-patient facilities serving a total population of 854,000 (non-Dutch residents: 180,000).
- To provide cultural consultations to the in- and outpatient services of Pro Persona Mental Health Services
- To provide cultural consultations for family physicians, mental health professionals, lawyers, courts, forensic psychiatric services, and, occupational physicians in the Netherlands
- To provide trainees in psychiatry and psychology with a setting for clinical cross-cultural experience
- To engage in cross-cultural research aimed at improving clinical care for ethnic groups in the Netherlands
- To assist cross cultural consultants in improving diversity management issues
- To participate in projects aimed at improving cultural competence in Mental Health institutions
- To create and implement cross cultural adaptations of Dutch professional mental health guidelines
Cultural consultation service De Evenaar – Center for Transcultural Psychiatry (The Netherlands)
De Evenaar (Dutch for the equator) is a center for transcultural psychiatry In the northern part of the Netherlands. Patients with a migratory background – mainly refugees – are referred to the specialized center because of cultural issues that interfere with mental health problems. The most common mental health problems that are included in these patients are trauma and stressor-related disorders, anxiety and depressive disorders. The reasons for referral vary from mental health issues that remain after trauma exposure treatment to somatically unexplained stress-related problems, mental health issues that complicate labor reintegration, to sleeping problems or memory problems with no clinical history.
A team of transcultural specialists include a cultural anthropologist, transcultural psychiatrists, cross-cultural psychologists, and mental health nurses who take turns to answer questions during consultation hours every Tuesday. There is a special team for children and adolescents that include a child psychiatrist, and educational psychologists. Questions are divided into: advice, case consultation, referrals, and other questions. The main part of the consultation questions concern information about whether behavior could be related to mental disorders or cultural background. Other reasons for consultation concern mental health professionals who want to be sure whether they need to refer a patient to the specialized center, relocation of patients, difficulties getting into contact with patients, and a number of other issues concerning language, religion, ethnicity, intelligence, social embeddedness, participation in society, and so on. If necessary we include ethnographic or sociohistorical background information for better understanding of a particular question.
Cultural consultation service De Evenaar
Tuesdays 12:30 – 13:30 pm
Website | Simon.Groen [at] ggzdrenthe.nl (E-mail)
Duke Multicultural Consultation Team (USA)
The Multicultural Consultation Team is housed within the Department of Psychiatry and Behavioral Sciences at the Duke University School of Medicine. The team members include faculty, staff, and trainees from a range of disciplines (e.g., clinical psychology, psychiatry, social work). The team meets weekly rotating through peer-consultation, didactics, and a “diversity action committee” focused on dissemination of resources and creating system-level changes. Team members are encouraged to bring requests for consultation and seek input from other members on the team. The team was developed as an intentionally inclusive space designed to increase mental health care providers’ capacity to create a healing and wellness home for patients from any and all backgrounds. The team strives to hold a deliberately broad conceptualization of multiculturalism and diversity and to maintain a focus on the intersections of various identities. The team is an open team whereby new interested members are always welcome to join.
Data we are currently collecting:
- Types of requests
- Team member & patients (requests) demographics
We will collect qualitative data pertaining to sustainability of our team. Please see attachment (not to distribute).
Sacramento County Cultural Consultation Service (USA)
Hendry Ton, MD
Tel.: (916) 734-5070 ext. 60250
hton [at] ucdavis.edu (Email)
The Sacramento County Cultural Consultation Service was established in 2003 as a collaboration between Sacramento County Mental Health Services and the University of California at Davis, Department of Psychiatry to enhance existing mental health services for Sacramento's diverse low income community. Prior to its implementation, a qualitative needs assessment was conducted which showed significant shortcomings in conventional strategies to provide culturally competent care, such as ethnic matching and ethnospecific clinics. Since its establishment, the Cultural Consultation Service has provided numerous training workshops to enhance clinicians' cultural efficacy, consultation for the development of culturally focused mental health programs, and cultural evaluations utilizing the DSM-IV Cultural Formulation for patients in our county's psychiatric hospital and clinics. While we are currently active in the adult mental health system, we have plans to expand into the children's mental health system.
Tower Hamlets Cultural Consultation Service (London)
Professor Kamaldeep Bhui, MD
Centre for Psychiatry
Old Anatomy Building
Wolfson Institute of Preventive Medicine
Barts and the London School of Medicine & Dentistry
London EC1M 6BQ
Tel.: +44 20 7882 2012
Fax: +44 20 7882 5728
Website | k.s.bhui [at] qmul.ac.uk (Email)
The CCS is commissioned by NHS Tower Hamlets and the National Mental Health Development Unit, as a workforce development and complex intervention to improve narrative based, patient centred and recovery orientated outcomes. The service is based on an international cultural consultation model adapted for local contexts. This was evolved using learning from sociology and anthropology, alongside health care.
