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					WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 47




                                       Editor’s Message


                       Clinical, educational and           WACPCongress2006.org will be updated in
                     research programs in                  early Aug with details of the scientific program
                     cultural          psychiatry          and related activities.
                     continue to expand, to the
                     extent that it is difficult to          I look forward to meeting many of our
                     keep up with them. If                 readers in Beijing in Sep.
                     readers would like to have
                     particular         programs
                     mentioned in forthcoming               Ronald Wintrob, M.D.
                     issues of the Newsletter,              Editor, WACP Newsletter
please contact the editor and attach a 2-3 page             Secretary, WACP
description.

  In this issue of the Newsletter, we include a
report on the WPA-Transcultural Psychiatry
Section ( WPA-TPS ) conference convened in
Vienna, Austria, 18-20 April, 2006.

  The next WPA-TPS conference will be held
in Kamakura, Japan, 27-29 Apr 2007, jointly
sponsored by the Japanese Society of
Transcultural Psychiatry. WACP members are
welcome to attend and participate in this
conference. For more information, contact Prof
Fumitaka Noda, chairman of the Kamakura
Organizing            Committee,            at
nfumita@attglobal.net

  The 2006 annual meeting of the Society for
the Study of Psychiatry and Culture ( SSPC ) is
being held 12-15 Oct in Washington, DC. For
more detailed information, access the SSPC
website at; www.psychiatryandculture.org

  SSPC and WPA-TPS will be holding a jointly
sponsored conference in Stockholm, Sweden 9-
12 Sep 2007. Planning for this conference is
already in progress. More detailed information
will be included in the next issue of the
Newsletter.

  This issue is my last opportunity to remind
readers to register for the First World Congress
of Cultural Psychiatry, being held 23-26 Sep in
Beijing, China. The Congress website;

                                                      47
                                                         WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 48-51

                                                                                     CONFERENCE REPORT


FUTURE DIRECTIONS OF TRANSCULTURAL PSYCHIATRY
WPA-TPS Conference
Vienna, April 2006


                            The spring 2006                        historic and cultural attractions of Vienna,
                          meeting of the                           especially in springtime, combined with the
                          World Psychiatric                        overall theme of the conference on “Future
                          Association      –                       Directions of Transcultural Psychiatry”,
                          Transcultural Psy-                       attracted participants from all over the world to
                          chiatry    Section                       register for the conference. The total number of
was organized and hosted by Thomas Stompe                          149 registrants makes this conference in Vienna
and his colleagues at the Vienna University                        one of the best attended of any the Section has
Psychiatric Clinic 18-20 April. The obvious                        held.

                         ____________________________________________

               Figure 1 - Participants in the WPA-TP Section Conference; Vienna, Apr 18-20, 2006


                              Austria                                                            62

                              Europe                                                         60

                                Asia            5

                               Africa           5

                       North America                     12

                      South America         2

               Australia, New Zealand       3

                                        0           10        20     30     40      50      60        70




                         ____________________________________________

   After the final symposium, comprising a total
of over 100 presentations, one has to ask: do                        One can distinguish three broad areas of
we now have a clearer idea about the direction                     research in cultural psychiatry:
transcultural psychiatry will/should develop?                          (1) Cross-cultural–comparative psychiatry
To cite Roland Littlewood: “Quo vadis                                  (2) Ethnopsychiatry
transcultural psychiatry?”                                             (3) Migration psychiatry
   Before trying to answer this question, it is
necessary to reflect on the history of our field                     Each of these areas has been addressed in the
of study. This task was undertaken by Wolfgang                     symposia that comprised the 2006 WPA-TPS
Jilek, Alexander Boroffka and Gerhard Ortwein-                     conference in Vienna.
Swoboda in the first symposium of the Vienna
conference, on the “History of Transcultural
Psychiatry”.

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WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 48-51


