Project

Designing for Culturally Inclusive Mental Health

CTP Veldzicht x Design Across Cultures

How can we support transcultural psychiatric patients and their caregivers in their treatment process by making it more culturally sensitive? How might we design a culturally sensitive ‘conversation keeper’ for the transact care team and asylum seekers that ensures we can capture the understanding of the patient on their treatment trajectory?

The Center for Transcultultural Psychiatry (CTP) Veldzicht is an institution providing mental healthcare to patients who arrive in The Netherlands as asylum seekers. Mental distress has high prevalence among asylum seekers, including higher rates of depression, PTSD and other anxiety disorders.

While the group of patients receiving treatment at CTP Veldzicht is extremely diverse – they come from many different countries, hold different beliefs, and have different stories – they all end up at CTP Veldzicht after the decision is made in Dutch courts that they need psychiatric care because of (suspected) severe mental health issues forming a danger to the patients themselves and possibly others. Furthermore, the situation of this group of asylum seeker patients also complicates their mental health further – with very few chances of getting permanent residency in The Netherlands. In order to support this group of people wherever possible, it is therefore key that they receive the right psychiatric care so that any psychiatric problems are identified at an early stage.

However, the big cultural diversity of these patients can make it difficult for caregivers working at CTP Veldzicht to implement standardised interventions for patients’ intake and to monitor their treatment progression and effectiveness. One reason for this resides with the patients’ own understanding of mental health: coming from different backgrounds, they express mental health issues much less from their individual perspective but rather in relation to their community, they sometimes talk about physical pain when they mean to address issues related to their mental state, mental health can be a taboo in the country they are coming from, or they are altogether unaware of any issue they may have. Furthermore, the patients sometimes struggle trusting and opening up to caretakers because of bad experiences they may have had with such institutions in previous countries they resided in.

On a deeper level, however, this also raises the question to what extent these standardised methods (often questionnaires) that CTP Veldzicht is required to work with can fully capture the experience of this culturally diverse group of patients. Such methods are built on principles of Western Psychiatry and therefore mostly tuned to the experience of Western patients; the problem with this level of standardised questionnaires is that they can become too tunnel-visioned on the Western mental health experience alone and are therefore not particularly culturally sensitive – indeed, they might not be able to recognise mental health problems outside of this spectrum as problems at all. Without such recognition, the risk here is that patients might not get the right treatment or diagnosis and that the treatment itself possibly even works in counterproductive ways for the patient.

 

In order to bridge this gap, CTP Veldzicht has paired up with the Design Across Cultures Track at Digital Society School. With a team of 6 trainees, who have very different cultural and educational backgrounds, we are working together with CTP Veldzicht on a digital methodological solution that supports the caregiver in their work of treating and diagnosing the patient. The goal is not to abandon the previously existing methods as such – rather, the focus is to broaden the range of insights that these methods can provide. To put it more simply: How can we help change the treatment process into more of a dialogue between caregiver and patient, instead of a one-directional conversation? How can we give the patient the space to express their stories, and how can we give the caretaker the means to interpret that? Through experimental design and visual storytelling ,we are currently working on a high-fidelity prototype to support them in that journey.

 

For more information, stay tuned as updates will be posted on this page!