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Objectives: To understand the key descriptors of the Top End Mental Health Service, Northern Territory's, perinatal mental health consultation service (PMHCS). Method: A retrospective cross-sectional review of all referrals to the PMHCS in the 12 months period 1 January to 31 December 2021 inclusive was undertaken. The study was descriptive in nature. Results: From January 2021 to December 2021, there were 266 women referred to the service. There was a large proportion of Aboriginal and Torres Strait Islanders. Mean age was 28.8 (SD = 6.04) years. A statistically significant difference was identified between the average age of the Aboriginal and Torres Strait Islander women (n = 53, M = 24.6 years, SD = 6.31) which was significantly less than Caucasian women (n = 161, M = 29.4037, SD = 4.982) and women of other cultural backgrounds (n = 52, M = 31.154, SD = 6.792), p <.00,001. Sixty two percent of patients managed had a history of trauma with significantly more service contact. Conclusion: This data gives insight into a unique population group. It also highlights the impact that trauma has on patient care and management. [ABSTRACT FROM AUTHOR]

Genuine Chinese dance therapy is in the ascendant and psychiatric approaches that involve a broad spectrum of principles such as ontological identity, social inclusion and collective support, aestheticisation and expressive catharsis, symbolic exorcism, trance and Buddhist mindfulness. Its models are based on a wealth of Chinese dance genres originating from various dynasties as well as cultural traditions of ethnic minorities. Due to different epistemological backgrounds of Western diagnostic manuals and traditional Chinese views of mental diseases, complex understanding of pathologies and therapeutic dynamics is needed. Therefore, this opinion piece suggests a theoretical framework that encourages interdisciplinary approaches as well as inclusive transcultural psychiatry and related philosophy of science. [ABSTRACT FROM AUTHOR]

• Clinicians have used the CFI to complete cross-cultural assessments with patients. • Information from the CFI can help clinicians with devising a differential diagnosis. • Information from the CFI can help clinicians with treatment planning. • More research is needed on how clinicians use the CFI in case formulations. The publication of the 16-item Cultural Formulation Interview (CFI) in DSM-5 has initiated a robust line of international scholarship on whether patients and clinicians find it feasible, acceptable, and useful in different practice settings. Studies have routinely concluded that the CFI improves rapport when clinicians use it with patients, though less attention has been focused on how clinicians use information from the CFI in clinical tasks or case formulations. This state-of-the-science review describes the development of the CFI and uses a specific methodology, the state-of-the-art review, to analyze peer-reviewed studies reporting how clinicians have used information from the CFI in clinical tasks, namely diagnostic and treatment planning. Twelve studies met inclusion criteria, with 10 indicating that the CFI was helpful for these tasks. All studies emphasized that the CFI can help clinicians understand the social contexts of patients' lives. The article concludes with an agenda for future research, such as exploring how preexisting conceptions of culture influence clinical decision making and determining how the CFI affects case formulations. [ABSTRACT FROM AUTHOR]

Gypsy, Roma and Traveller (GRT) communities have considerably worse mental health outcomes than the general population and many other ethnic minority groups. We argue that there is a dynamic, interplaying ‘accessibility mismatch’, resulting in a failure of healthcare services to adequately understand and work with GRT communities in a meaningful way. The consequences are limited engagement and poor health outcomes. Contact with services is often at crisis points, such as in forensic services, which reinforces existing prejudice. Research is limited, and therefore so is the evidence base. It is critical that the UK's National Health Service takes a culturally informed approach to co-produce services that are accessible and responsive to GRT communities. Here we offer practical actions that healthcare organisations can undertake to help redress imbalances and increase equity of healthcare outcomes for these overlooked populations.

Aims and method Calls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists’ attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered. Results In 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants’ opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common. Clinical implications Mental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice.

