Presentation Information
[SY-109-01]Comprehensive case formulation: its role in the future of cultural psychiatry
*Roberto Lewis-Fernandez (Columbia/NYS Psychiatric Institute(United States of America))
Keywords:
comprehensive case formulation,nomothetic and ideographic integration,contextual thinking
The future of cultural psychiatry depends on our ability as a field to impact direct clinical care. Our efforts in this area have been substantial, including in classification, clinical assessment, treatment adaptation, and mental health service organization. The future depends on our successful integration and promotion of these separate elements into a comprehensive case formulation approach that can be tailored to persons and care settings and remain practicable in local health systems. This formulation effort involves approaching assessment by integrating nomothetic diagnosis with the person’s and family’s ideographic account of their lived experience to decipher cultural variation in phenomenology. It also includes attention to the contribution of objectively and subjectively assessed social-structural determinants of mental health, leveraging technological advances to the medical record for patient-focused societal information. It depends on clinician training in contextual thinking and adaptation of psychosocial and pharmacological treatments to the person’s presentation and sociocultural reality to direct treatment planning. And, finally, it guides and relies on a mental health system that incentivizes this comprehensive approach and utilizes the input of various members of a health care team. Research on the benefits of such a comprehensive case formulation approach is needed to deliver the promise of cultural psychiatry.