February 02, 2007

Cultural Competency And All That

I first ran into the term "cultural competency" as applied to our nation's mental health system in 2000. That's when the public mental health system in Multnomah County (Portland), Ore. was in meltdown and various politicians were trying to put Humpty-Dumpty back together again. At some point, people started pointing out that the mental health system in Stumptown was very white and that measures needed to be put into place to ensure that ethic minorities in the system would have someone of their own culture they could work with.

Marissa Miller, author of the fine depression introspection blog, offers her thoughts on the subject, in response to a woman claiming to have PTSS--post traumatic slave syndrome.

As we found out in Portland, sometimes cultural competency alone is not enough. In 2001, a Mexican-Indian (I think that's the right term) named Sergio Mehia Poot, who was either schizophrenic or an epileptic, was hospitalized and later killed in the hospital by Portland Police officers (the story is just too ugly to get into and still makes me sick to my stomach). It was never clear whether Poot should have been in the hospital since he spoke a rare mountain dialect of Spanish and none of the Spanish speakers in the mental health system knew what he was talking about.

Sometimes, life and death are fucked up like that.

Posted by Philip Dawdy at February 2, 2007 12:03 AM
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Comments

I heard of a few stories, I guy speaking a strange language is beleived to be crazy and is hospitalized, when all he was doing was speaking another language. I don't have a link for this one.
another story is almost lost but still in googles cache memory.
(Man)illegally held in the D.C. Jail for nearly two years after a court ordered him to be released from custody. During his unlawful imprisonment, the District never provided Mr. Heard with any communication assistance, even though he is deaf and unable to speak..performed medical testing on Mr. Heard and gave him potentially-dangerous anti-psychotic medications...
http://72.14.203.104/search?q=cache:RL02oZ0Zq5IJ:news.findlaw.com/scripts/printer_friendly.pl%3Fpage%3D/prnewswire/20050804/04aug20051354.html+Unlawfully+Detained+Man+Awarded+Over+%241.1+Million&hl=en&ct=clnk&cd=1&gl=ca
It is pure Kafka to illegally throw a man in jail on charges of nothing and then make it impossible for him to protest the illegality," Mr. Moustakas continued. "But that is precisely what the District of Columbia did for 670 days when it recklessly jailed Mr. Heard on false information, repeatedly failed through sloth and incompetence to recognize and correct its mistake, and refused to provide him with the federally-mandated sign language interpreter services and other communication assistance that would have allowed him to call attention to his wrongful imprisonment

Posted by: Mark at February 2, 2007 04:05 PM

I heard a story once (back around 1979 or 1980) of a woman who had been committed to a psych hospital and spent several decades there because a psychiatrist said she would only speak "gibberish". After her being locked up for something like 30 or 40 years, someone discovered that she was actually speaking some not widely understood foreign language (I think it may have been Hungarian). I recall a big headline in The Boston Globe - or maybe it was the other Boston paper - that said something like "After 40 Years, Her 'Gibberish' Becomes Clear".

Posted by: Kent at February 3, 2007 11:16 AM

There is another language some people may not know exists, but psychiatrists have named it "word salad". This happens to disoriented, confused, and (most likely over-medicated)patients in hospital settings.
Getting over that "language" barrier is not easy. Unless a patient has a loved one there to help decipher through bits and pieces of words and body language, this patient is never going to be discharged.
Anyone reading this in the psychiatric inpatient setting knows what I am talking about.
Anyone reading who uses the phrase "word salad" in front of a patient, and assumes they cannot hear or will remember what you talked about in front of them later...is WRONG.
It is not uncommon for patients to lose ability to communicate verbally, but they are still communicating, and they can still hear.
Communication can be heard in many forms, if the docs took the TIME to sort it out.

Posted by: Stephany at February 3, 2007 05:23 PM

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