Aims and method Calls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists' attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered. Results In 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants' opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common. Clinical implications Mental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice. [ABSTRACT FROM AUTHOR]

Gypsy, Roma and Traveller (GRT) communities have considerably worse mental health outcomes than the general population and many other ethnic minority groups. We argue that there is a dynamic, interplaying 'accessibility mismatch', resulting in a failure of healthcare services to adequately understand and work with GRT communities in a meaningful way. The consequences are limited engagement and poor health outcomes. Contact with services is often at crisis points, such as in forensic services, which reinforces existing prejudice. Research is limited, and therefore so is the evidence base. It is critical that the UK's National Health Service takes a culturally informed approach to co-produce services that are accessible and responsive to GRT communities. Here we offer practical actions that healthcare organisations can undertake to help redress imbalances and increase equity of healthcare outcomes for these overlooked populations. [ABSTRACT FROM AUTHOR]

Objective: Australia has inadequate publicly available data regarding the use of involuntary psychiatric care. This study examined the association between patient clinical/demographic factors and involuntary psychiatric admission following initial psychiatric assessment in Royal Darwin Hospital. Method: Retrospective review of 638 psychiatric assessments followed by covariate analysis of patient variables associated with involuntary psychiatric admission. Results: Most of the 225 psychiatric admissions were involuntary (92%). Male patients and those with a preferred language other than English had the highest risk of being admitted involuntarily (RR 1.09, χ2 [1] = 3.9, p =.048, and RR 1.11, p =.036, respectively). Conclusions: Further research regarding the influence of patient demographics and clinical factors on rates of involuntary admissions, particularly for Aboriginal patients, is recommended. The findings prompt discussion on strategies to improve monitoring of involuntary care and barriers to voluntary treatment. [ABSTRACT FROM AUTHOR]

Background: Elevated risk of psychosis for ethnic minority groups has generally been shown to be mitigated by high ethnic density. However, past survey studies examining UK Pakistani populations have shown an absence of protective ethnic density effects, which is not observed in other South Asian groups. Aims: To assess the ethnic density effect at a local neighbourhood level, in the UK Pakistani population in East Lancashire. Method: Data was collected by the East Lancashire Early Intervention Service, identifying all cases of first episode psychosis (FEP) within their catchment area between 2012 and 2020. Multilevel Poisson regression analyses were used to compare incidence rates between Pakistani and White majority groups, while controlling for age, gender and area-level deprivation. The ethnic density effect was also examined by comparing incidence rates across high and low density areas. Results: A total of 455 cases of FEP (364 White, 91 Pakistani) were identified. The Pakistani group had a higher incidence of FEP compared to the White majority population. A clear effect of ethnic density on rates of FEP was shown, with those in low density areas having higher incidence rates compared to the White majority, whereas incidence rates in high density areas did not significantly differ. Within the Pakistani group, a dose-response effect was also observed, with risk of FEP increasing incrementally as ethnic density decreased. Conclusions: Higher ethnic density related to lower risk of FEP within the Pakistani population in East Lancashire, highlighting the impact of local social context on psychosis incidence. [ABSTRACT FROM AUTHOR]

The dominance of Western orthodox models of psychiatry has led to colonisation of the mind and marginalisation of diverse cultural conceptualisations of distress and forms of caring. Compounded by a crisis of care and chronic underfunding, this has also diminished our practice here in the UK. This article probes the biases that UK psychiatry must unlearn and what lessons it can learn from decolonising praxes originating in the Global South. This is a call to action. We must transform our mindsets and advocate for contextualised, collective, integrative and socially just mental healthcare in the UK.

The relationship between spirituality and behavioural addictions is complex. Although some studies have suggested spirituality to be a protective factor helping in recovery from addictive behaviours, others have found spirituality to be a potential risk factor. To better understand the relationship between spirituality and various behavioural addictions, this review summarises the literature on the association between spirituality and the following behavioural addictions: gaming disorder, gambling disorder, problematic internet use, problematic smartphone use, compulsive sexual behaviour disorder and compulsive buying/shopping disorder. Implications for clinical practice and future research are discussed.

