"Cultural Competence With Migrant Children With Mental Illness In Nursing." (Written, Line-and-Copy Edited. %0-100 in less than 8 hours of contract, only prior info based on syllabus. Client was thrilled. I was happy to learn a lot. original in APA.) Abstract Acculturation is a huge step in any Immigrant’s process after coming to another country or ingratiating themselves into another culture. Health-care providers and clinicians alike must strive to provide the best care within these boundaries as much as they normally do with culturally similar patients. The key to Cultural Competence and Cultural Formulation, especially in the cases of immigrant children with mental illness, is constant broadening of the mind when it comes to other cultures abnormal from the clinician’s own, therefore encouraging the patient/clinician bond, effectually communicating, and providing the standard of care. The purpose of this paper is to bolster the conclusion that taking steps to understand the cultures of would-be patients only strengthens the overall community in being able to tackle not only mental illness, but any ailment that, even with different cultural explanations and definitions, may be present in those that need the appropriate and best treatment. Keywords: Cultural Competence, Cultural Formulation, Standard of Care, Acculturation, Immigrants, Mental Illness. Cultural competence in nursing is the belief in and the understanding that throughout our society and others, there are countless instances of medical practice and thought that are to be taken in to account when treating any patient who the nurse in question is aware of having a different culture than the societal majority to better help and understand, and therefore treat more accurately, the aforementioned patient. Due diligence in these instances help to better keep the patient current as to what is, if anything, evolving in their medical case in ways that best match their own cultural understanding. With the cultural competence correctly being first grasped and sought out extensively, we better execute our policies, secure liabilities, and therefore provide better service and care to as many would-be patients and families as possible. This specific thought, that with cultural understanding comes better care, is inherently present in treating children and adolescents with mental illness, especially in those children hailing from cultures other than our “norm,” specifically within terms of their immigration. As with many differences in culture that consistently vary from casual to congenial, everyday to sacred, the medical industry provides sometimes difficult, if not awkward, cultural differences. For instance, in India, schizophrenia is generally found to, when presenting its symptoms, result in much arguably "happier" or benign hallucinations than those in the average American, theorized due to cultural and existential belief as well as upbringing itself. The disease is not any more pathologically different because of borders on a map, but it is argued that the surrounding culture helps to shape what the symptoms reveal in the disease. So how does a clinician practice the appropriate medicine or act to diagnose if the patient, hailing from the Indian culture in this example, isn't particularly interested in relieving what we would identify as an issue, regardless of whether the side effects are objectively good or bad? Rather than possibly berating, or subconsciously but verbally judging this patient, or others with different cultures for that matter, perhaps it would be more prudent and likely more medically effective to seek to understand the hailing culture and explain that, good or ill in a cultural perspective, it is still a health problem that benefits from the proper treatment. As with anything, a lack of understanding leads to challenging confrontations and instances that could be solved with a modicum of forward thought. Unless a certain amount of understanding in Acculturation is met in a conflicting nurse/patient relationship, there are several problems that may occur. First and foremost in a medical instance, would be a lack of ability to communicate effectually. The issues stemming from a lack of not just communication, but an ability to communicate at almost any level, logically results in sub-level care due to not being able to navigate and ascertain what the patient needs. This could be anything from a language barrier, to a more unfortunately mundane and avoidable stubbornness to connect with the other person based off of something like skin color, dress, or other subconscious judgments that may be the unquestioned “normal” of either culture. In cases of migrant adolescents, ironically, the children adapt to the new culture more quickly than their parents. (Masaud, T., McNicholas, F., Skokauskas, N., 2010) Knowing this, it can be assumed that in most cases where there are children or adolescents involved, they can be brought to bear in terms of helping the navigation of the problems at hand, and at the very least, translating between care-provider and guardian so everyone involved is on the same page, therefore resulting in the most communicative and cared-for situation as is possible to create within these boundaries. In terms of assessing mental health in migrant children, we should strive for understood assimilation on both ends of the spectrum and be as close to proficient as is possible with the child in question’s culture. Working towards Cultural Competency and Cultural Formulation can seem daunting, but there are strains of thought to provide mental tools and systems to ensure the best possible care. “When assessing the mental health of a migrant child or a child from a different culture, or ethnic or minority group, one has take into account a number of factors in order to provide an accurate and culturally competent assessment. Looking at the predisposing, precipitating and perpetuating factors through a culturally competent viewpoint will help to understand the child's problem, and to tailor help to their needs. This can be done systematically.” (Masaud, T., McNicholas, F., Skokauskas, N., 2010) The system in question lists more than several examples of object awareness in these situations including the child’s preferred language, accurate explanations of distress, as many cultures vary in their descriptions of specific ailments, if there is an understanding and support in their native community for the illness, and the background of that culture’s definition of the illness if it is, indeed, known to them. While there is not much the care-providing industry can do for the inclusive parameters in the preimmigration phase our patients undergo, “Clinicians have little influence over the preimmigration risk factors and the difficulties of the immigration process. Yet, there is a lot that can be done in the postmigratory stage to minimize negative outcomes. These can be considered at different levels,” (Masaud, T., McNicholas, F., Skokauskas, N., 2010) there are ways to circumvent issues that will typically occur. Effectually providing care to a culturally different child with mental illness and their family would require engaging and pragmatic actions such as finding common ground, if any, and building your nurse/patient relationship there. It is important to not discriminate or make differences evident. Upon entering a new country and culture, many children must learn a language, obviously foreign in itself, but adapt to a shock in their preconceived notion of what they defined as “culture.” Based upon that, differences are apparent and could, if pointed out or remarked upon, push the child into a possible further feeling of alienation or even stigmatization. A basic understanding of where the child is coming from, mentally and geographically or culturally, helps progress the identification of the issue. This notion also provides a safer and more welcoming environment that the child is more understandably able to be more helpful in the identification process as well. Consistent and accurate training in the multi-cultural aspect on both the health-care provider and the clinician’s end massively and healthily impact the overall experience when diagnosing, providing care, and communicating with possibly less culturally aware patients. The bolstering of the patient’s place in our society, different or not, can be assumed to be met with kindness, if not at least cooperation and communication. Learning the culturally specific finer details of different illnesses can also impact a clinician’s view and understanding of what the issue is as well. As different cultures have their own way of describing illnesses they may be aware of or support, so too can we expand our awareness of what our culture would designate and diagnose, as well as how to care for that same issue more effectively. The promotion of tolerance and forward thinking in these areas are incredibly important here, as everyone from every culture deserves and has the right to the utmost care as can possibly be provided. With that tolerance, training, forward thinking, and sheer determination of the establishments and clinicians alike, we can help deter, treat, and hopefully better stop these illnesses altogether. Citations Masaud, T., McNicholas, F., Skokauskas, N., (2010). Overcoming the challenges of managing mental health in migrant children. Future Medicine Ltd. Doi:http://dx.doi.org/10.2217/phe.10.69 ProQuest ID: 818536358
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