The Psychiatric clinics of North America
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Psychiatr. Clin. North Am. · Jun 2021
ReviewMoving from Cultural Competence to Cultural Humility in Psychiatric Education.
Given the significant, persistent health care inequities encountered by minority populations, health care organizations and training programs have sought to incorporate cultural competency training initiatives. However, the variety of pedagogical models demonstrate the current lack of a uniform standardized curriculum. Limitations of knowledge-based cultural competence initiatives have resulted in a shift toward attitude- and behavior-based "cultural humility." Cultural humility, the ability to maintain an interpersonal stance that is open in relation to aspects of cultural identity that are most important to the patient, expands on cultural competence, which is essential to improving patient care in mental health care settings.
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Psychiatr. Clin. North Am. · Sep 2020
ReviewAn Anti-Racist Approach to Achieving Mental Health Equity in Clinical Care.
Racism is an important determinant of health and health disparities, but few strategies have been successful in eliminating racial discrimination from medical practice. This article proposes a novel antiracist approach to clinical care that acknowledges the racism shaping the clinical encounter and historical arc of racial oppression embedded in health care. Although preliminary, this approach can be easily implemented into clinical care and may reduce the harm done by racism. It could also serve as a template for antiracist service provision in other sectors, such as education and law enforcement.
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Mixed states in patients with a perinatal mood episode is seldom encountered. Lack of appropriate assessment tools could be partly responsible for this observation. ⋯ In many instances of reported postpartum depression, either a first onset or an onset in the context of bipolar disorder, mixed states were identifiable. However, the strict application of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, mixed features specifier to these episodes risks misdiagnosis.
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Psychiatr. Clin. North Am. · Sep 2019
ReviewEmbracing Diversity and Inclusion in Psychiatry Leadership.
Recognizing and embracing culture, diversity, and inclusion is essential to the practice of high-quality clinical care in medicine and, more specifically, in psychiatry. When leadership lacks diversity, the organizational policies and norms may skew toward devaluing the importance of diversity and inclusion. Considering the significant underrepresentation at the academic faculty level, substantive individual and systemic efforts are required to recruit, retain, and advance a diverse and inclusive student pipeline and faculty in academic psychiatry. For meaningful progress to be made, leaders in psychiatry must resemble an increasingly diverse field of psychiatry residents who serve a more diverse community of patients.
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This article provides an update based on recently published literature and expert consensus on the current state of knowledge regarding feeding and eating disorders in children aged 2 to 12 years. It covers the 6 main diagnostic categories-pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder-discussing issues and findings specific to this age group. It highlights the need for ongoing research in a number of key areas, to include improved understanding of etiologic pathways, characterization of presenting disorders, and the development of standardized evidence-based assessment tools and treatment interventions.