COUNCIL AWARD
World Association of Cultural Psychiatry , and the Chair of the Transcultural Psychiatry Section of the Canadian Psychiatric Association . In 2016 , Dr . Fung was the recipient of the American Psychiatric Association ’ s Award for Advancing Minority Health .
We recently spoke to Dr . Fung about his life and work :
You moved to Canada in the 1980s , what was that experience like for you and your family ? My family came to Canada as part of the wave of people leaving Hong Kong before its repatriation to China . We arrived in Canada in the late fall and I remember thinking that Canada was very beautiful and very cold . We quickly became part of Toronto ’ s established Chinese community and I would have to say that , all in all , I had a very happy childhood . Despite that , my younger brother and I still experienced tremendous cultural shock as we dealt with differences in language , how children played and interacted with each other and with adults , and some subtle as well as overt instances of racism . Initially , I even misunderstood instructions from my teachers as I had trouble understanding the Canadian-English pronunciation as opposed to British- English . Our parents also went through the common struggles of immigrant families in finding jobs and having non-Canadian qualifications recognized .
What led you to believe there was an unmet need for culturally sensitive mental health programs ? I was doing one of my first clinical rotations in psychiatry during my second year of residency . One day , during rounds , I learned of a particular patient described by medical staff as being uncooperative . Among the list of behaviours that was being characterized as a manifestation of his mental illness was the patient ’ s refusal to drink tap water . He insisted upon drinking only boiled water . When I realized that the patient was of South Asian heritage , I suggested to the medical team that this particular behaviour might not have anything to do with his health issues at all . In many countries in South Asia , people routinely boil tap water before drinking it .
It bothered me that my suggestion to consider culture was dismissed outright and I was perceived as colluding with the patient .
Why is it important to consider cultural factors when delivering mental health services to patients ? Paying attention to culture is about delivering competent services that speak to the individual needs of the patient – it is the essence of patient-centred care . When dealing with patients , families and medical teams , it is helpful to take into consideration the effect culture has on how individual patients approach their illness . Many cultures have negative attitudes towards mental illness – lack of knowledge and awareness is one component of the problem that is common in all stigmas . Yet , at the same time , there are cultural differences that will cause the experience of stigma to be different . One culture may tend to blame the illness on bad parenting , while another community may tend to place the blame on karma . The effects of mental illness on a patient ’ s family as a whole may also be different according to culture , with one family viewing mental illness as an individual disease , while another perceives the illness as having tainted the whole family and causing implications for their status in the community . There are also different perceptions on how best to interpret symptoms and get better . When these types of factors are in play on top of mental illness , things can get confusing for clinicians and we can fail to recognize the scope of problems , and lose time pursuing the wrong treatments . When we understand the whole patient , we can better tailor treatment to meet their needs .
Can concepts of cultural psychiatry be applied to the broader community ? The lessons from cultural psychiatry have implications for all of us and studying diverse approaches to mental health means we explore other , non-Western models of human development that may have a better or different understanding of resilience and the causes of illness . I think the strength in Canada ’ s diversity brings a richness that enables us to see a more holistic picture of medical care and ensure there isn ’ t only one single vision of psychiatry . MD
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DIALOGUE ISSUE 4 , 2017