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Spring 2008 | Vol 11 No 3

A view from CAMH

Dr. David Goldbloom

The focus on cultural competence in this issue is a relevant one for CAMH – and for all of us who provide health care anywhere in Canada. We remain a nation of Aboriginals and immigrants, and for the latter it’s only a question of how long ago we arrived in this country.

Transcendent qualities for culturally competent care include respect, openness and curiosity on the part of all clinicians. It is not the impossible goal of encyclopedic knowledge of all cultures, races and ethnicities that carries the day. Rather, it starts with simple gestures such as inquiring how people wish to be addressed and learning how to pronounce their names properly. This takes less than 60 seconds at the beginning of a clinical encounter, but it sets an enduring and remembered tone right at the outset. It is the first step in asking the people we serve to teach us about themselves, their values, beliefs and traditions. This is not an “add-on.” It is an essential component of our task, even as we look for signs and symptoms of recognizable disorder, to contextualize these reproducible patterns in the unique trajectory of an individual.

Similarly, we must not make assumptions about individuals based on group memberships. Diversity exists within as well as between. We can easily fall into stereotyped thinking about other groups while appreciating the wide range within the one we happen to belong to. Thus, as CAMH’s Rani Srivastava points out in her introduction to this issue, cultural competence has to include taking a hard look at our own assumptions and reactions.

Most of us are in this line of work because of our curiosity about people, our wish to learn more and our desire to help. Textbooks of cultural competence can point the way and provide some skills for the journey, but the source of true knowledge is within the people we serve. The rate-limiting step is the degree of our willingness and ability to learn from them.

David S. Goldbloom, MD, FRCPC
Executive Editor, CrossCurrents;
Senior Medical Advisor,
Education and Public Affairs, CAMH
Professor of Psychiatry, University of Toronto