Cultural and Language Mismatch: Clinical Complications

Abstract

The catchment area of the South Glasgow Child Psychiatry Team includes a high proportion of families of South Asian origin, yet few are referred for services. For those who are referred, team members, all white British, have found that there is often a gulf between their understanding of the child’s problems and that of the family, which makes provision of an adequate service difficult. We made a review of all available case notes of South Asian families attending the service in the preceding year with the aim of identifying barriers to referral, assessment and treatment. Assessments were complex and often unsatisfactory, although around half of families eventually reached consensus on diagnosis and treatment with the clinician(s). A larger proportion of South Asian children were diagnosed with and treated for ADHD compared with the general population of children being seen at that time. A minority of families did not receive the treatment of choice because of language mismatch or lack of consensus over the child’s diagnosis. The implications of the difficulties with shared language and other aspects of communication for practice and for further research are discussed.