Background The use of feedback to address gaps and reinforce skills is a key component of successful competency-based mental health and psychosocial support intervention training approaches. Competency-based feedback during training and supervision for personnel delivering psychological interventions is vital for safe and effective care. Aims For non-specialists trained in low-resource settings, there is a lack of standardised feedback systems. This study explores perspectives on competency-based feedback, using structured role-plays that are featured on the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform developed by the World Health Organization and United Nations Children’s Fund. Method Qualitative data were collected from supervisors, trainers and trainees from multiple EQUIP training sites (Ethiopia, Kenya, Lebanon, Peru and Uganda), from 18 key informant interviews and five focus group discussions (N = 41 participants). Qualitative analysis was conducted in Dedoose, using a codebook with deductively and inductively developed themes. Results Four main themes demonstrated how a competency-based structure enhanced the feedback process: (a) competency-based feedback was personalised and goal-specific, (b) competency-based feedback supported a feedback loop, (c) competency-based feedback supported a comfortable and objective feedback environment, and (d) competency-based feedback created greater opportunities for flexibility in training and supervision. Conclusions A better understanding of the role of feedback supports the implementation of competency-based training that is systematic and effective for trainers and supervisors, which ultimately benefits the learning process for trainees.

Exploring traditional healing practices in the Arab world unveils a diverse range of methods deeply rooted in ancient beliefs. Traditional healing practices encompass natural remedies, spiritual rituals and physical treatments. These historical practices persist today, reflecting their enduring relevance in Arab culture and their influence on healthcare approaches. Factors such as accessibility to traditional healing services, a lack of affordable medical treatment, cultural familiarity and a strong belief in the efficacy of traditional healing methods in treating mental problems contribute to their continued use. However, potential challenges arise when an exclusive reliance on traditional methods might hinder access to critical medical interventions. Thus, the need for further documentation and research into these deeply ingrained healing traditions is emphasised. Some research has focused on integrating these traditional approaches with the modern medical system, recognising their combined value in healthcare. This balanced approach holds the potential to bridge the gap between culturally informed traditional practices and contemporary medical treatments.

The dominance of Western orthodox models of psychiatry has led to colonisation of the mind and marginalisation of diverse cultural conceptualisations of distress and forms of caring. Compounded by a crisis of care and chronic underfunding, this has also diminished our practice here in the UK. This article probes the biases that UK psychiatry must unlearn and what lessons it can learn from decolonising praxes originating in the Global South. This is a call to action. We must transform our mindsets and advocate for contextualised, collective, integrative and socially just mental healthcare in the UK. [ABSTRACT FROM AUTHOR]

The relationship between spirituality and behavioural addictions is complex. Although some studies have suggested spirituality to be a protective factor helping in recovery from addictive behaviours, others have found spirituality to be a potential risk factor. To better understand the relationship between spirituality and various behavioural addictions, this review summarises the literature on the association between spirituality and the following behavioural addictions: gaming disorder, gambling disorder, problematic internet use, problematic smartphone use, compulsive sexual behaviour disorder and compulsive buying/shopping disorder. Implications for clinical practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Language barriers are among the most critical factors in health care disparities. Low language proficiency is consistently associated with a high prevalence and severity of mental health disorder symptoms. Despite the advantages of working with an interpreter, most practitioners report difficulties, especially with trust and the feeling of control. The main objective of this exploratory qualitative intervention research is to examine the impact of training when working with interpreters and their inclusion in follow-ups. This impact is evaluated in the changes in feelings of control and trust for the practitioners who received the training, for the trained interpreters included in follow-ups and for the patients of these follow-ups. Semistructured interviews were conducted with individuals involved in five follow-ups at four public mental health clinics in Paris, France. The project had two phases: before (N = 18) and a few months after (N = 12) the training. Interviews were transcribed and thematically analyzed. Before the training, practitioners perceived the potential for collaboration with interpreters and the complexity of triadic consultations. Interpreters expressed irritation and disappointment at the lack of recognition, and patients seemed confident because they had already built a relationship with practitioners. After the training and inclusion of interpreters, trust is better established between interpreters and practitioners, which has substantial effects. All the protagonists state that trust positively impacts the relationship with patients and the therapeutic process. Although some practitioners still doubt the sessions' control, the intervention helps them to gain knowledge and critically examines their clinical modus operandi. Public Policy Relevance Statement: Employing an interpreter is the most effective way to overcome language barriers, yet mental health practitioners are reluctant to do so. This study shows that a few hours of training working with an interpreter not only enables practitioners to develop collaborative behaviors but also transforms the therapeutic process. Ensuring that practitioners have access to and know how to work with interpreters is key to improving access to care for highly vulnerable populations. [ABSTRACT FROM AUTHOR]

