Abstract
This qualitative study explores Sami and non-Sami clinicians’ assumptions about Sami culture and their experiences in providing mental health services to Sami patients. The aim is to better understand and improve the ways in which culture is incorporated into mental health services in practice. Semi-structured interviews were conducted with 20 clinicians in mental health outpatient clinics in the northern Sami area in Troms and Finnmark County in Norway. The findings show that clinicians’ conceptualizations of culture influence how they take cultural considerations about their Sami patients into account. To better integrate culture into clinical practice, the cultures of both patient and clinician, as well as of mental health care itself, need to be assessed. Finally, the findings indicate a lack of professional team discussions about the role of Sami culture in clinical practice.
Highlights
Culture matters in mental health care because it shapes the experience and expression of mental health problems, as well as health-related beliefs, help-seeking behaviors and ideas about treatment (Helman, 2007; Kirmayer, 2012; Kleinman & Benson, 2006)
A non-Sami participant stressed the impact of having knowledge about the history and local society to understand the patients in a better way: We need to know more about the history, and how our patients live, this applies to the inland, but to the coast as well . . . the Sea Sami . . . those who have lost the language, who feel like Sami, but do not speak Sami . . . It’s important to know a little more about that . . . how people feel about that
That would be a strange approach to our work that I’m not comfortable with.’’ Overall, the findings show that few participants had experiences in which they felt that their clinical assessment of, and communication with, Sami patients was influenced by Sami culture
Summary
Culture matters in mental health care because it shapes the experience and expression of mental health problems, as well as health-related beliefs, help-seeking behaviors and ideas about treatment (Helman, 2007; Kirmayer, 2012; Kleinman & Benson, 2006). Cultural differences are often used as an explanation for why minority populations and indigenous people are less satisfied with health services than majority populations (Alizadeh & Chavan, 2016; King, Smith, & Gracey, 2009). In Norway, studies indicate that the indigenous Sami population experience more communication problems and are less satisfied with mental health services than the majority population (Dyregrov, Berntsen, & Silviken, 2014; Møllersen, 2007; Sørlie & Nergard, 2005). Limited research is available on the provision of culturally adapted mental health services to Sami patients. There is no research showing that any specific diagnosis or treatment directions require Sami cultural facilitation of mental health care or are more suitable for it than others. In this study, we explore clinicians’ assumptions about Sami culture and their experiences
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