Transcultural Psychiatry Symposium

Friday 22nd March 2013
10am to 5pm
Council Room
Royal College of Psychiatrists
17 Belgrave Square, London SW1X 8PG
DR LAURENCE MYNORS-WALLIS The Registrar of The Royal College of Psychiatrists
has kindly agreed to Chair our symposium.
Laurence has been Registrar of the College
since 2010.
In this role he has overall
responsibility for policy, public education,
revalidation and membership engagement.
Laurence is a general adult psychiatrist
working in a community mental health team in
Poole and is the Medical Director of Dorset
Healthcare NHS Foundation Trust. In his role
as College Registrar he has focussed on
support the provision of high quality mental
health services, and setting new standards for
job descriptions that allow consultants to
practise safely and to a high standard. He is
professional concerns and can be contacted
on [email protected]
Transcultural Psychiatry in the 21st Century
Dr Hellme Najim, Basildon Essex, United Kingdom.
Graduated from Mosul Medical College 1977.
Membership of the Royal College of Psychiatrists 1983.
Assistant Professor of Neuropsychiatry Mosul University Iraq 1989 - 93.
Assistant Professor in Neuropsychiatry Sana'a University Yemen 1993 94
Lecturer at The Institute of Psychiatry London 1996-8
Consultant Psychiatrist South Essex University Foundation Trust 1998 present
Special interest:Psychopharmacology, Service provision of people with severe mental
illness, Interface between primary and secondary care.
He was elected as a chair for the Transcultural Psychiatry Special
Interest Group at the Royal College of Psychiatry in July 2012.
Transcultural psychiatry deals with psychiatric disorders and services in
different cultures and how cultural systems and beliefs influence
psychiatric presentations and response to treatment.
The revolution in transport and communication has led to more interaction
and mobilization of people across the countries and continents. The
global village concept has developed which made people more aware of
different nations and customs much more than before.
Conflicts and unrest has displaced people from their countries. They
settled in their hosting countries and exposed them to different cultures
and enriched the hosting cultures with their traditions. Economic
immigration has made people move from there home countries searching
for a better life. Usually people move from low income to high income
Immigration has been proved to be stressful and immigrants have high
psychiatric morbidity internationally.
Psychiatrists practicing in hosting countries started to encounter
presentations they haven’t studied or come across before. Transcultural
Psychiatry jumped from the shelves of libraries to day to day practice,
especially in the West where waves of immigration have rippled on their
The Royal College of Psychiatrists, as an academic institution, has
always paved the way for psychiatric training, research practice in the
United Kingdom and worldwide.
Transcultural Psychiatry special interest group is the relevant venue to
lead the way in this field.
In order to achieve this objective, our plan is to organise regular meetings
and symposia about psychiatry in different parts and to publish our
electronic news letter regularly. We will create an electronic forum to
discuss transcultural issues and update news worldwide. We will try to
liaise with other special interest groups at the Royal College and create
channels of communications with ethnic minorities in the United Kingdom.
We will also liaise with self-help groups and different cultural
organisations, through attending their activities or inviting them to our
All these objectives cannot be achieved without your help and support.
Transcultural Linguistic Intricacies of Expression of
Dr.Archie Acharyya
Graduated from India.
Worked in Psychiatry in India.
Worked and trained at the Institute of Psychiatry for many years.
Has been a Consultant Psychiatrist for 25 years in Essex.
Medical Director for many years in Essex.
He contributed a chapter in the volume "Intercultural Psychiatry" edited by
Late Jafar Kareem & Prof.Rowland Littlewood.
He was a co-founder of Nafsiyat Intercultural Therapy Centre with Late
Jafar Kareem.
He writes poetry.
His main interest is Transcultural Psychiatry and philosophy.
Title: "Verbal language and Expression of Affect - Intercultural
understanding between Psychiatrists and Patients - a Jobbing
Psychiatrist's Dilemma!
Although the world has been "multicultural" for several millennia, now, in
our small island nation, psychiatrists -multicultural, are seeing patients
who are multicultural. Given the present state of the NHS (not to mention
the national and international economies - in hock to the capitalists), it is
not possible (except, perhaps, in very few, very select, centres of superexcellence), for patients to be exactly -matched with psychiatrists in terms
of their culture, down to the microcosmic aspects.
So, the question an ordinary jobbing psychiatrist is asking is this: - we
have been researching fairly extensively, for at least the last two decades,
schizophrenia, from a transcultural perspective, across the world and
amongst native and immigrant populations in particular countries. This
has been extensively discussed and is being discussed. Yet,
schizophrenia is such a rare condition - as epidemiologists will readily
advise us!
