Cultural competence and evidence-based practice in mental health: Epistemic communities and the politics of pluralism
Evidence-based practice (EBP) and cultural competence (CC) aim to improve the effectiveness of mental health care for diverse populations. However, there are basic tensions between these approaches. The evidence that purports to ground EBP is limited, often in ways that are biased by specific disciplinary, economic or political interests and cultural assumptions. In particular, the paucity of evidence regarding cultural minorities results in standard practices based on data from the majority population that have uncertain relevance for specific cultural groups. As well, research evidence about intervention outcomes tends to focus on individual symptoms and behaviors and may not reflect culturally relevant outcomes. To some extent, these limitations can be addressed by refining and extending current methods of evidence production. However, consideration of culture raises two deeper problems for EBP: 1) The diagnostic and conceptual frameworks used to pose questions, devise interventions, and determine outcomes in EBP are themselves culturally determined and therefore potentially biased or inappropriate; and 2) Cultural communities may have “ways of knowing” that do not rely on the kinds of observational and experimental measures and methods that characterize EBP. Attention to the nature of clinical evidence and to the importance of cultural context in illness and healing can help both EBP and CC move beyond their current limitations and contribute to the evolution of mental health services that respond effectively to cultural diversity.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 75 (2012)
Issue (Month): 2 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Joseph Henrich & Steve J. Heine & Ara Norenzayan, 2010. "The Weirdest People in the World?," Working Paper Series of the German Council for Social and Economic Data 139, German Council for Social and Economic Data (RatSWD).
- Goldenberg, Maya J., 2006. "On evidence and evidence-based medicine: Lessons from the philosophy of science," Social Science & Medicine, Elsevier, vol. 62(11), pages 2621-2632, June.
- Sergio Sismondo, 2007. "Ghost Management: How Much of the Medical Literature Is Shaped Behind the Scenes by the Pharmaceutical Industry?," Working Papers id:1254, eSocialSciences.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:2:p:249-256. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei)
If references are entirely missing, you can add them using this form.