Sadly, much of the world is no stranger to Psychological Trauma, particularly in poorer areas with poor health infrastructure. Western Aid Organisations frequently deploy to such areas bringing with them a western psychiatric tradition of nosology and therapy which may not be appropriate in other cultures. We argue that imposing a western system of diagnosis and treatment may not only undermine local culture but may also be bad for the patient. We discuss this with reference to the WHO's Mental Health Gap initiative (MHGap). [ABSTRACT FROM AUTHOR]

The Roma are Europe's largest ethnic minority group, and often face discrimination and social exclusion. Social strife and lack of access to healthcare are associated with increased symptoms of psychopathology. We aimed to review evidence on mental health outcomes and on access to mental healthcare among the Roma population in Europe. We systematically searched five databases (PsycINFO, Global Health, Social Policy and Practice, Web of Science and PubMed) and conducted a grey literature search in August 2020. We identified 133 studies, 26 of which were included for final analysis. We present the results using a narrative synthesis. The available literature indicates a relatively high prevalence of anxiety, depression and substance abuse among Roma, and females seem to be more affected than males. Roma children exhibit more externalizing and internalizing disorders when compared with non-Roma children. Mental health and perceived well-being among the Roma population are strongly linked to social determinants of health such as housing or economic income. Access to mental healthcare is limited for Roma people because of several barriers pertaining to language, lack of information regarding available services, and the insurance and economic status of Roma people. Roma people report mainly negative experiences with mental health services, including a lack of understanding from healthcare providers, and instances of racism and discrimination. There is a need for more research on mental health and access to healthcare in Roma people. Future studies should be participatory in order to provide guidelines for mental healthcare that addresses the needs of the Roma population. [ABSTRACT FROM AUTHOR]

This review essay explores recent historical and anthropological literature on the emergence and development of transcultural psychiatry in the second half of the twentieth century. It examines how postcolonial psychiatry attempted to remove itself from its erstwhile colonial frameworks and strove to introduce new concepts and paradigms to make itself relevant in the context of decolonization and postwar reconstruction. The essay looks at both continuities and discontinuities between colonial and post-colonial transcultural psychiatry, asking how the recent surge of scholarly literature in this field engaged with these issues. It also aims to identify the most important avenues for future research. [ABSTRACT FROM AUTHOR]

To address the growing need for good-quality mental health service provision to patients in Iraq, mhGAP-IG 2.0 training in mental, neurological and substance use (MNS) disorders was delivered for primary care physicians in May–June 2022 by the Royal College of Psychiatrists (RCPsych) volunteers scheme. An innovative hybrid model was used to deliver this training to improve engagement compared with virtual training alone. Pre- and post-training assessment tools showed a significant improvement in participants knowledge of MNS disorders. Follow-up fortnightly supervision sessions by RCPsych volunteers were planned to help participants consolidate their learning in managing MNS disorders.

People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery.

Summary There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice.

