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© 2012 Elsevier Masson SAS. All rights reserved.
European Psychiatry 27 (2012) / supplement n°2 / S63-S69
Proofs
EUROPEAN
PSYCHIATRY
THE JOURNAL OF THE EUROPEAN PSYCHIATRIC ASSOCIATION
The concept of “intercultural opening”: the development of an assessment
tool for the appraisal of its current implementation in the mental health
care system
S. Penka a, * , U. Kluge a , A. Vardar a , T. Borde b , D. Ingleby c
a Department of Psychiatry and Psychotherapy, Charité Berlin, Germany
b Alice Salomon University of Applied Science, Berlin, Germany
c Faculty of Social and Behavioral Sciences, Utrecht University, Netherlands
Keywords:
Immigration
Mental health care
Germany
Intercultural opening
Assessment tool
1. Introduction
ABSTRACT
In the past, European countries have developed different
approaches to improve the accessibility and quality of health
and social care services for migrants. In the United Kingdom, for
example, an approach named “Equality and Diversity Strategy”
has been implemented while other European countries like Italy
and the Netherlands have adopted “intercultural health strategies”
[23], based on “cultural competence” concepts borrowed
from the United States [1,3]. Since the 1990s, an approach called
“intercultural opening” [2,13] has been promoted as a way of
improving the accessibility and quality of services for migrants
in Germany. Based on this approach, guidelines for the mental
health care system were announced by professional psychiatric
* Corresponding Author.
E-mail address: simone.penka@charite.de (S. Penka)
68767
ISSN 0924-9338
June 2012
Vol. 27 - Supplement n°2
pp. S1-S81
Migration
and Mental Health
S1 Editorial
A. Heinz, U. Kluge
S4 The willingness to participate in health research
studies of individuals with Turkish migration
backgrounds: barriers and resources.
A qualitative analysis of focus groups
D. Dingoyan, H. Schulz, M. Mösko
S10 Socio-economic status and emotional distress
of female Turkish immigrants and native
German women living in Berlin
MC. Aichberger, Z. Bromand, A. Heredia
Montesinos, S. Temur-Erman, A. Mundt, A.
Heinz, MA. Rapp, M. Schouler-Ocak
S17 Mental health of Turkish woman in Germany:
resilience and risk factors
Z. Bromand, S. Temur-Erman, R. Yesil,
A. Heredia Montesinos, MC. Aichberger,
D. Kleiber, M. Schouler-Ocak, A. Heinz,
MC. Kastrup, MA. Rapp
S22 The infl uence of stigma on depression, overall
psychological distress, and somatization
among female Turkish migrants
A. Heredia Montesinos, MA. Rapp, S. Temur-
Erman, A. Heinz, U. Hegerl, M. Schouler-Ocak
S27 Translation and adaptation of the Zung
Self-Rating Depression Scale for application
in the bilingual Azerbaijani population
F. Mammadova, M. Sultanov, A. Hajiyeva,
M. Aichberger, A. Heinz
S32 Construction and interpretation of self-related
function and dysfunction in Intercultural
Psychiatry
A. Heinz, F. Bermpohl, M. Frank
S44 Explanatory models and concepts of West
African Malian patients with psychotic
Symptoms
F. Napo, A. Heinz, A. Auckenthaler
S50 How to express mental health problems:
turkish immigrants in Berlin compared to native
Germans in Berlin and Turks in Istanbul
A. Vardar, U. Kluge, S. Penka
S56 Health services and the treatment of
immigrants: data on service use, interpreting
services and immigrant staff members
in services across Europe
U. Kluge, M. Bogic, W. Devillé, T. Greacen,
M. Dauvrin, S. Dias, A. Gaddini, NK. Jensen,
E. Ioannidi-Kapolou, R. Mertaniemi,
R. Puipcinós i Riera, S. Sandhu, A. Sarvary,
JFF. Soares, M. Stankunas, C. Straßmayr,
M. Welbel, A. Heinz, S. Priebe
S63 The German concept of “intercultural opening”
as an answer to challenges of migration
- the development of an assessment tool
for the appraisal of its current implementation
in the mental health care system
S. Penka, U. Kluge, A. Vardar, T. Borde,
D. Ingleby
S 70 Cross-cultural training in mental health care
– challenges and experiences from Sweden
and Germany
S. Bäärnhielm, M. Mösko
S75 Teaching psychiatry and establishing
psychosocial services – lessons
from Afghanistan
I. Missmahl, U. Kluge, Z. Bromand, A. Heinz
S80 Afterword
A. Kleinman
The German concept of “intercultural opening” is an approach to facilitating migrants’ access to the
health care system and improving the care they receive. No data exist concerning the current status
of the implementation of this approach in Germany, and the concept has never been analysed in
practice. To assess the status of “intercultural opening” in the German mental health care system
and to further analyse the concept, we developed a tool by combining pre- existing instruments. In
order to review the preliminary tool we combined experts’ knowledge by carrying out a consensusoriented,
expert- based Delphi process with actual practice by piloting the instrument in each type of
institution to be assessed. The assessment tool thus developed1 is the fi rst one to evaluate the current
status of “intercultural opening” in the community mental health care system in Germany from a
broad perspective. This paper is intended to present the development process of our assessment
tool for demonstrating the benefi ts of this approach and as a model for future studies, as well as to
increase transparency in relation to the current German approach to health care structures in dealing
with migrants.
© 2012 Elsevier Masson SAS. All rights reserved.
associations in 2002 [22]. Researchers and practitioners started
to face the fact that immigration into Germany and the integration
of migrants could only be successful if German society
changed and started adapting to the needs of these citizens [17].
Particular importance was placed on changing the way German
institutions dealt with migrants.
The basic principle of the concept of “intercultural opening”
is to change institutions to improve the accessibility and quality
of services for migrants. Each institution should be competent
to ensure equal access and quality for all migrants regardless of
their country of origin or native language. “Intercultural opening”
represents a long- term process of organizational development with
consequences for structure, processes and results [12]. Its goals
include different main approaches on four various levels (Fig. 1).
In 2004, a new immigration law (ZuwG) was passed. For
the fi rst time, the integration of foreigners was defi ned by law
1 See: http://www.segemi.de/delphiprozess/download/IKOE_P_1_English.pdf
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