Abstract
In this chapter, we describe the development, implementation and evaluation of the cultural consultation service (CCS). We begin with some background on the development of intercultural services in Montreal. The next section describes the rationale for the CCS approach and the steps involved in setting up the service. The third section provides an overview of the cases seen by the service in the first decade of its operation, including sources and reasons for referral, as well as socio-demographic and clinical characteristics. This provides a sense of the portfolio of cases from which vignettes are drawn throughout this book to illustrate key issues in cultural consultation. The remaining sections summarize findings from qualitative process and outcome evaluations of the service. The analysis of cases seen in the CCS and transcultural clinics indicates that access to mental health care varies widely by linguistic and cultural background. In a significant number of cases, language barriers and the cultural complexity of the cases had prevented adequate assessment in conventional mental health care settings. The CCS was able to provide clinical reassessment and redirection of treatment in a substantial proportion of cases and these interventions have been well received by referring clinicians. Although cultural consultations require substantial resources, in terms of specific expertise in cultural psychiatry as well as interpreters and culture brokers, the result of this intensive process is often a change in diagnosis and treatment plan with significant immediate and long-term consequences for patients’ functioning, use of services, as well as clinician satisfaction.
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Notes
- 1.
1 The data in this paragraph reflect the census metropolitan area of Montreal. Data on language (mother tongue and language spoken at home) is from the 2011 census (Statistics Canada, 2012. Montréal, Quebec (Code 462), and Quebec (Code 24) (table). Census Profile. 2011 Census. Statistics Canada Catalogue no. 98-316-XWE. Ottawa. Released October 24, 2012. http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E). Data on ethnicity and immigration was not available from the 2011 census, and the 2006 census was used (Statistics Canada, n.d.). Population by immigrant status and period of immigration, 2006 counts, for Canada and census metropolitan areas and census agglomerations -20 % sample data (table). “Immigration and Citizenship.” “Highlight tables.” “2006 Census: Data products.” Census. Last updated March 27, 2009. http://www.statcan.gc.ca/pub/12-591-x/2009001/02-step-etape/ex/ex-census-recensement-eng.htm#a2 (accessed February 21, 2013).
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2 Statistics Canada. No date. Visible minority groups, 2006 counts, for Canada and census metropolitan areas and census agglomerations -20 % sample data (table). “Ethnocultural Portrait of Canada.” “Highlight tables.” “2006 Census: Data products.” Census. Last updated October 6, 2010. http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/hlt/97-562/pages/page.cfm?Lang=E%26Geo=CMA%26Code=01%26Table=1%26Data=Count%26StartRec=1%26Sort=2%26Display=Page (accessed February 21, 2013).
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Kirmayer, L.J., Groleau, D., Rousseau, C. (2014). Development and Evaluation of the Cultural Consultation Service. In: Kirmayer, L., Guzder, J., Rousseau, C. (eds) Cultural Consultation. International and Cultural Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7615-3_2
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