Exploring traditional healing practices in the Arab world unveils a diverse range of methods deeply rooted in ancient beliefs. Traditional healing practices encompass natural remedies, spiritual rituals and physical treatments. These historical practices persist today, reflecting their enduring relevance in Arab culture and their influence on healthcare approaches. Factors such as accessibility to traditional healing services, a lack of affordable medical treatment, cultural familiarity and a strong belief in the efficacy of traditional healing methods in treating mental problems contribute to their continued use. However, potential challenges arise when an exclusive reliance on traditional methods might hinder access to critical medical interventions. Thus, the need for further documentation and research into these deeply ingrained healing traditions is emphasised. Some research has focused on integrating these traditional approaches with the modern medical system, recognising their combined value in healthcare. This balanced approach holds the potential to bridge the gap between culturally informed traditional practices and contemporary medical treatments. [ABSTRACT FROM AUTHOR]

Acute behavioural disturbance (ABD) is a highly contentious topic, with debate about its validity as a construct. Particular concerns have been raised about how it places societal problems ‘in’ people – disproportionately from minority ethnic backgrounds – medicalising being a victim of violence. The author reflects on his experiences ‘with’ ABD.

Background: A patient's pathway to care is often characterized by a sequence of actions taken to remedy ill-health. Research exploring the help-seeking behavior of individuals with mental health problems in sub-Saharan Africa is relatively limited. This study assessed the perceptions and experiences of mental illness and treatment among patients with mental illness at two psychiatric facilities in Johannesburg, South Africa. Methods: 309 interviewer administered surveys were conducted between January and July 2022. We used a logistic regression model to examine factors associated with receiving treatment for mental illnesses from traditional healers. Semi-structured interviews were conducted with 18 participants during the same period. Interviews were transcribed and translated into English. Data were managed using NVivo 11 software and thematically analyzed. Findings: Results showed that 144 (47%) patients sought mental health care from traditional healers. Higher anxiety symptoms, number of people in the household, believing that traditional medicine can cure mental illnesses, and township living were associated with seeking mental healthcare from traditional healers. Qualitative analysis indicated that participants often believed that mental illness was due to bewitchment and consulted with multiple traditional healers, thus spending large amounts of money for treatment and ultimately delaying access to biomedical care. Conclusion: Collaborative approaches between traditional healers and biomedical professionals show promise in terms of allowing for improved identification and treatment of individuals with mental disorders. [ABSTRACT FROM AUTHOR]

People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery. [ABSTRACT FROM AUTHOR]

There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice. [ABSTRACT FROM AUTHOR]

BackgroundThe Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure.AimsTo translate and culturally adapt the THQ for use in a population of homeless people with severe mental illness in Tamil Nadu, India.MethodWe used Herdman et al's model of cultural equivalence to conduct an in-depth qualitative assessment of the cultural validity of the THQ. Following several translations, conceptual, item, semantic and operational equivalence of the THQ was assessed through four focus groups with user-survivors (n = 20) and two focus groups with mental health professionals (n = 11).ResultsSeveral adaptations, including the addition of 18 items about relationships, homelessness and mental illness, were necessary to improve cultural validity. Three items, such as rape, were removed for reasons of irrelevance or cultural insensitivity. Items like 'adultery' and 'mental illness' were reworded to 'extramarital affair' and 'mental health problem', respectively, to capture the cultural nuances of the Tamil language. Findings revealed a divergence in views on tool acceptability between user-survivors, who felt empowered to voice their experiences, and mental health professionals, who were concerned for patient well-being. Providing a sense of pride and autonomy, user-survivors preferred self-administration, whereas mental health professionals preferred rater administration.ConclusionsCulture significantly affects what types of events are considered traumatic, highlighting the importance of cultural validation of instruments for use in novel populations and settings.

Mindfulness-based therapies (MBTs) have shown promising results in non-psychotic disorders. Unlike most other psychotherapy models, which are claimed to be Western in origin, MBTs are firmly based in Indian philosophy and traditions. This paper summarises the concepts of the observer self (sakshi) and attention (dhyana) that underlie the principles and practice of MBT, correcting some erroneous assumptions in the process. It is argued that better understanding of these concepts is beneficial not just for specialist psychotherapists, but for all clinicians interested in the craft of healing.

