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S74 S. Bäärnhielm et al. / European Psychiatry 27 (2012) / supplement n°2 / S70-S75 Finally, a fi nancial evaluation of cross- cultural training is missing [7]. In order to evaluate the economic benefi t of training from the perspective of an institution the direct and indirect costs of training have to be considered. To further enhance the quality of cross- cultural training the development of quality standards will be an important aspect. With the help of such quality standards the conceptualisation of future training will be upgraded. This will also make it easier to compare studies and study outcomes. 5. Implications In order to adapt mental health care systems to globalisation and migration in Europ ean countries like Sweden and Germany a general awareness of cross- cultural issues and a shared knowledge base among professionals can provide a platform for improved care and also new knowledge. To give an example, both the diagnostic systems DSM- IV and ICD- 10 have the ambition of universal validity. For DSM- IV some efforts have been made to incorporate cultural awareness. However, the validity of western psychiatric categories for non- western populations is questioned [44]. Cultural sensitivity among professionals and working with structured models taking culture into account, like the Cultural Formulation, can contribute to obtaining more information about variety in the phenomenology of mental illness. This might in turn shed more light on the discussion of universal validity of psychiatric categorisations and how to adapt treatment to the existing variety in the population. In an essay on multicultural medicine, Kirmayer [22] argues that intercultural health care services can contribute to the larger project of building a pluralistic society that allows the coexistence and co- evolution of diverse traditions. He points out that the clinical encounter offers a space for exploring ways of living and working with cultural differences and it can promote trust that encourages the other to consider a new point of view. Acknowledgement The current manuscript has been the result of an inspiring and fruitful German- Swedish co- operation in the research project on “Mental Health and Migration” (www.segemi.de) founded by the Volkswagen Foundation. Confl ict of interest statement The authors declare that there is no confl ict of interests. References [1] Aeder L, Altshuler L, Kachur E, Barrett S, Hilfer A, Koepfer S et al. The “Culture OSCE” - Introducing a Formative Assessment into a Postgraduate Program. Educ Health (Abingdon), 2007;20(1):11 . [2] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (4th ed.) Text Revision. Washington, DC: Author; 2003. [3] Bäärnhielm S, Ekblad S, Ekberg J, Ginsburg BE. Historical Refl ections on Mental Health Care in Sweden. The Welfare State and Cultural Diversity. Transcult Psychiatry 2005;42(3):394- 419. [4] Bäärnhielm S, Håkansson B, Löfvander M. (2011). Transkulturell medicin Läkemedelsboken, 2011- 2012; Läkemedelsverket. (in Swedish). http:// www.lakemedelsverket.se/upload/om- lakemedelsverket/publikationer/lakemedelsboken/LB- 2011- 2012/Transkulturell%20medicin.pdf [5] Bäärnhielm S, Scarpinati Rosso M, Pattyi L. (2007). Kultur, kontext och psykiatrisk diagnostik. Manual för intervju enligt kulturformuleringen i DSM- IV. Stockholm: Transkulturellt Centrum, Stockholms läns landsting (in Swedish). [6] Bäärnhielm S, Scarpinati Rosso M. The cultural formulation: a model to combine nosology and patients’ life context in psychiatric diagnostic practice. Transcult Psychiatry 2009;46(3):406- 28. [7] Beach MC, Price EG, Gary TL, Robinson KA, Gozu A, Palacio A, et al. Cultural competence: a systematic review of health care provider educational interventions. Med Care 2005;43:356 [8] Berlin A, Nilsson G, Törnkvist L. Cultural competence among Swedish child health nurses after specifi c training: A randomized trial, Nurs Health Sci 2010;12:381- 91. [9] Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Serv Res 2007;7:15. [10] Boyle DP, Springer A. Toward a Cultural Competence Measure for Social Work with Specifi c Populations. Journal of Ethnic And Cultural Diversity in Social Work, 2001;9(3):53- 71. [11] Calliess IT, Ziegenbein M, Gosman L et al (2008) Interkulturelle Kompetenz in der Facharztausbildung von Psychiatern in Deutschland: Ergebnisse einer Umfrage. GMS Zeitschrift für medizinische Ausbildung 25:3;1- 12. [12] Campinha- Bacote J. The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care. J Transcult Nurs 2002;13(3):181- 4. [13] Cantor- Graae E. 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[31] Mösko M, Gil- Martinez F, Schulz H. Cross- cultural opening in German outpatient mental health care service – An explorative study of structural and procedural aspects. J Clin Psychol. (resubmitted) [32] Mösko M, Pradel S, Schulz H. Die Versorgung von Menschen mit Migrationshintergrund in der psychosomatischen Rehabilitation. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 2011;54(4):465- 74. [33] Mösko M. Stand der psychotherapeutischen Versorgung von Frauen und Männern mit Migrationshintergrund in Deutschland. Fachtagung - AG Gender und Depression im Bündnis gegen Depression; 2011 Jun 22; Hannover [34] National Center for Cultural Competence - Georgetown University. http://nccc.georgetown.edu/ [35] Penka S, Krieg S, Hunner C, Heinz A. Unterschiedliche Erkärungsmodelle für abhängiges Verhalten bei türkischen und deutschen Jugendlichen: Bedeutung für Prävention und Behandlungsangebote. Der Nervenarzt 2003;74:581- 6. [36] Price EG, Beach MC, Gary TL, Robinson KA, Gozu A, Palacio A, et al. A Systematic Review of the Methodological Rigor of Studies Evaluating Cultural Competence Training of Health Professionals. Aca Med 2005;80(6):578- 86. [37] Qureshi A, Collazos F, Ramos M, Casas, M. (2008). Cultural competency training in psychiatry. European Psychiatry 2008;23:49- 58. [38] Rapps E, Ramsden I. Cultural safty in nursing: the New Zealand experience. In J Qual Health Care 1996;8(5):491- 7. [39] SoS rapport. Folkhälsorapport (Public Health Report) Socialstyrelsen (Board of Social Welfare) (1997). Stockholm: Modin- Tryck (in Swedish). 1997;18. [40] Statistic Sweden. Statistical Yearbook of Sweden 2011, SCB: Örebro, 2011 [41] Statistisches Bundesamt. Bevölkerung und Erwerbstätigkeit Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2009. Fachserie 1 Reihe 2.2. Wiesbaden: Statistisches Bundesamt, 2010 S. Bäärnhielm et al. / European Psychiatry 27 (2012) / supplement n°2 / S70-S75 S75 [42] Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Van Ommeren M. Association of Toture and Other Potenially Traumatic Ecenets With Mental Health Outcomes Among Populations Exposed to Mass Confl ict and Displacement. A systematic Review and Meta- analysis. JAMA 2009;5(302):537- 49. [43] Sue DW, Sue D. Counseling the culturally different: Theory and practice. 2 nd ed. New York, NY: John Wiley & Sons; 1990. [44] Summerfi eld D. How scientifi cally valid is the knowledge base of global mental health? BMJ 2008;336:992- 4. [45] Tervalon M, Murray- Garcia J. Cultural humility versus competence: a critical distinction in defi ning physician training outcomes in multicultural education. J Health Care Poor Underserved 1998;(2):117- 25. [46] Tseng W- S. (2004). Culture and Psychotherapy. In W- S Tseng., & J Streltzer (Eds.) Cultural Competence in Clinical Psychiatry. USA: American Psychiatric Publishing [47] UNHCR. UNHCR Global Trends, 2010 http://www.unhcr.org/4dfa11499. html [48] Wade P, Berstein B. Culture sensitivity training and counselor’s race: effects on black female client’s perceptions and attrition. J Couns Psychol 1991;38:9–15. [49] Way BB, Stone B, Schwager M, Wagoner D, Bassman R. Effectiveness of the New York State Offi ce of Mental Health Core Curriculum: direct care staff training. Psychiatr Rehabil J 2002;25:398–402. [50] Wohlfart E, Hodzic S, Özbek T (2006) Transkulturelles Denken und transkulturelle Praxis in der Psychiatrie und Psychotherapie. In: Wohlfart E, Zaumseil M (eds) Transkulturelle Psychiatrie- interkulturelle Psychotherapie. Springer Medizin Verlag, Heidelberg [51] Xakellis G, Brangman SA, Hinton WL, Jones VY, Masterman D, Pan CX et al. Curricular framework: Core competencies in multicultural geriatric care. Journal of the American Geriatrics Society 2004;52(1):137- 42. [52] Yeo S. Language barriers and access to care. Annual Review of Nursing Research 2004;22:59- 73. Proofs
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68767 EUROPEAN PSYCHIATRY THE JOURN
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Vol. 27, Supplement n°2, June 2012
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Editorial © 2012 Elsevier Masson S
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health of Turkish woman in Germany:
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studies [8,6,27]. Commonly suggeste
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lack of desire to obtain an educati
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the study should be emphasised [4,1
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clear is the picture regarding depr
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SD=15.9; t(183)= - 2.575; p=.011).
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as caring for children and taking c
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© 2012 Elsevier Masson SAS. All ri
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were then scrutinized independently
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[6] Berry J, Kim U. Acculturation a
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Page 33 and 34: F. Mammadova et al. / European Psyc
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Page 37 and 38: society, history (slavery and colon
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Page 47 and 48: Acknowledgements This work was supp
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Page 61 and 62: 1. Introduction The number of immig
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Page 69 and 70: our study, we composed an assessmen
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Page 73 and 74: Acknowledgments We are very gratefu
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Page 85 and 86: Epilogue A. Kleinman Esther and Syd
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