 Recent development of cross-                                Surveying the broad range of studies in this
cultural-comparative psychiatry                            field of research, some perspectives on
                                                           challenges for the future development of this
  Since     Kraepelin’s     time,     transcultural        direction of transcultural psychiatry emerge:
psychiatry has developed three more or less
separate professional and scientific facets. Until           (a)      Reflections of the philosophical,
the late 1970s transcultural psychiatry was                epistemological and linguistic basic conditions
dominated by cross-cultural comparative                      This task demands the processing of
studies. This scientific direction aims to                 important current directions in philosophy,
investigate the aetiological and pathoplastic              such as philosophy of mind. Christian Postert
influence of cultural pattern on symptoms,                 introduced the impact of the ideas of William
syndromes and diseases. By means of this kind              Ornam Quine, one exponent of the analytical
of investigation it is simultaneously possible to          philosophy, for the construction of intercultural
isolate stable areas of psychic illnesses and              hermeneutics. The second important direction
diseases, the morbidity-specific “core” of                 of modern philosophy, valuable for cross-
mental disorders. This tradition was carried               cultural-research, was represented by the
forward by important researchers like                      German philosopher Bernhard Waldenfels, in his
Kraepelin, Murphy and Wittkower.                           lecture about the “Doubled Otherness in
  The climax was reached in the early 1970s                Ethnopsychiatry”.
with the International Pilot Study of
Schizophrenia. This investigation, organized                 (b) Definitions of the objects of knowledge
and performed by the WHO, has set new                        The preconditions for the validity and
methodological standards, defining strict                  reliability      of      epidemiological       or
criteria, especially for the reliability of cross-         phenomenological studies in cultural psychiatry
cultural-comparative research. Currently the               are exact structural definitions and concepts of
Vienna Research Group on Cultural Psychiatry               diseases, syndromes or symptoms. Comparative
(Austria: Thomas Stompe, Gerhard Ortwein-                  psychiatry needs definitions that do not depend
Swoboda, Kristina Ritter, Susanne Bauer,                   on culture and therefore should be appropriate
Alexandra Strnad, Norbert Benda, Martin                    for all cultures. That’s why the Vienna Research
Letmeier, Alexander Dvorak; Pakistan: Haroon               Group on Cultural Psychiatry has endeavored to
R. Chaudhry; Ghana: Sharon Gschaider;                      sharpen some concepts of mental symptoms
Nigeria: Sunday Idumedia; Poland: Hanna                    before starting the empirical research. In the
Karakula, Anna Grzyzwa; Lithuania: Palmira                 WPA-TP Section meeting in Providence (USA)
Rudaleviciene; Georgia: Nino Okribelashvili) is            in 2004, Susanne Bauer has introduced a
trying to revive this tradition of research by             concept of hallucinations basing on Karl
undertaking cross-cultural-comparative studies             Jaspers and Manfred Spitzer. This year Gerhard
on various aspects of schizophrenia, major                 Ortwein-Swoboda     presented     a    definition
depression, obsessive-compulsive disorders,                influenced by analytical philosophy (Brendom,
PTSD and suicidal behavior (Vienna                         Sellars)
Conference Symposia 16, 20, 22, 24). But the
renaissance of this kind of comparative studies              Future efforts will be necessary to adopt our
is also being done by other researchers, who               definitions and concepts of culture, ethnics and
presented their results in this year’s TPS                 religion to the new developments of scientific
conference; including David Lester (suicide),              fields such as ethnology, anthropology, cultural
David Cooke (psychopathy), Maria Mutzik                    history and sociology. In practical terms, the
(postpartum depression), Gabriele Fischer                  personal networks of members of the WPA-TP
(cocaine use in Europe), Martin Aigner                     Section, SSPC and WACP should be
(somatoform disorders).                                    increasingly used to establish joint studies on
                                                           these topics.
  New challenges for              cross-cultural-
comparative psychiatry