Acknowledging the impact of imperialist and colonialist attitudes on the development of psychiatry allows for the recovery of the work of practitioners whose contribution may have been overlooked, as well as recognising racist attitudes in predominant thinking. These combined approaches aid in the construction of a more complete critical history. [ABSTRACT FROM AUTHOR]

The World Psychiatry Exchange Program in Iran is an academic experience we are delighted to share. As two participating early career psychiatrists, a local psychiatry faculty member manager, and the lead founder and international coordinator of the programme, we focus in this article on the unfolding of this new learning experience, the difficulties we encountered and the main lessons learned by the participants: commonalities and differences in training and practice in general adult psychiatry and child psychiatry in Tunisia and Iran, as well as in idioms of distress between the Arab and Persian cultures.

To address the growing need for good-quality mental health service provision to patients in Iraq, mhGAP-IG 2.0 training in mental, neurological and substance use (MNS) disorders was delivered for primary care physicians in May–June 2022 by the Royal College of Psychiatrists (RCPsych) volunteers scheme. An innovative hybrid model was used to deliver this training to improve engagement compared with virtual training alone. Pre- and post-training assessment tools showed a significant improvement in participants knowledge of MNS disorders. Follow-up fortnightly supervision sessions by RCPsych volunteers were planned to help participants consolidate their learning in managing MNS disorders. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between historical research and the field of global mental health. It identifies a gap in the current literature, and argues that an in-depth historical approach is critical for understanding and overcoming current challenges and controversies in global mental health. The authors propose that a thick historical analysis has the capacity to broaden and diversify the discussion about the core concepts in global mental health (such as illness, suffering, care or culture), and to nuance our understanding of the field’s development and impact in specific political and social contexts. The paper analyzes how a systematic historical approach is crucial for understanding colonial and post-colonial power relations embedded in the field of global mental health, and encourages researchers and practitioners to view history as a source of imagination, and of alternative ideas and initiatives in mental health that go beyond existing psychiatric frames of representations, and towards truly radical and egalitarian projects and relations. This exercise in alternative historical imagination does not need to interfere with nor disrupt the urgency of mental health practice today; on the contrary, it is meant to improve the effectiveness of interventions. It can provide practitioners with a new and enriched language to resolve long-standing clinical dilemmas (e.g. related to patient adherence or limited success of certain cultural adaptations), which could not be properly addressed previously

Spiritualist mediums are sought out from a variety of cultures for their advanced spirit communication healing techniques. Otherworldly spirits use mediums to create spirit art, which guides an individual to discover their authentic self and work through self‐limiting beliefs. To serve as a bridge for the spirit world, the medium develops an ability to enter an altered state of consciousness and use a multisensory embodied language to communicate with spirits. I describe this language as "dancing with spirits." To investigate this language, I use my own spirit art as an innovative experiential ethnographic tool that blends auto‐ethnographic perceptions of spirits with sensory and artistic ethnography, and cultural healing techniques. I provide three case studies of how my spirit art provides unique insights into the less explored experiential dimensions of spirit communication. I layer my experimental ethnographic approach with Deleuze and Guattari's "rhizome" to show that spirit communication overcomes limitations of normal linguistic models. The spirit language serves as a rupture for unconscious forces to offer individually tailored healing and insight to a recipient through heightened sensory and physiological phenomena. Art, altered states of consciousness, and anomalous sensory experiences may offer insights to address a pressing global challenge, mental ill‐health. [ABSTRACT FROM AUTHOR]

This article traces the career, scientific achievements, and emigration of the Berlin-born physician, psychoanalyst, and psychosomatic researcher Eric Wittkower. Trained in Berlin and practicing internal medicine, he became persecuted by the Nazi regime and, after fleeing Germany via Switzerland, continued his professional career in the United Kingdom, where he turned to psychosomatic medicine and worked in the service of the British Army during World War II. After two decades of service in the UK, Wittkower joined McGill University in Canada. His increasingly interdisciplinary work contributed to the establishment of the new research field of transcultural psychiatry. Finally the paper provides a detailed history of the beginning of the section of transcultural psychiatry at the Allan Memorial Institute. [ABSTRACT FROM AUTHOR]

