Child psychiatry in a multicultural context

Abstract

The diversity of ethnic groups in the increasingly multicultural world that children inhabit, has reawakened interest in the relationship between ethnicity and child mental health. Recent writing in cultural child and adolescent psychiatry has focused on the interpretation of the data from cross-cultural comparative studies, raising critical questions about conceptual and methodological issues such as, the cross-cultural validity of diagnostic tools, the contribution of underlying social and economic variables in accounting for difference and cultural differences in the interpretation of childhood behaviour. Differences between parental and professional interpretation of children's behaviour are known but professionals from different cultural backgrounds may also differ significantly in their expectations and interpretations of childhood behaviours. There is little evidence of culture specific disorders in children although there are some reported differences in symptomatology. The cross cultural data reviewed in the paper pertains largely to studies undertaken in the UK but also draws upon related studies from other parts of the world.

Clinicians practising in an ethnically diverse world must necessarily develop a conceptual framework for understanding difference and examining their own practice. Contributions from the related disciplines of Cultural Psychology and Anthropology have furthered our understanding of cultural differences in care giving environments and child rearing practices which may reflect competencies expected of adults in the cultural environment. Given that cultures are dynamic and continuously evolving, the end point of the search is less likely to be how cultures differ, rather how we deconstruct difference and work with diversity.