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Advances in Psychiatric Treatment (2004) 10: 474-478
© 2004 The Royal College of Psychiatrists

Communication with patients from other cultures: the place of explanatory models

Kamaldeep Bhui and Dinesh Bhugra

Kamaldeep Bhui is Professor of Cultural Psychiatry and Epidemiology at St Bartholomew’s and The Royal London School of Medicine and Dentistry (Queen Mary and Westfied College, Mile End Road, London E1 4NS, UK. E-mail: k.s.bhui{at}qmul.ac.uk). He is interested in cross-cultural and epidemiological psychiatry, service development and explanatory models of illness. Dinesh Bhugra is Professor of Mental Health and Cultural Diversity and heads the Section of Cultural Psychiatry at the Institute of Psychiatry, London. His research interests include cultural factors in the aetiology and diagnosis of mental illness.

We discuss the complicated nature of communication between people from different cultural groups, perhaps using a second language. We focus on the fact that mental health practitioners and service users often have in common neither their cultural backgrounds nor their explanatory models of illness. Communication even in a shared language can be less than optimal as words carry multiple meanings. Consequently, consultations that involve culturally grounded explanatory models of illness challenge the professional. We give examples showing that reconciling different explanatory models during the consultation is a core task for psychiatrists and mental health practitioners working in multicultural settings.




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