Careful assessment of the social and cultural context of psychiatric problems must form a central part of any clinical evaluation. Beyond this, culturally based attitudes and assumptions govern the perspectives that patient and clinician bring to the clinical encounter. Patients articulate their suffering and concerns through cultural models, idioms, and practices located with social networks and systems of meaning. Awareness of differences in the social and positions and cultural perspectives of patient and clinician is important for the development of a clinical alliance, the negotiation of treatment, and the delivery of effective care. This chapter introduces key concepts and approaches to culturally and structurally competent and safe clinical practice, including: notions of culture, ethnicity, and racialized identity; the intersectionality of culture with age, gender, sexual orientation; the use of the cultural formulation interview; working with interpreters and culture brokers; and issues of stigma, coping, and recovery.

Keywords

• Culture
• Ethnicity
• Cultural formulation
• Social determinants of health
• Racism
• Idioms of distress
• Explanatory models
• Cultural syndromes
• Cultural competence
• Cultural safety