2023 14th Annual NUBE Conference

A 13-year-old female with a history of Leber Congenital Amaurosis presents to the ED for acute behavior and mental status changes. The patient and her family are refugees who came to the US 1 year ago. The patient is struggling with visual impairment and difficulty learning English and Braille and is only partially responding to questions on interview. How can we best provide culturally competent care with the limited time and resources we have in the ED? The cultural beliefs and attitudes of patients directly influence their utilization of emergency psychiatry services [1]. In an increasingly diverse and globalized world, cultural differences in the emergency setting are becoming more and more common. Cultural competence is defined as a set of congruent behaviors, attitudes, and policies that help systems or professionals work effectively in the context of cultural differences [2]. It bridges the gap between the intersection of the patient’s culture, the clinician’s culture, and the medical culture of the place where clinical work is being performed [1]. Culturally sensitive assessments are critical to patient-centered care and have been noted to improve clinical rapport, patient participation in care, and the efficacy of clinical therapies [3]. The Cultural Formulation Interview, or CFI in the DSM-5, is an internationally validated tool that contains questions that elicit patients' experiences and identify subtle sociocultural factors that impact diagnosis formulation [1]. Through this case-based discussion, we will illustrate how to incorporate elements of the CFI into a culturally sensitive interview in the context of cultural differences in EP settings. Our talk will also highlight how to 1) best utilize language interpreters and cultural informants to provide effective patient care, 2) gain a better sense of awareness of nonverbal components of communication and 3) integrate patients’ cultural values and perspectives into their diagnoses to formulate comprehensive treatment plans.

Learning Objectives:

1. Learn about the internationally validated Cultural Formulation Interview (CFI) and how to use components of the CFI in formulating culturally sensitive assessments. 
2. Understand how to best utilize language interpreters and cultural informants to provide effective patient care in the ED and gain a better sense of awareness of nonverbal components of communication. 
3. Learn how to incorporate patients’ cultural experiences into their psychiatric diagnosis and treatment.