Get access

Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results

Authors

  • J. A. Owiti RMN BSc (Hons) MSc HE Dip (Nursing) PhD,

    Postdoctoral Research Fellow, Corresponding author
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    • Correspondence:

      J. A. Owiti

      Centre for Psychiatry

      Wolfson Institute of Preventive Medicine

      Queen Mary University of London

      Charterhouse Square

      Old Anatomy Building

      London EC1M 6BQ

      UK

      E-mail: j.a.owiti@qmul.ac.uk

    Search for more papers by this author
  • A. Ajaz MBBS BSc MRCPsych,

    Research Fellow, Higher Trainee in Forensic Psychiatry
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    2. West London Mental Health NHS Trust, London, UK
    Search for more papers by this author
  • M. Ascoli MD (Hons) MRCPsych,

    Research Fellow, Consultant Psychiatrist
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    2. East London NHS Foundation Trust, London, UK
    Search for more papers by this author
  • B. de Jongh BSc MSc,

    Data Analyst
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    Search for more papers by this author
  • A. Palinski BSc MSc,

    Non-Clinical Lecturer
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    Search for more papers by this author
  • K. S. Bhui BSc MBBS MSc MSc MD FRCPsych

    Professor of Cultural Psychiatry and Epidemiology, Honorary Consultant Psychiatrist
    1. Centre for Psychiatry, Queen Mary, University of London, London, UK
    2. East London NHS Foundation Trust, London, UK
    Search for more papers by this author

Abstract

Accessible summary

  • Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes.
  • At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown.
  • We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals.
  • The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation.

Abstract

Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner-city area to work with community mental health services to improve on patients' outcomes and clinicians' cultural competence skills. We targeted 94 clinicians in four mental health service teams in the community. After initial training sessions, we used a cultural consultation model to facilitate ‘in vivo’ learning. During cultural consultation, we used an ethnographic interview method to assess patients in the presence of referring clinicians. Clinicians' self-reported measure of cultural competence using the Tool for Assessing Cultural Competence Training (n = 28, at follow-up) and evaluation forms (n = 16) filled at the end of each cultural consultation showed improvement in cultural competence skills. We conclude that cultural consultation model is an innovative way of training clinicians in cultural competence skills through a dynamic interactive process of learning within real clinical encounters.

Ancillary