                                                      49
                                               WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 48-51


  Ethnopsychiatry                                           Migration psychiatry
  Ethnopsychiatry investigates issues such as                More than 30 presentations pointed out the
the characteristics of mental disorders, illness          great importance of this branch of transcultural
knowledge,        stigmatization,       indigenous        psychiatry that deals with issues like the psychic
treatment methods and related subjects, in                disturbances of migrants caused by the stressful
single cultures or in specific ethnic communities         experiences inherent in the process of
within countries. This branch of transcultural            acculturation. Lopez Gastroman presented
psychiatry was represented at the Vienna                  research on mental health problems of the
conference with 23 presentations. In the                  growing community of Hispanics in Madrid,
symposium on “Culture Bound Syndromes”                    Katharina Behrens and her colleagues tried to
Wolfgang Jilek pointed out that some of these             clarify the role of cultural attitudes and
disorders, like Koro, may occur in various                communication problems for the treatment of
cultural contexts. Fakhr El-Islam (Egypt) and             migrants in a psychiatric day clinic, Cornelis
Cesar Korolenko (Siberia) elaborated on the               Laban et al introduced their data on quality of
cultural and social meaning of several culture-           life of Iraqi asylum seekers in the Netherlands.
bound syndromes of their countries. This years’           Two symposia dealt with legal issues associated
symposium on “Religion and Psychiatry” dealt              with mentally ill migrants. Another symposium,
exclusively with ethnopsychiatric issues too.             organized by Martine Verwey, addressed
Other examples for the ethno-psychiatric                  European countries’ refugee policies and the
traditions were the presentation of Mischa Engel          impact those policies on the experience of
on the phenomenology of Ayahuasca                         mental health care for migrants. The current
experience, and the research reports of Mitchell          dilemma of immigrants, refugees and asylum
Weiss about stigma of mental illness in West              seekers from Muslim North Africa and from
Bengal and Louise Jilek-Aall about sociocultural          Sub-Saharan Africa to Europe was the topic of
aspects of epilepsy in East Africa, the video             the inaugural WPA-TPS chairman’s panel
documents about traditional healing in Nepal              discussion on current issues in cultural
(Dagmar Eigner) and India (Atti Pakaslathi) and           psychiatry. The subject was selected because of
the valuable documentation of the history of              the worldwide attention generated by the
Nigerian psychiatry presented by Alexander                rioting in France in Nov 2005 that generated
Boroffka.                                                 lively discussion throughout Europe and
                                                          around the world on the issue of cultural
  New challenges for ethnopsychiatry                      integration versus cultural exclusion and
  (a) Archiving of descriptive data, audiotapes           alienation of immigrants over several
and movie-material for future investigations. In          generations.
our era of globalization and assimilation                    Presentations in the panel discussion
processes, these documents are important                  addressed these issues in France, Spain, the
snapshots that should be made available for               Netherlands, Austria and Malta (Rachid
further cross-sectional and longitudinal                  Bennegadi, Joan Obiols, Joop de Jong, Thomas Stompe
comparisons.                                              and Charles Pace ).
  (b) Adaptation and increasing use of scientific
methods for analysis and interpretation of these            New challenges for migration psychiatry
data going beyond mere description (semiotic                (a) Reflection of the role of professionals
and linguistic analyses, content analysis,                engaged in this field. This issue was discussed in
grounded theory, behavioural biology etc.) and            two symposia in Vienna on male and female
elaboration of knowledge of the cultural and              career development this year.
ethnic background.                                          (b) The importance of ethics for a culturally
  (c) Integration of new topics of clinical               sensitive psychiatry. This topic was discussed by
psychiatry like quality of life and research on           Solvig Ekblad, Johanna Tamm and Palmira
cultural resilience.                                      Rudaleviciene.

                                                            This report started with the question as to the
                                                          future direction of transcultural psychiatry.
                                                     50
WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 48-51

Presentations at the conference discussed a
number of dimensions of that question.
Observers of the rapid growth of the field of
cultural psychiatry over the past two decades
have been astonished at the continuing
redefinition of the field in both its research and
clinical dimensions. The only answer to the
question about the future of cultural psychiatry
that seems justified by experience over these
past twenty years is that the scope and
dimensions of our field, like Einstein said about
the universe, are going to continue to expand.
We have reason to be confident that continuing
illumination of the field, as expressed in the
greater understanding of human behavior in all
its complexity, will accompany the continuing
expansion of the universe of cultural psychiatry.

  Prepared by Thomas Stompe




                                                     51
                                                WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 52-53

                                                           WACP SPONSORING ORGANIZATIONS


Division of Social & Transcultural Psychiatry
McGill University
Montreal, Quebec (Canada)

