Diversity in Action: Case Studies in Cultural Psychiatry

Contents
Contributors
1: Introduction
	Cultural Constructs in the DSM-5
	Definition of Culture to Improve Clinical Care
	Culture and Mental Health Conceptual Model
	Training and Education
	Survivors, Special Populations, and Systems and Settings
	Clinical Case Vignettes
	Conclusion and Future Directions
	References
Part I: Survivors
	2: Survivors of Torture
		Vignette
		Introduction
		Definitions
			Intersection with Healthcare
		Screening and Assessment
		Treatment
			Psychotherapy Treatments
			Pharmacologic Treatments
			Social and Legal Services
			Children and Adolescents
			Pregnancy
		Conclusion
		Summary of High-Yield Points
		References
	3: Survivors of Human Trafficking
		Introduction
		Cultural Considerations of Human Trafficking
			Criminal Justice System
				A Criminal Justice Approach to Trafficking
				Community and Police Relations
				Immigration Policy
			Race
				Racial Stereotypes
				Media
				Mental Health
				Access to Services and Legal Outcomes
			Adverse Childhood Experiences (ACEs)
			Family Structure
			Socioeconomic Factors
			Gender
		Vignette
		Psychiatric Assessment and Treatment of Human Trafficking Survivors
			Assessment
			Treatment Recommendations
				Trauma-Informed Care
				Culturally Responsive Care
				Addressing Clinician Bias
				Systemic Changes
		Conclusion
		Summary of High-Yield Points
		References
	4: Survivors of Combat Trauma
		Introduction
		Background
			Military Structure and Organization
			The Pillars of Military Culture
			Combat and Its Effects
			Combat Trauma in the Modern Day
			Defining the Problem
			Factors Impacting Care
		Vignette
		Case Discussion
		Comments and Recommendations
		Summary of High-Yield Points
		References
Part II: Special Populations
	5: Co-occurring Disorders
		Introduction
		Background
			Historical Significance
				Alcohol
				Opioids
				Stimulants
				Tobacco
			Cultural Considerations
		Vignette
			Discussion
		Culturally Competent Care in Co-occurring Disorders
			Social Risk Factors
				Isolation
				Stigma
			Special Populations
				Pregnancy, Postpartum, and Motherhood
				Physical and Cognitive Disabilities
				Incarcerated Populations
				Military Service Members and Veterans
				Indigenous Populations
		Treatment for Co-occurring Disorders
			Alcohol
			Opioids
			Stimulants
			Tobacco
		Conclusion
		Summary of High-Yield Points
		References
	6: Telepsychiatry to Rural Populations
		Vignette 1
		Introduction
		What Is Culturally Competent Care and How Can TMH Help in Rural Settings?
			Approaches to Provide Culturally Competent Care
		Vignette 2
			Setting Goals with Patients
			TMH and Its Use in Cultural Populations
		How Do We Provide Culturally Competent Care Via TMH?
			Assess Needs for Cultural and Language “Fit” Between Patients and Providers
			Attend to Language and Culture over Distance
			Training Approaches to Telehealth and Culture
			Models of Care: Enhancing Access, Providing Flexibility, and Leveraging Resources
			Refugees and Disaster Victims and TMH
		What Are the Dos and Don’ts of Addressing Barriers, Problems and Sustainability Issues
			Barriers in Patient/Provider Culture and Access to Technology
			Physician and Workflow Barriers
			Funding and Cost Analysis
			Evaluation
			TMH Administration and Models of Care
		Discussion
			Policy/Advocacy
		Conclusion
		Summary of High-Yield Points
		References
			Suggested Reading
	7: Religion, Spirituality, and Mental Health
		Introduction
		Background
		Vignette 1
		Culturally Competent Care
		Vignette 2
		Training and Education
		Disorder Specific Considerations
			Substance Use Disorders
			Psychotic Disorders
			Trauma- and Stress or-Related Disorders
			Anxiety Disorders
			Mood Disorders
		Recommendations
		Conclusion
		Summary of High-Yield Points
		References
	8: Biculturalism: The Case of Two North American Neighbors
		Introduction
		Background
			Biculturalism in the Context of Culture
			Historical Significance Between the Two Countries
			Biculturalism in the Context of Art, Business, Science, and Entertainment
		Culturally Competent Care and Biculturalism
			Interaction Between Psychiatry and Biculturalism
		Vignette 1: Bill
			Discussion
		Vignette 2: Sebastian
			Discussion
		Training and Education in Biculturalism
		Recommendations
		Conclusion
		Summary of High-Yield Points
		References
Part III: Systems and Settings
	9: Correctional Psychiatry
		Vignette
		Mass Incarceration and Cultural Implications
			Introduction
			The Problem of Mass Incarceration
			Cost of Mass Incarceration
			Overrepresentation of People of Color
			Overrepresentation of People with Mental Illness
		Right to Treatment in Correctional Institutions
		Challenges of Practicing in Correctional Settings
			Typical Responsibilities
			Cultural Differences: Penal System Versus Mental Health System
			Ethical Considerations of Professional Practice
			Boundary Challenges
			Resource Limitations
			Security Restrictions
			Threats to Confidentiality
			Mental Health Stigma
			Implicit Racial Bias
		Special Considerations When Working with Patients in Correctional Settings
			Suicide Risk
			Trauma and Victimization
			Behavioral Challenges
		Solitary Confinement
			Background
			By the Numbers
			Mental Illness and Segregation
			Psychological Impact of Segregation
			Mental Health Screening and Monitoring in Segregation
			Barriers to Treatment in Restricted Housing Units
			Movement Away from Segregation
		Vignette Discussion
		Conclusion
		Summary of High-Yield Points
		References
	10: Shifting Gears: Cultural Assimilation into Primary Care
		The Culture of Primary Care
		Interprofessional Education and Practice
		The Collaborative Care Model
		Measurement-Based Care in Primary Care and Collaborative Care
		Vignette 1
			Traditional Model of Care
			Collaborative, Interprofessional Model of Care
		Vignette 2
			Traditional Model of Care
			Transition to Collaborative, Interprofessional Model of Care
		Conclusion
		Summary of High-Yield Points
		References
	11: Psychiatric Care in Residential Care Environments
		Introduction
		Background
		Psychiatric Illness in Residential Care Environments
		Vignette
		Case Discussion and Recommendations for Optimal Treatment
		Conclusion and Recommendations
		Summary of High Yield Points
		References
Index