Psychotherapy is a learning process. Updating the prediction models of the brain may be the mechanism underlying psychotherapeutic changes. Although developed in different eras and cultures, dialectical behavior therapy (DBT) and Morita therapy are influenced by Zen principles, and both emphasize the acceptance of reality and suffering. This article reviews these two treatments, their common and distinct therapeutic factors, and their neuroscientific implications. Additionally, it proposes a framework that includes the predictive function of the mind, constructed emotions, mindfulness, therapeutic relationship, and changes enabled via reward predictions. Brain networks, including the Default Mode Network (DMN), amygdala, fear circuitry, and reward pathways, contribute to the constructive process of brain predictions. Both treatments target the assimilation of prediction errors, gradual reorganization of predictive models, and creation of a life with step-by-step constructive rewards. By elucidating the possible neurobiological mechanisms of these psychotherapeutic techniques, this article is expected to serve as the first step towards filling the cultural gap and creating more teaching methods based on these concepts. [ABSTRACT FROM AUTHOR]

In the UK, the incidence of schizophrenia appears highest in Black Caribbean and Black African communities (four- to six-fold that of the White British population). The incidence of psychosis in other minority ethnic groups is also raised, but to a lesser magnitude. Although there are numerous environmental confounding factors, the data stresses the importance of optimising treatment in high-risk (minority) groups. Antipsychotic nonadherence is the most common reason for schizophrenia relapse, and is associated with increased rates of relapse, readmission to hospital and suicide. This article examines available literature to discover how culture can affect antipsychotic nonadherence, and considers culture-based solutions that could enhance antipsychotic adherence. Acknowledging the importance of the therapeutic alliance and sociocultural aspects in antipsychotic adherence, I argue that current cultural competence training provided to clinicians is inadequate. Organisational- and system-level approaches are required to reduce oppressive practise and promote culturally competent, person-centred care.

Abstract Background Unaccompanied refugee minors—or unaccompanied minors—are children and adolescents who have been separated from parents and other relatives and are not being cared for by an adult. Unaccompanied minors are a vulnerable population, with numerous stressors and complex psychiatric symptoms necessitating specialized mental health care. This study explores patients’ experiences of a Multimodal Co-Therapy for Unaccompanied Minors (MUCTUM), which encompasses cultural, biological, narrative & institutional approaches to care. Methods MUCTUM is a co-therapy program for unaccompanied minors, with a psychiatrist, psychologist, native-language interpreter, and caseworker for each patient. In this qualitative study, we interviewed adolescents about their experiences with MUCTUM and analyzed these semi-structured interviews using a phenomenological framework (Interpretative Phenomenological Analysis). Results Qualitative analysis of 16 interviews discovered that unaccompanied minors felt misunderstood before participating in MUCTUM, describing a sense of strangeness and loneliness in relation to psychiatric symptoms. Several youths experienced triple stigmatization: of being unaccompanied minors, of suffering from psychotrauma, and of being mental health patients. We further describe three overarching domains that inform on MUCTUM support to unaccompanied minors: (1) A safe space for unaccompanied minors; (2) Helpful interventions during therapy; and (3) Narrating one’s story can “set us free” if guided carefully by care providers. Conclusion This study suggests that MUCTUM therapy may efficiently support unaccompanied minors’ mental health by acknowledging their hierarchy of needs. Psychotherapeutic strategies include creating a safe place, providing culturally appropriate care and patient-centered therapy, addressing concrete problems, supporting relationships, and making use of limited reparenting in therapy. Delayed and progressive inquiry about traumatic events may be beneficial. Replication of these findings and their field application is warranted.

Objectives: To understand the prevalence of psychosis in Aboriginal and Torres Strait Islander populations. Methods: A systematic review of the literature was conducted using PubMed, Embase and Cochrane. Results: Eight studies were reviewed. The prevalence of psychosis appeared higher in Aboriginal and Torres Strait Islanders, compared with non-Aboriginal and Torres Strait Islander populations. Conclusion: Although the literature suggests the prevalence of psychosis in Aboriginal and Torres Strait Islander populations is substantial, there are few studies and limited scope. Cultural competency is essential to understanding psychosis in this context. [ABSTRACT FROM AUTHOR]

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