                   The Division of Social and              illness beliefs and healing practices; patterns of
                 Transcultural Psychiatry is a             psychoactive drug use (alcohol, cannabis, coca);
                 network of scholars and                   a1ttitudes toward the mentally ill; and the
                 clinicians       within       the         healing functions of trance and religious
                 Department of Psychiatry,                 experience. Members of the Division were
                 Faculty of Medicine, McGill               instrumental in establishing cultural psychiatry
                 University,       devoted      to         as field of study recognized by American and
promoting research, training and consultation              Canadian Psychiatric Associations and H.B.M
in social and cultural psychiatry.                         Murphy founded the World Psychiatric
  The Division traces its history to 1955, when            Association Section on Transcultural Psychiatry
Drs. Eric Wittkower and Jack Fried set up the              in 1970.
section of Transcultural Psychiatric Studies as a             In recent years, with the changing
joint venture between the Departments of                   composition of Québec society, Division
Psychiatry and Anthropology at McGill. In                  members have come to focus their attention
1956, they began a newsletter to bring together            not only on international mental health but
an international network of clinicians and                 equally on the mental health problems of
researchers      interested     in     exchanging          immigrants, refugees, Aboriginal peoples and
information and observations about the effects             the many ethnocultural communities that
of culture on psychiatric disorders. The list of           comprise the Canadian mosaic. Canada has
people involved in this early network includes a           been called “the house of difference” and
veritable ‘who’s-who’ of cultural psychiatry as            owing to its high proportion of newcomers and
well as such key figures in psychological                  explicit policy of multiculturalism, is ideally
anthropology as George Devereux and                        suited to developing mental health research and
Margaret Mead. The newsletter subsequently                 models of practice to address cultural diversity.
became Transcultural Psychiatric Research Review           The study of psychiatric theory and practice
and, in 1996, Transcultural Psychiatry—an                  itself as a cultural construction is also a major
interdisciplinary,     peer-reviewed     scientific        focus of research. A strong tradition of open
journal, published by Sage (UK). Among the                 collaboration across disciplines has made it
many scholars of cultural psychiatry who taught            possible to link qualitative ethnographic
at McGill in the 1950s and 60s were Norman                 research, psychiatric epidemiology, cognitive
Chance, Henri Ellenberger, H.B.M. Murphy,                  social psychology, and social studies of science.
Raymond Jean-François Saucier, and Ronald                     There are three main research centers
Wintrob. In 1981, a Division of Social and                 associated with the Division: (1) the Culture &
Transcultural      Psychiatry      was    formally         Mental Health Research Unit of the Sir
established to integrate research and teaching in          Mortimer B. Davis-Jewish General Hospital
these fields.                                              (Director: Laurence J. Kirmayer); (2) the
  Drs. Wittkower, Murphy, Prince and other                 Psychosocial Division of the Douglas Hospital
members of the Division conducted path                     Research Centre (Director: Suzanne King); and
breaking research on a wide range of topics,               the Immigrant and Refugee Children's Mental
including cultural variations in psychiatric               Health Research Unit of the Montreal
disorder and culture-bound syndromes; cross-               Children's Hospital (Director: Cécile Rousseau).
cultural and cross-national epidemiology of                Current research at these units includes projects
psychiatric disorders; cultural variations in              on: the impact of racism on the mental health
                                                      52
WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 52-53

of immigrants; school-based interventions for            setting for research and training in cultural
mental health promotion among immigrant and              psychiatry. In the years to come, cultural
refugee children; the cultural shaping of                psychiatry will move from the margins to the
psychotic experience; social determinants of             center of concern, spurred on by findings in
resilience among Indigenous peoples; the use of          cognitive social neuroscience and the demands
psychopharmaceuticals        by      adolescents;        of migration in a globalizing world. In addition
evaluation of the cultural formulation; and the          to its importance for advancing psychiatric
development of an international consortium for           theory and providing effective care, cultural
cultural consultation. A grant from the                  psychiatry can contribute to the important
Canadian Institutes of Health Research funds a           project of building pluralist civil societies that
Strategic Training Program in Culture and                respect both cultural diversity and human
Mental Health Services Research which offers             rights. We are confident McGill will continue to
postdoctoral fellowships and support for                 play an active role in meeting this challenge.
graduate students who wish to learn how to
integrate social sciences perspectives into              For more information:
psychiatric research.
  In the 1950s, McGill had many international            Division of Social & Transcultural Psychiatry
trainees in psychiatry and their experience and          Department of Psychiatry
concerns were a major driving force behind the           McGill University
development of research and training in cultural         1033 Pine Ave West
psychiatry. From the 1960s onward, it became             Montreal, Quebec H3A 1A1
more difficult and expensive for foreign                 Tel: 514-398-7302
trainees to study in Canada. To encourage                Fax: 514-398-4370
international exchange, in 1995, we began the
Annual McGill Summer Program in Social and
Cultural Psychiatry. Every year, during the
month of May, we host 30-40 students
(including     trainees,   graduate     students,
academics and clinical practitioners from both
mental health and social science backgrounds),
who take part in courses and workshops in
cultural psychiatry, psychiatric epidemiology,
qualitative and quantitative research methods
and community-based participatory research
presented by faculty from McGill as well as
guests from other universities. In 1999, we
began an annual Advanced Study Institute in
Cultural Psychiatry, which follows the summer
program in early June and focuses on a
different topic each year. The themes of past
institutes have included: the politics of trauma;
the mental health of Indigenous peoples;
models of mental health services in
multicultural societies; psychotherapy in a
creolizing world; stigma and the dynamics of
social integration; and refugees and forced
migration. These Advanced Institutes have
become a meeting place for colleagues from
around the world who enjoy the informal
academic setting that allows intensive exchange.
  Over the last 25 years, the Division has
continued to thrive and grow as a unique

                                                    53
                                               WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 54-55

                                                                                          BIO-SKETCH


Laurence J. Kirmayer, M.D.