Affective Disorders of all kind, far, far outnumber schizophrenia in all
countries across the world. In the British Isles, given the multicultural
profile of psychiatrists, the multicultural profile of their prospective
patients, how well do psychiatrists understand their patients' emotions and
emotional tones, expressed in words? How much of the psychiatrists'
questions and advice is fully comprehended by their patients - given that,
in so many cases, English is neither the patient's nor the psychiatrist's first
This is the jobbing psychiatrist's dilemma - how am I doing with my
multicultural patients? How can I do better? Please advise?"
3. Transcultural
Models of Cognitive Behaviour Therapy
Dr Farooq Naeem
In addition to specialist qualifications in psychiatry:
Masters degree in research methodology and a PhD.
Published more than 60 publications in journals, in few books and in book
Main areas of interest in research include transcultural psychiatry,
psychosocial interventions and genetics of mental health disorders.
Ran many projects in both the UK and Pakistan.
Has been part of funded research projects and has collaborated with
Durham, Manchester and Toronto University’s.
Developed culturally adapted CBT for local clients in Pakistan and ethnic
minority clients in the UK.
Founding President, Pakistan Association of Cognitive Therapists
Cognitive Behaviour has a strong evidence base and is recommended by
National Organizations in both the UK and USA. There is some evidence
from research to suggest that CBT might need some adaptations when
working with clients from non European background. Most research on
this area originates from the US. Developing culturally sensitive CBT
project at Southampton University involved adaptation of CBT for black
and ethnic minority communities in UK and for local population in
Pakistan. A series of mixed method studies were conducted in Pakistan
and in UK. We adapted CBT for depression and psychosis in Pakistan,
while in the UK CBT was adapted for psychosis. Based on this work
guidelines were developed for adapting CBT. These were further adapted
during our work in Manchester and Pakistan. We will describe the guiding
principles for working with South Asian Muslims (SAM), using CBT, which
emerged from our work. We found that in order to effectively work with
clients from SAM background, therapists need to consider and develop
three fundamental areas of cultural competence; (1) Awareness of
relevant cultural issues and preparation for therapy; (2) Assessment and
engagement and, (3) Adjustments in therapy techniques. Awareness of
cultural issues in turn includes awareness of cultural and religious issues,
capacity and circumstances of both the individual and the system and
cognitions and beliefs.
Overall, findings from, developing culturally sensitive CBT project suggest
that minor adjustments in therapy are required in order to work with SAM
clients. However, further work is required in this field.
The aim of this presentation is to describe guidelines which emerged from
our work on developing culturally sensitive CBT with SAM.
My Adventures with Doctors from Many Lands
Dr.Chris Fasey
Born 1958, qualified in medicine 1981, MRCPsych 1987, FRCPsych
2006, MBA 2007.
Appointed Consultant in Psychiatry of Old Age at Basildon Hospital 1994
to present including a time as Clinical Director of Old Age Services.
Recognised Senior Registrar trainer from late 1990s.
Joint director East London and South Essex SpR training rotation 20042008.
Worked part-time from 1997 with the birth of 1st son and is currently
working 4 ½ days/week.
Due to retire 30/06/13 at age of 55.
The future is unplanned but decidedly less onerous.
When I was asked to do a presentation on my experiences with junior
doctors I was put in a quandary. Over the last 19 years I have worked
with many doctors, from many parts of the world and of many religions. I
am not aware, however, of making any special allowance or altering my
practice – they were all junior doctors seeking to understand, at some
level, the vagaries of old age psychiatry and develop skills to help with
their future practice and their exams.
This task has forced me to reflect on my work with juniors
How one deals with the cultural differences and expectations
The differences in ethical problems – how much are these individual and
how much cultural
Differences in language given the nuances in English vary so wildly
Navigating the cultural differences within modern English society, which
are as often class based, and ethics.
This presentation is the product of my reflections……………….
Attitudes Towards Mental Health of Women in a Pakistani
Community in UK
Dr Rashda Tbassum
Medical Degree from Pakistan.
Moved to UK in 1993.
Completed MPhil from Sheffield Hallam University Sheffield in 1997 it was
about the attitudes of Pakistanis towards the mental health of Pakistani
Joined Psychiatry Training scheme as a part-time SHO.
Became a member of Royal college of Psychiatrist in 2006.
Worked as an Associate Specialist in Old Age Psychiatry since 2005.
Transcultural psychiatry is one of her special interest and her latest
research about the “use of translated version of MMSE with south Asian
elderly patients in the UK” was published In INTERNATIONAL
PSYCHIATRY in April 2010. It led to the production of DVDs in two south
Asian languages for raising dementia awareness in BME community.
These DVDs are also being considered for use as a training tool.
