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Region Hovedstaden - en del af Københavns Universitetshospital

The encounter between clinicians and migrant patients in the outpatient mental health services in Denmark - A mixed methods study on cultural competences and the Cultural Formulation Interview.

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Immigrants make up approx. 8% of the Danish population. Studies show that migration is associated with an increased vulnerability and occurrence of mental disorders. The number of migrant patients conveys new challenges for the Danish health care system. Clinicians experience difficulty in their daily work when communicating with, diagnosing and treating migrant patients. Likewise, ethnic minorities experience less trust and receptiveness as well as more discrimination than ethnic Danes. Psychiatry in particular is faced with challenges because the presentation, interpretation, understanding and treatment of mental health symptoms vary across cultures.
This study takes its point of departure in the Cultural Formulation Interview (CFI) from DSM-5, which has a narrative approach and serves as a clinical resource for the systematic and individualised evaluation of cultural dimensions in psychiatric assessment. Cultural competent clinicians are better equipped to achieve therapeutic alliance in the patient encounter, which will often improve the treatment-efficacy and increase patient satisfaction.
The aim of the project is to describe cultural encounters and how they are understood and managed by clinicians, patients, and interpreters in outpatient mental health services. Furthermore, evaluate the implementation and clinical utility of a Danish translation of the CFI in outpatient mental health services

Four sub-studies will provide a thorough analysis of the cultural encounter between the mental health services and migrant patients, viewed from the perspectives of the clinicians, the patients and the interpreters in a consultation context. Empirical data will be generated at 4-5 Danish outpatient psychiatric services in the Capital Region of Denmark.

Expected Results:
The project will be carried out across different outpatient mental health clinics, involve personnel across professions and give a voice to the patients around whom the research revolves. Specifically, the study will result in a translated and thoroughly evaluated edition of the acclaimed tool, the CFI, which offers a systematic focus on the patient-centred approach and is expected to be widely used in the Danish health care services. The project will also contribute to the international research field with much needed evidence about the interview’s clinical utility.

Expected Impact:
The liaisons of CTP at transcultural centres in Oslo and Stockholm have requested the translation of the CFI and it is thus particularly expected that the experiences of this study will be useful in Scandinavia in which health care systems and migrant groups are similar to the Danish. With the knowledge from this project, it will be possible to establish a procedure for a more thorough and accurate assessment and diagnosis of ethnic minority patients with a mental disorder, and create an environment that increases the patient’s acceptance of the treatment. Improved treatment can increase the quality of life of patients and their relatives, and bring about more satisfactory working conditions for mental health clinicians.


  • Sundhedsvidenskab - Transcultural Psychiatry, Health Systems Research, Observational Study

ID: 46172059