                             My     interest    in        Good, who had just come from Harvard, where
                          cultural psychiatry has         they were colleagues of Arthur Kleinman. With
                          its roots in my family          a consultation-liaison psychiatrist, Henry
                          background. As the              Herrera, the Goods established a cultural
                          grandson             of         consultation service at the UC Davis Medical
                          immigrants who came             Center, where patients received evaluations and
                          to Canada in the                treatment from a mixed group of clinicians and
                          1910s          escaping         healers from the community, including a Puerto
                          pogroms in Eastern              Rican espiritista, Mexican curandera, and an
                          Europe, issues of               African American Baptist minister.
                          identity and tradition,           I returned to Montreal in 1980, completed a
                          racism and justice, and         research fellowship and took a staff position at
the riches and pleasures of cultural diversity            the Jewish General Hospital (one of five McGill
were the topics of many conversations while I             teaching hospitals) as a consultation-liaison
was growing up. I began my university studies             psychiatrist and researcher. My early research
in physics and mathematics, but discovered I              studies examined somatization in primary care.
had an aptitude for psychology and completed              In a very fruitful collaboration with Jim
my undergraduate degree in physiological                  Robbins, a medical sociologist now at the
psychology at McGill. Among my teachers and               University of Arkansas, we developed an
mentors at that time were Dalbir Bindra,                  approach to somatization as illness behavior,
Donald Hebb, and Ronald Melzack. My                       with an emphasis on causal attributions and
undergraduate research was on state-dependent             interpersonal processes.
learning with drugs and ACTH in mice and                    Soon after my return to Montreal, I
electrical stimulation of the hippocampus in              discovered that McGill had a Division of Social
rats. This early exposure to research convinced           and Transcultural Psychiatry, then headed by
me that empirical psychology could provide a              Raymond Prince. At his invitation, I wrote a
firmer foundation than psychodynamic theory               review article on culture and somatization for
for psychiatry.                                           the journal he edited, Transcultural Psychiatric
   I planned to continue on to a doctorate in             Research Review. I continued to learn medical
clinical psychology, but was persuaded that               anthropology by osmosis in the congenial
medical training would provide me with a                  company of an evening study group that
politically more effective platform from which            included Margaret Lock, David Howes and
to address my concerns about the misuse of                John Leavitt.
psychiatric power, which came from reading                  Montreal at that time was also home to the
R.D. Laing and other writers on ‘anti-                    Interuniversity Group for Research in Medical
psychiatry’. During my last year of medical               Anthropology and Ethnopsychiatry (usually
school at McGill, I took a course on                      referred to by its French acronym, GIRAME),
ethnopsychiatry       from       the      medical         founded by Guy Dubreuil of the University of
anthropologist Margaret Lock, who had just                Montreal and H.B.M. Murphy of McGill. At a
come to McGill after completing her doctorate             time when linguistic tensions in Montreal ran
at Berkeley. The topic captivated me and it               high, it was an inspiring example of integration,
became clear that this was the direction I                in which both English and French were used
wanted to take. I went to the University of               freely, as suited the comfort of the speaker.
California at Davis for my residency in                   With Guy Dubreuil, I took on co-editorship of
psychiatry. There I had the good fortune to               GIRAME’s               bilingual         journal,
meet the anthropologists Byron and Mary-Jo                Culture/Santé/Health. My friendship with the
                                                     54
WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 54-55

