In the traditional setting, an interpretation is reliant on the quality and depth of the communication between the dyad. During this process of communication, interpretation of symptoms takes place but which essentially borrows thought processes from the clinician’s medical expertise and education. Nowadays in the UK, such expertise is no longer sufficient because of the multi-culturalisation of the patient and workforce cohorts. Psychiatry’s reliance on the observation and interpretation of manifestations necessitates a cross-cultural education that facilitates a deconstruction of cultural signifiers of the patient. It also requires a self reflective cultural awareness and an understanding of how one’s own background affects the clinical decisions one makes. Quintessentially, the meta-ethnography results corroborated the idea that patient’s symptoms ultimately depend on the clinician’s own cultural experience, cultural beliefs and medical expertise. Neighbors et al. (1989) claim that clinicians are unaware and insensitive to cultural differences as part of the problem in psychiatry. Cultural and clinical factors have been suggested to “hinder the process of diagnosis” specifically within the realm of the interpretation of symptoms (Egeland et al., 1983). Bias has been seen to take place when there is cultural incompetence, language improficiency, and an imprecision in assigning diagnoses amongst clinicians (Minsky et al., 2003; Tranulis et al., 2008). Blow and colleagues (2004) have also reiterated the lack of cultural sensitivity when interpreting patient symptoms. As such and because positive symptoms are more prevalent among minorities, as we saw in chapter four, it appears that there are higher rates of schizophrenia (Blow et al., 2004; Bergner et al., 2008).
Thesis from Brunnel University, United Kingdom, London