Assessing Mental Health Across Cultures is a new book that fills a gap in the Australian literature on cross-cultural mental health. It draws together the wide array of international literature that is available on various aspects of cross-cultural mental health assessment and places it in an Australian clinical context. With an audience in mind of mental health practitioners and students of all professional disciplines, the book provides a theoretical and clinical guide to cultural and linguistic issues likely to be encountered in work with clients from cultures different to that of the clinician. The work arose out of the experience of the authors as clinical psychologists in Victoria’s mental health services, and their experience of developing and delivering a new training program in Cross-Cultural Psychiatric Assessment to mental health professionals. It reflects a decade of development from the work of the Victorian Transcultural Psychiatry Unit in Melbourne. The book was written in response to needs expressed by clinicians for a key reference to enable them to learn more about cross-cultural mental health assessment.

Assessing Mental Health Across Cultures addresses issues that mental health staff identified as areas in which they experienced most difficulty when conducting a cross-cultural assessment. Rather than providing a list of cultures with which the mental health worker should be familiar, Assessing Mental Health Across Cultures provides an individual cultural framework for conducting assessments which can be applied in diverse cross-cultural situations. The opening chapter reviews the assumptions underpinning Western psychiatry that Western diagnostic categories are universally applicable, with the resulting risks of misdiagnosis and inappropriate treatment. An extended version of the DSM-IV’s Outline for a Cultural Formulation is introduced as providing a useful framework for guiding clinicians through cross-cultural assessments and culturally sensitive case formulations. Case examples set in the Australian clinical context are used in illustration throughout the book.

Because clinicians have expressed difficulties in understanding family dynamics when treating clients from culturally and linguistically diverse communities, the chapter on Cultural Values and the Sense of Self explores how collectivist conceptions of the self are interlinked with family relationships and how these conceptions may conflict with the individualist values that underpin Western mental health practice. Misunderstandings that may arise in the clinical relationship due to cross-cultural differences in power distance are also explored. The chapter on Expression and Communication of Distress Across Cultures, examines differences in the regulation, expression and interpretation of affect across cultures and searches for an answer to the question, “Does depression exist across cultures?” Assumptions about emotion that underlie Western mental health practice are examined and the universal applicability of these assumptions is questioned, with an emphasis on somatic expressions of distress.

The potential for miscommunication that can occur when translating mental health terminology is addressed by the chapter on Issues in Translating Mental Health Terms across Cultures, with guidelines for working collaboratively with interpreters. The cultural fairness of psychological tests and measures is also discussed. Chapters on Explanatory Models of Illness and Cross-cultural Beliefs about Illness are in response to findings that mental health practitioners at times acknowledge difficulties in distinguishing cross-cultural beliefs from the culturally normative or psychopathological. Using the explanatory model framework, these chapters provide an overview of a range of cross-cultural explanations of illness. Two belief systems are explored in greater depth to illustrate how the explanatory model framework can be used to elicit an understanding of the client’s perspective on the problem and its appropriate treatment. Negotiation strategies to overcome differences in explanatory models between the clinician and client are illustrated using an interview transcript. To demonstrate how the cultural features of a case can be communicated to other clinicians, a case study is written up in a Culturally Sensitive Clinical Formulation.

The authors are Lena Andary, a Clinical Psychologist, who teaches for the Graduate Diploma in Community Mental Health at the University of Melbourne, and for the Victorian Transcultural Psychiatry Unit. Yvonne Stolk is a Clinical Psychologist who works as an Ethnic Mental Health Consultant in the Western Region of Melbourne. Dr Steven Klimidis, Clinical Psychologist and Deputy Director and Co-ordinator of Research of the Victorian Transcultural Psychiatry Unit, is the Associate Professor in the Centre for International Mental Health, School of Public Health, University of Melbourne.

The book is available through Australian Academic Press: www.australianacademicpress.com.au/assessing-mental-health.html