British Pakistanis make up the second largest subgroup of British Asians
and are also the second largest ethnic minority population in the United
Kingdom. Pakistani immigration to the United Kingdom increased,
especially during the 1950s and 1960s.The prevalence of mental disorder
in immigrant groups in the United Kingdom has received considerable
attention in the research literature over many decades although findings
have been inconclusive. The present study was designed to explore some
of the apparent contradictions in research literature. There have been few
studies in the UK looking specifically at the attitudes towards mental
illness in Pakistani community and the possible attributional factors
contributing to these attitudes. The second aim was to explore the needs
of this community, particularly women, in relation to mental health
Transcultural Interpretation of Depressive Presentation
Dr.Shahid Latif
Consultant psychiatrist and clinical director at Northamptonshire
healthcare NHS foundation trust.
Trained in Leicester which has a richly populated Asian community.
Developed an interest in transcultural psychiatry while working there.
Special interest in cultural and religious beliefs in possession states and
black magic; he works closely with the local community and religious
leaders in attempting to provide education into mental health problems.
My talk will focus on the importance of understanding the background and
belief systems of the patients that we see particularly from different ethnic
backgrounds. Also a little bit about my qualitative study on Muslims
Beliefs in black magic, evil eye and possession states. The talk focuses on
the cultural barriers that may effect meaningful therapeutic bridges. This may lead to
under recognition or misidentification of psychological distress. Thus unnecessary
diagnostic procedures or inappropriate treatment. It is important to decode the
meaning of somatic and dissociative symptoms which are not simply indices of disease
or disorder but part of a language of distress with interpersonal and wider social
PTSD and the Military: Is the Army a Culture Bound
Professor Sir Simon Wessely MA BM BCh MSc MD FRCP FRCPsych
Professor and Head of the Department of Psychological Medicine and
Vice Dean for Academic Psychiatry at the Institute of Psychiatry (IoP),
King’s College London.
Best known for his work on unexplained symptoms, syndromes and
military health.
Founded the King’s Centre for Military Health Research, a unique
collaboration between the IoP and the KCL Department of War Studies,
founded in 2003. Its flagship project, a large-scale ongoing study of the
health and wellbeing of the UK Armed Forces, has had a direct impact on
public policy and on forms of treatment and help for Service personnel.
Born and educated in Sheffield
Studied medical sciences and history of art at Trinity Hall, Cambridge
Finished his medical training at University College Oxford, graduating in
1981. He obtained his medical membership in Newcastle, before moving
to London to train in psychiatry, where he also obtained a Master’s and
Doctorate in Epidemiology.
Consultant Liaison Psychiatrist at King’s College Hospital and the
Maudsley Hospital since 1991.
Director of the Chronic Fatigue Research Unit at King’s in 1994 and of the
Gulf War Illness Research Unit in 1996.
Civilian Consultant Advisor in Psychiatry to the British Army
Member of the Defence Scientific Advisory Council
Foundation Senior Investigator of the National Institute for Health
Professor Wessely has over 650 original publications, with a particular
emphasis on the boundaries of medicine and psychiatry, unexplained
symptoms and syndromes, military health, population reactions to
adversity, epidemiology, history and other fields. He has co authored a
text book on chronic fatigue syndrome, a history of military psychiatry and
a book on randomised controlled trials, although none are best sellers..
He is a trustee of Combat Stress, and his contributions to veterans’
charities include cycling (slowly) six times to Paris to raise funds for the
Royal British Legion.
In 2012 he was awarded the first Nature “John Maddox Prize” for
Standing Up for Science, and was knighted in the 2013 New Year’s
Honours List.
Professor Simon Wessely has kindly agreed to talk about:
Psychiatric Practice in India – A Comparison with the
Western Model
Prof Sab Bhaumik
Prof Sab Bhaumik is currently Honorary Chair of University of Leicester,
Medical Director of Leicestershire Partnership NHS Trust
Royal College of Psychiatrists’ lead for primary mental health care.
Former Chair of Faculty of Psychiatry of Learning Disability
Chair of Trent Division of RCPsych.
Awarded OBE for services to Medicine in 2006
Winner of the Hospital Doctor Award in 2005.
Current lead for next stage review programme for Learning Disability in
East Midlands Chair of the Working Group on Development of Care
Published extensively in health service research and is currently leading
on a research project on implementation of care pathways in learning
India is a continent; health care in India is a reflection of its large
35 colleagues registered for the symposium. 22 feedback forms were returned. Most of the
feedback was excellent and very good. We received a few emails in addition to feedback forms.
Please see Correspondence to view a sample for authenticity and for the benefit of colleagues who
may consider attending future activities.
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