anthropologists Gilles Bibeau (who was Chair                sciences, Transcultural Psychiatry occupies a
of Anthropology at the University of Montreal)              unique interdisciplinary niche.
and Ellen Corin dates back to that time, and                  Since the early 1990s, my thinking about
they have both been tremendously supportive,                culture and psychiatry has been strongly
stimulating and challenging colleagues. In the              influenced by ongoing conversations with the
late 1980s, GIRAME and its journal wound                    medical anthropologist Allan Young, whose
down as other forms of networking and                       critique of the cultural construction of PTSD
collaboration took their place.                             has provided a model for the careful
  In the early 1980s, with the help of Margaret             ethnographic, historical and philosophical
Lock, I undertook some brief fieldwork in                   analysis of psychiatric research and practice. My
Japan, but clinical and family responsibilities             clinical perspective owes much to my colleagues
sidelined plans to continue. In 1989, I had the             Jaswant Guzder and Cécile Rousseau. I feel
opportunity to do psychiatric consultations for             extremely fortunate to have such innovative
the Inuit in the arctic region of Quebec and this           and committed scholars and clinicians as
began an ongoing involvement in Inuit mental                friends and colleagues. In addition to
health. Struck by the high suicide rate among               continuing work on Aboriginal mental health,
young men, I began a series of epidemiological              healing and resilience, I am engaged in a range
and     ethnographic       studies    aimed      at         of other projects on models of mental health
understanding the impact of internal                        services for multicultural societies, the use of
colonialism and culture change on Inuit mental              the cultural formulation in cultural consultation,
health. This led to a broader interest in and               the conceptual integration of cultural and social
involvement with the mental health of                       neuroscience research, and the role of
indigenous peoples and, eventually, the                     metaphor in illness and healing. At the center
founding of a National Network for Aboriginal               of my work in cultural psychiatry are two
Mental Health Research, which I co-direct with              fundamental concerns: the power of poetic
Dr. Gail Valaskakis, the Director of Research               language to transform experience and the
for the Aboriginal Health Foundation.                       politics of empathy and alterity in clinical
Currently, I am leading a cross-national                    practice.
research program on resilience among
Indigenous peoples, with colleagues from New                  E-mail:      laurence.kirmayer@mcgill.ca
Zealand.
  In 1991, Raymond Prince retired and I took
over the direction of the Division and
editorship of the journal. Transcultural Psychiatric
Research Review was the oldest journal in the
field, but because it published mainly abstracts
and reviews of other articles, did not have
much visibility outside its circle of devoted
readers. I was mandated to make over the
journal as a peer-reviewed publication and
arranged to move from in-house publication to
an arrangement with Sage (UK), a leading
publisher of social science and other journals.
This arrangement has allowed the journal to
grow and to become an arena for current
research work in cultural psychiatry. We remain
committed to maintaining its diversity both in
terms of the geographic origins of contributors
and the many disciplines represented. As an
international journal that cuts across psychiatry,
psychology, anthropology and other social


                                                       55
                                               WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 56-58

                                                                                          BIO-SKETCH


Kamaldeep Bhui, M.D., F.R.C.Psych

                          I     am    currently           overtones of such an approach. I puzzled my
                        Professor of Cultural             colleagues and mentors by sticking with my
                        Psychiatry & Epide-               interests, ambitions, and curiosity about a
                        miology      at     the           subject which seemed to me familiar and
                        Research Centre for               essential, but which was not part of any formal
                        Psychiatry at Barts (St.          teaching I had received.
                        Bartholomew’s Hos-
                        pital) & The London                 The formation of the Transcultural Special
                        School of Medicine.               Interest Group within the Royal College of
                        This is a school of               Psychiatrists, inclusion of cultural psychiatry in
Queen Mary College of the University of                   the curriculum and increased attention to
London. I also work as consultant psychiatrist            racism in psychiatric practice were the
for a major service provider, the East London             hallmarks of maturation of cultural psychiatry
& City Mental Health Trust.                               in the UK. Regrettably, sometimes cultural
                                                          psychiatry is still seen as strictly a minority
  My interests in cultural psychiatry were                issue, to do only with black people or people
aroused during my early experiences as a                  from
psychiatry resident.                                        ‘other cultures’, rather than being of wider
  I realized that patients from diverse cultural          relevance to all psychiatric practice.
groups had a different story to tell from the one
recorded in their clinical case notes and that the          I pursued a fairly conventional training in
official diagnostic process captured little about         clinical psychiatry, at Guys & St Thomas’
their life experience,                                    Hospitals (1989-1992), followed by the
  or indeed their distress. I was struck by how           Maudsley (1992-1995) and then a period of
this difference was marked even for patients              research training at the Institute of Psychiatry
with whom I shared a culture. My Punjabi Sikh             (1995-2000) supported by the Wellcome Trust.
background clearly played a part in contributing          It was in this research training that I was
a cultural dimension to my thinking about                 especially challenged to try to integrate
culture, conflict, colonialism and distress. The          anthropological notions of culture and research
heritage of challenging social injustice and              methods, with epidemiological principles. My
tackling prejudice was similarly inculcated in me         work since that time continues this process,
from a very early age by parents and family,              with a special focus on health services research,
largely shaped by Sikh teachings. My parents,             psychotherapy, consultation dynamics, and
although of Indian origin, lived in Kenya most            training and education.
of their early adult lives.
                                                            My research interests and skills flourished
  I was born in Kenya, but educated in the UK.            under the mentorship of Prof. Dinesh Bhugra
I graduated in medicine in 1988 at the United             and Prof. Sir David Goldberg, supported by the
Medical & Dental Schools of Guy’s and St                  clinical pragmatism I had absorbed from Prof.
Thomas’ (UMDS). At that time, in the 1980s                Jim Watson and Dr Geraldine Strathdee, and
and early 1990s, cultural psychiatry played               some thought provoking encounters and
virtually no part in the training of residents in         anthropological critiques from Drs Simon Dein
the UK, and a cultural psychiatrist was an                and Maurice Lipsedge. I became fascinated with
unheard-of specialty in psychiatry. I was                 the thinking of international experts such as
advised against pursuing a career in cultural             Kleinman, Kirmayer, Tseng, Littlewood, Weiss,
psychiatry because of the perceived political             Wintrob, Prince & Minas. During my research
                                                     56
WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 56-58

