Improving Case Management through Culturally sensitive practice.

Improving Case Management through Culturally sensitive practice.

Last year I had the opportunity to participate in a Trans-cultural Training Program offered by my employer. The course was provided and run by the Williams Road Family Therapy Center and ran over a twenty-week period. Sessions ran every Wednesday for four hours. The topics covered a range of issues in regards to migration, acculturation, cultural lag, marginalization, cultural beliefs and values just to name a few.

Since doing this training I have become aware of the need for case-managers to become more “in tune” with the cultural aspects of the clients the serve. Case managers draw on varying sources to help their clients achieve planned goals. These include personal experience, voluntary, private and statutory sources. This requires a repertoire of knowledge and skills and the ability to work across a variety of disciplines and differences. They must be able to understand and communicate effectively with clients and their care givers. In order to establish and sustain rapport, health professionals need to develop skills that are culturally sensitive. To become culturally competent, case managers must first become aware of their own prejudices and assumptions regarding differences in ethnicity, gender, class, ability, age or sexual orientation. The impact of this on their ability to work effectively with colleagues, consumers and other professionals can then be examined.

As communities become more culturally diverse, we all need to understand how culture and tradition affect the client’s ability to accept help and comply with medical treatment. Consideration for their own beliefs and customs concerning health care and expected outcomes is of great importance. Failure to understand cultural issues regarding mental illness and treatment can lead to poor compliance and reduce positive outcomes. Case Managers need to prepare themselves with appropriate knowledge, sensitivity and understanding of cultural differences. This can come through in-service training programs, continuing education programs and academic studies. Staff education can make a great difference in helping case managers become more familiar with differing customs, values, beliefs and attitudes to health care of clients and their care givers. Specific knowledge, values, and skills that are culturally relevant, ethnically sensitive and anti discriminatory must be included as core content in education and training of case managers. For instance, in some cultures it is disrespectful look the client directly in the eyes and could even be regarded as offensive. Other cultures regard close body proximity very uncomfortable and find touch disrespectful. Attitudes to silence also vary. Some cultures find silence as important as dialogue, whereas others are embarrassed with it. Cultural reactions to illness and perceptions of health differ, and are influenced by spiritual beliefs and rituals that are handed down for generations.

It is also very important that cultural stereotyping is avoided. It is wrong to surmise that “all Italians are like this” or “all Kooris are like that” or “all Croatians behave that way”. It would be unrealistic to expect health professionals to become knowledgeable about all the differing cultures. Information regarding cultural issues can be provided by the family in the first instance and from a “cultural informant” such as a colleague, interpreters or other professionals listed in the “Bilingual mental Health Directory”.

Differences exist across cultures in terms of language, clothing, generational status, religious practice, acculturation, socioeconomic status and the migration experience. However, if case managers can become aware that diversity, ethnicity and cultural differences exist, they can improve the service they deliver to their client.