Transcultural Centre, Stockholm County Council (Sweden)
Sofie Bäärnhielm, MD, PhD
Website | sofie.baarnhielm [at] sll.se (Email)
The Transcultural Centre was established in 1999 by the Stockholm County Council and is a knowledge centre for Transcultural psychiatry and health care for asylum seekers and refugees. The Transcultural Centre offers consultation, training and networking for the health and medical staff of Stockholm County Council. The consultation service includes counselling, consultation and supervision offered to health professionals via telephone, visits to the Centre or at the workplace. The consultations are free of charge and are based on a reflexive approach. The Centre publishes the electronic Newsletter "Nyhetsbladet" in Swedish free of charge, subscribe at: info.tc [at] sll.se.
Minkowska Centre (Paris, France)
Transcultural psychiatry clinic
Mr. Christophe Paris
Research, Teaching and Professional Training Department Director
Stéphanie Larchancé, PhD
Tel.: ++ / 33 (0) 1 53 06 85 01
Website | larchanche [at] minkowska.com (Email)
Organisation and Activities
Centre Minkowska was created in 1962 by psychiatrist Eugène Minkowski. It receives migrants and refugees from Paris and the greater Paris area. The Centre’s clinical approach is informed by clinical medical anthropology and a person-centered, global approach to mental health.
The staff is interdisciplinary, and multilingual. All clinicians are trained in clinical medical anthropology and work with professional public service interpreters.
Beyond the clinic, Centre Minkowska organizes teaching, research and professional training activities. We offer a continuing education graduate program with Université de Paris on cultural competence in health and social services (https://odf.u-paris.fr/fr/offre-de-formation/diplome-d-universite-du-diu-1/sciences-technologies-sante-STS/du-sante-maladie-soins-mediation-et-competence-culturelle-XUE6_121.html), as well as professional training programs to health and social service professionals (http://www.minkowska.com/content/d%C3%A9velopper-les-comp%C3%A9tences-des-professionnels-dans-la-prise-en-charge-des-personnes). Through action-research projects, Centre Minkowska promotes advocacy, which aims to improve care by influencing policy and increasing resources for migrants (https://www.rutgersuniversitypress.org/cultural-anxieties/9780813595375).
Mount Sinai Hospital Assertive Community Treatment Team (Toronto, Canada)
In 1999, the Mount Sinai Hospital Assertive Community Treatment Team (ACTT) initiated a joint venture with the Hong Fook Mental Health Association, a community based mental health agency in Toronto, to establish a multidisciplinary, culturally and linguistically sensitive Assertive Community Treatment Team. This is in response to the needs of mental health services for ethno-racial populations, which have been greatly underestimated and underrepresented according to research evidence from surveys in Toronto. Our target population includes adults with severe and persistent mental illness from the South East Asian, Tamil, Black and Aboriginal communities in Toronto.
The Mount Sinai ACT Team offers year round support that is 24 hours a day, 365 days a year to provide treatment, rehabilitation and support for people who suffer from severe and persistent mental illness. Through hiring of ethnically matched staff, clients with severe mental illness from specific ethno-racial populations can be served efficiently and effectively. Clients referred to this program have generally not been successful at other types of mainstream treatment and have typically experienced numerous and protracted psychiatric hospitalizations prior to ACT involvement. We have a maximum of 80 clients.
A particular focus of our ACT team is the emphasis placed on cultural formulation as part of the overall clinical assessment. We attempt to collect information about the cultural background of each client as set out in the DSM-IV cultural formulation and use this information to guide our treatment plan. Another special feature of ACT is the family assisted model. A family psychosocial education group and ongoing support group are offered to client's family members on admission. This is an especially important facet of the ACTT model given that many of our minority clients have strong family ties and often may have very different expectations and understanding of mental illness.
With these goals in mind, frequency of re-hospitalizations, crises or relapses may decrease and we can see an increase in self-reliance and self-monitoring, resulting in a much improved level of client functioning in the community.
Mount Sinai Hospital Assertive Community Treatment Team (ACTT)
Office Hours: Monday to Friday, 8 a.m. to 8 p.m.
Weekends and Holidays 8 a.m. to 4 p.m.
Address: 260 Spadina Avenue, Suite 204
Toronto, Ontario M5T 2E4
Tel.: (416) 586-9900
Fax: (416) 586-9700
Wendy Chow, MSW, Manager, wchow [at] mtsinai.on.ca (Email)
Sam Law, MD, Clinical Director, slaw [at] mtsinai.on.ca (Email)
Lisa Anderman, MD, Psychiatrist, landermann [at] mtsinai.on.ca (Email)
Information about the ACT team available at this website.