training I also undertook training in                     ensuring that there is transfer of knowledge and
psychoanalytic   psychotherapy,       another             skills to routine mental health practice. It is a
paradigm for democratic criticism of dominant             multi-disciplinary    course     (teachers   and
ideologies.                                               students), and is in its fourth successful year.
                                                          We are about to embark on an e-learning
  My interests in cultural psychiatry enabled me          process for our future international students.
to conduct a critical re-analysis of how mental           We have 35 MSc students and 5 PhD students
health services were indeed discriminatory and            in our post-graduate program, as well as
often failed to provide culturally appropriate            medical students.
care. Proponents of radical service re-design at
that time (1990s) were Drs Parimala Moodley &              My research interests include:
Suman Fernando and Prof. John Cox, who
further supported and legitimated my interests               !   South Asian’s pathways to care and
as being of immediate and widespread                             recognition of mental disorder in
relevance to psychiatry as a whole and not just                  primary care (funded by the Wellcome
to minority ethnic groups.                                       Trust)
                                                             !   African Caribbean mentally disordered
  Since my first consultant jobs and my                          offenders in Brixton Prison and their
academic appointment at the Medical School in                    pathways to care (DH funded)
East London (2000), I have seen cultural                     !   Somali Refugees and risk factors for
psychiatry become a major force in critical                      mental disorders (NHS funded)
thinking about service users, ethics, philosophy
                                                             !   Mixed sampling methods using
of psychiatry, and now, even enshrined in
                                                                 qualitative and quantitative methods,
national policies that advocate training in
                                                                 specifically the interface between
cultural competency for all mental health
                                                                 anthropology and epidemiology (NHS
professionals. Prof Goffredo Bartocci has
                                                                 & Home Office funded)
almost single-handedly raised the profile of
cultural psychiatry in Europe within the last five           !   Cultural Capability of Services for Black
years. The formation of WACP is therefore                        and Minority Ethnic (BME) Groups
timely, as it offers the potential for our subject               (New Zealand Research Council
matter to be understood in its richest and                       funded)
fullest context, as a core ‘philosophy’ in                   !    Policy formulation for effective
psychiatric practice and research, and to bring                  services for BME groups in the UK
together different schools of cultural psychiatry.               (DH funded)
                                                             !   Racism as a risk factor for mental health
  I currently serve as Chair of the Transcultural                problems
Special Interest Group of the Royal College of               !   Adolescents’ risk of mental disorder by
Psychiatrists (2004-2008) which has some 1650                    ethnic group and cultural identity (DH,
psychiatrist members in the UK. I am also a                      ELCHA funded)
member of the World Psychiatric Association                  !   Eating disorders and ethnicity
Transcultural Psychiatry Section, and a member               !   Explanatory     models      of     mental
of the founding Board of Directors of the                        disorders, and use in clinical assessment
World Association of Cultural Psychiatry. I am                   and diagnosis (Barts and The London
also a member of the British Association of                      Research Board)
Psychotherapists and a Fellow of the Royal                   !   Suicide & Ethnicity in the UK (DH
Society of Medicine (UK).                                        funded, Charitable foundation of Barts
                                                                 & The London)
  I am Director of MSc Transcultural Mental
                                                             !   Dual Diagnosis and Ethnicity (Mellow
Healthcare at Queen Mary College, University
                                                                 Campaign funded)
of London.
  This innovative Masters program is focused                 !   Improving Pathways to Care for BME
on health services’ research and practice,                       groups (DH funded)


                                                     57
                                             WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 56-58

   The Centre for Psychiatry has strategic
alliances with the Royal Free Hospital & UCL
School of Medicine (Centre for Health
Improvement & Ethnic Services: CHIMES),
and with the Faculty of Health Sciences at the
University of Auckland (Centre for Asian
Research and Evaluation: CARE-UK and
CARE-NZ). I have also worked with national
DH policy leads and NIMHE (UK) to develop
improved services and care for black and ethnic
groups in the UK. I have published numerous
peer-reviewed research and educational papers
in international journals, and have authored
and/or edited five books.

