Clinical challenges in cultural psychiatry - searching for meaning, searching for methods † .

BACKGROUND: Mental health services in Sweden are confronted with globalization and refugee migration from conflict- and war-torn countries.

AIM: To discuss how clinicians in Sweden can deal with a series of challenges in a changing globalized society, ranging from difficulties of overcoming barriers to help seeking to difficulties of identifying trauma and finding culturally adapted clinical tools.

METHOD: Case vignettes are presented to exemplify challenges. Different approaches developed to support clinicians are presented.

RESULTS: The concepts of patient centered care and shared decision-making as well as the cultural formulation interview, are recommended to explore the significance of culture and context in psychiatric assessments. Acknowledging relational aspects of care and of paying attention to the patients' social worlds in clinical work is also essential.

CONCLUSIONS: The article includes recommendations for training as well as an appeal for the involvement of the wider society in the work to guarantee equitable and high-quality mental health services for some of the most vulnerable patient groups in society.