Cultural sensitivity

The cultural sensitivity of refugee mental health practitioners is essential to the proper therapeutic relationship to the refugee patient. This means that the refugee mental health practitioner must be informed as to the type of trauma experienced by the refugee and its sociocultural meaning, the cultural idioms by which human suffering is expressed in a given community, and the social stigma associated with mental illness. Despite the refugees' own adversity, long-standing social prejudices against mental illness will persist throughout the refugee crisis.

Little cross-cultural literature exists on the relationship between refugee patient, Western professional, and bilingual interpreter. The use of refugees themselves as interpreters is especially problematic. Ideally, in the best-case scenario health professionals from the refugee communities should be recruited to participate in psychiatric intervention. These individuals will have had professional medical training as to the importance of confidentiality and can also provide insight into the cultural nuances of the doctor-patient relationship. The use of untrained interpreters from the refugee community should be avoided if at all possible, especially family members or members of a community or government institution that has previously threatened the security of the refugees. In addition, medical practitioners must respect patient dignity by not allowing young people to interview community elders or males from the community to ask refugee women explicit sexual questions and/or witness or be exposed to an undressed refugee woman during a medical examination. The more the bicultural interpreter can function in the role of a trained mental health paraprofessional, the more successful will be the therapeutic experience of all involved.

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