  The main studies our research group is
undertaking as part of our future strategy
include:
! Adolescents’ mental health: prevalence and
    cultural risk factors including cultural
    identity.
! Studies of refugee and asylum-seeker
    mental health, especially Somali refugees
! Studies of mental health problems among
    Asian populations (Chinese and Indian-sub-
    continent origin) across continents
! Cultural Competency Training, and our
    Masters Program
! Suicide Prevention and Ethnicity
! Improving Pathways to Recovery
! Studies of Common Mental Disorders
    among adults: risk factors and interventions
! Religious Values and Coping with Mental
    Distress




                                                   58
WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 59-60

                                                                                        BIO-SKETCH


Marianne Kastrup, M.D.

                         I grew up in a family           international professional networks, as well as
                       believing in the UN               friendships. I am now a member of the WHO
                       Human Rights Decla-               Expert Advisory Panel on Mental Health.
                       ration, and the first
                       book I recall being read            On the personal level, I had become the
                       to me was the UN                  partner of an Indian scientist who settled as a
                       children’s book.                  professor in Denmark and taught me more
                         As I grew up, pen pals          about culture than anyone else. Close contact
                       from various parts of             with his family in India opened my eyes to a
                       the world colored my              culture and a way of life that has been dear to
views of my safe middle-class upbringing in one          me ever since.
of the world’s most ethnically homogenous and
peaceful societies; Denmark.                               My psychiatric career was centered around
                                                         Copenhagen, but with interests that had an
  I was told growing up that all human beings            international flavor.
were alike in dignity and rights. As a medical             Via Amnesty International I got in contact
student I joined Amnesty International and               with Dr Inge Genefke, the founder of the work
worked for the charity movement, Abbe Pierre,            in Denmark with torture survivors. I was a
to raise money for developmental projects.               volunteer examiner of asylum seekers, and had
  I joined Nobel Peace Prize winner Pater                from its very start, close contact with the
Pire’s Peace University in Belgium and had               Rehabilitation and Research Center for Torture
wonderful social interactions with students              Victims.
from all over the world.
                                                           As a member of the Danish Medical
  The feminist movement and political                    Association Ethics Committee, the human
activities in the Social Democratic Party have           rights agenda of the Committee led to the
been important parts of my life, and in                  establishment of interdisciplinary educational
medicine it was the community aspects that               activities in Eastern Europe, with a focus on
primarily interested me.                                 professional ethics and the rights of patients.

  I was attracted to psychiatry for several                And I have been lucky that the European
reasons. One was an interest in women’s issues.          Council’s Committee for the Prevention of
Another was a wish to increase the dignity and           Inhumane, Cruel and Degrading Treatment and
human rights of the mentally ill.                        Punishment has used me as an expert
  My mentor, Dr Annalise Dupont, the                     consultant on a number of missions, visiting
Director of the Danish psychiatric case register,        prisons and psychiatric facilities around
gave me ample opportunity as a junior female             Europe, focusing on patients’ rights and access
doctor and paved my way into international               to care.
psychiatry, along with Professor Erik
Strömgren, who took me to WHO, where I                     From the beginning of my psychiatric career I
participated in one of the WHO IPSS meetings.            have been active in international organizations
                                                         and found it a challenge to be part of
  The cosmopolitan atmosphere at the WHO                 multicultural groups working for a common
meeting influenced my career.                            goal.
  Professionally and personally these were very            I was fortunate enough to be elected, in 1996,
formative years, enabling me to develop                  to the Executive Committee of the World
                                                    59
                                            WACP NEWSLETTER July 2006 – Vol. 2, N. 3: 59-60

Psychiatric Association, where I chaired the
Standing Committee Reviewing the Abuse of
Psychiatry and received cases from many parts
of the world.

  Almost at the same time I decided to leave
my position as Head of the Department of
Psychiatry of Copenhagen University and
become the Medical Director of the Danish
Rehabilitation and Research Center for Torture
Victims, with projects helping traumatized
people in a number of countries.

  After the reorganization of the Center, I
decided in 2001, to return to psychiatry and
became Head of the newly established National
Center for Transcultural Psychiatry at the
Department of Psychiatry, Rigshospitalet,
Copenhagen; with the aim to set cultural
aspects on the psychiatric agenda.

  Cultural issues are central in my work in the
establishment of a Nordic Transcultural
Network of Psychiatrists and Psychologists, as
well as with my membership of the WPA-
Transcultural Psychiatry Section and now the
WACP also.

  I welcome the inauguration of WACP and
look forward to fruitful collaboration with
colleagues around the globe who share the
same interests.




                                                  60

				
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