Abstract
Background
Although the literature in medical anthropology and transcultural psychiatry has documented how cultural representations shape individual experiences and perceptions of psychosocial distress and its management, less attention has been given to what is actually meant when the concept of culture is used in professional practice, and how this may influence experience of care.
Objective
The objective of this article is to explore what understandings of culture circulate in youth mental health practitioners’ and families’ narratives, and to analyse how different operationalizations of the concept may affect experience of services.
Methods
This article draws upon the qualitative components of a larger mixed-methods research program on collaborative care in youth mental health. Semi-structured interviews were conducted in Montréal (Québec, Canada) with 39 parents, 48 youths and 29 practitioners about their experience of services, and with 26 practitioners about their experience of intercultural training. Data was analyzed using thematic and narrative approaches.
Results
Results show that families and practitioners use a multiplicity of understandings of the concept of culture in their discourses as a narrative strategy to mediate dialogue in clinical encounters, either by engaging in it, avoiding it, or refusing it.
Conclusions
The concept of culture and its use in the clinical realm can be seen a double-edged sword, both as a tool to reify stereotypes and inequalities, and as a means to mobilize representations towards cultural safety and transformative practices. Minority families’ experiences of services may be improved by providing intercultural training and a supportive work environment to clinicians.
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Data are available upon request. The first author takes responsibility for the integrity of the data and the accuracy of the data analysis.
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Acknowledgements
The authors would like to thank all the research participants for their time and for having generously agreed to participate in the study. They would also like to acknowledge the contribution of Michaela Field and Jordan Hodgins for English editing, as well as that of Zoé Richard-Fortier, Diana Miconi, Prudence Caldairou-Bessette and Annie Pontbriand for their assistance with data collection.
Funding
This research was supported by grants from the Fonds de recherche du Québec en santé (FRQS) (grant # 198690), and the Canadian Institutes of Health Research (CIHR) and Ministère de la Santé et des Services sociaux (MSSS) du Québec (grant # 01-003-002).
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All authors made substantial contributions to the analysis and interpretation of data. The first author wrote the first draft of the manuscript, while the co-authors gave comments and feedback and edited the first versions. All authors read and approved the final manuscript.
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All procedures performed in this study were in accordance with the ethical standards of the ethical research committee of the CIUSSS Centre-Ouest-de-l’île-de-Montréal.
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Johnson-Lafleur, J., Nadeau, L. & Rousseau, C. Families’ and Practitioners’ Use of Culture in Youth Mental Health Services: A Double-Edged Sword. Child Youth Care Forum 52, 311–329 (2023). https://doi.org/10.1007/s10566-022-09688-8
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DOI: https://doi.org/10.1007/s10566-022-09688-8