Sbbtle Biasin the Treatment of the Spanish Speaking

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Sbbtle Biasin the Treatment of the Spanish Speaking pOcuRENT RESUME ED 139 585 C 009 920 AUTHOR Padilla, Eligio R., Ed,; Padilla, mado M., Ed., ic Perspective. - TITLE* Transcultural Psychiatry: An Hisp earch Center . Spanish Spetkiling Mental.Health ae Monograph Number Four. INSTITU.TION ' California Univ., Los Angeles: Spanish Speaking Mental Health Research and Development Program. PUII-DATE'a , 77 NOTE 107p. AVAILABLE FROM UCLA, Spanish Speaking Mental Eealth Research Center, Los Angeles, California 90024 ($2.50) EDRS PRICE MF-$0.83 HC-$6.01 Plus Postage. -DESC1WTORS' Agency Role; 15ias; Bilingualism; Blacks; Child Abuse; , Community Involvement; COmMunity Organizatiobs;, Community Programs; *Cultural Factors; Drug Thetapy; Folk Culture; Human ServiCes; Language Handicapped; *Mental Health; Mental 18-ealth Clinics; *Mental Health Programs; Neglected Children; *Patients (Pethons); *Psychiatric Services; Psychiatry; Puerto Ricans; , Spanish AMeriCans; *Spanish Speaking: Urban Areas : ,ABSTRACT a Presenting multi-ethnic views.about the delivery of mental health services to the Hispanic population, this monograph th4 joint,meeting of the Puerto Rican , contains 18 papers presented at .Medical Association's ipsychiatry,-Neurology, and Neurosurgery Section, .the Caribbean Psychiatric,Association, and 'the AmericanPsychiatric , Association held in May 1(976. .The papers cover such topics.as: the psychodynamicsf of prejudice; the evaluation and quality controLOf mental llealth services; the community neaial healthcenter'in the central city--issues fdr adminastrators;clinical isSues in the psydhiatric treatment of Puetio Ricans; a community mental health program for Chicago's Spanish speaking people(8 years of evolution) ; psychlatric services to Puerto Rican patients in the Bronx; the importance of a community mental health center in a 'Spanish speaking community; diagnostic and prognostic surprises in Spanish American 'patients in Colorado;.a separate cdmplate program fot Spanish speaking patients; the use of community workers in a Spanishspeaking community; sbbtle biaSin the treatment of theSpanish speaking; participatioT of iatinos and Blacks in obtpatientservices consumer iurieys;.day .treatment 'of,Hispanic adolescents involved with the courts;.Lthe IangUage landiCapped psychiatrist and.patient in a bilingual situation; pharmacotherapy; voodoo, spiritualism and psychiatry; psyclipatryand'ithe criminal system; and the abusedand° neglected child., 1NQ) Documents acquired by ERIC include many informal. unpublished materials not available from other sources. ERIC makes 'every effort to obtain the best copy ivailable. Nevertheless, items of marginal reproducibility are often encountered and this affects the quality of the microfiche and hen:loopy reproductions ERIC makes available via the ERIC Document ReProduction Seikrice (EDRS).. EDRS is not responsible for the quality of the original document. Reprochictions supplied by E RS are the best that can be made from tite original. lea ,RANSCULTURAL PSYCHIATRY: AN HISPANIC PERSPECTIVE I Edited by I, 4. gio R. Padilla and Amado M. Padilla with a ForewOrd by Victor Bernal y del Rio U t DEPARTMENT OF HEALTH. EDUCATION & WELFARE NATIONAC-INSTITUTE OF EDUCATION THIS DOCUMENT HAS BEEN REPRO. DUCED EXACTLY AS RECEIVED FROM THE PERSO19 OR ORGANIZATION ORIGIN. AT,ING IT POINTS OF VIEW OR OPINIONS STATED DO.NOT NECESSARILY REPRE SENT OFFICIAL NATIONAL INSTITUTE OF EDUCATON POSITION OR POLICY t ONOGRAPH UMBER FOUR 16.roduced by the paniih Speaking kental HealthResearch Center 6 4 mado M. PaOill, Principal Investigator niversity of pali ornia os Angeles,al forn# 90024 PERMISSION TO REPRODUCE THIS COPY RIGHTED MATERIAL HAS BEEN GRANTED BY E. Olmedo for Sp.Alp Me_n_taLliith Cen te r TO ERIC AND ORGANIZATIONS OPERATING UNDER AGREEMENTS WITH THE NATIONAL IN- STITUTE OF' EDUCATION FURTHER REPRO-..: , DUCTION OUTSIDE THE ERIC SYSTEM RE. WIRES PORMISSION Or THE COPYRIGHT OWNER Spanish SithiakIng Mental HealthResearch Center ,Monograph Series SerlesEdItor . Victor B. Nelson Cisneros*,' Monograph Number One . Latino Comiilunity Mental -Health Monograph Number Two Delivery of Services for Latino 'Community Mental Health Monograph Number Three -Psychotherapy with the j Spanish-speaking: Issues in Research and Service Delivery Monograph Number Four franscultural Psychiatry: _An Hispanic Perspective , . Copyright © 1977 by Spanish Speaking Mental He Research Center..All -rights reserved. printed in the Ukted States otAmerica. o FOREWORD. i The joint meeting of the Section frif. Psychiatry, Neurology and Neurosurgery of the Puerto Rican Medical Association, the Caribbean Psychiatiic Association, and the American Psychiatric Association took place in San Juan, Puerto RiCo in May, 1976. The Section of Psychiatry, Neurology\ and Neurcisurgery, under the auspices of the puerto Rico Institute of Psychiatry, 'organized and coordinated the meeting. The ., theme was 'Psychiatric Services to the Spanish Speaking Population in the United States and Transcultural Aspects of Psychiatry in the Carib- bean.", Participants were invited to look with us and through us at particular 3er/ices rendered to the foreign-born population in the .United States and .to the culturally different who are not in the Main- stream of the \'Arnerica'n bream"; and to evaluate whether they all receive'their dt4 share of health and care. the occasioi was faced with many considerations. Was this to be called a congress:\,. a meeting or an encounter? Was the theme "human services," or more speCifically "psychiatric services"? Both inspection and, introspection were required to answer these questions. Thust we hesi- tated as we proceeded tO invite other disciplines to participate. In order to make-inspection' thorough arid introspection profound, it was decided that our emphasis must accentuate the, relationship between the human and the humane. All services in which encounters occur, whether' judiCiary, police, health, education, etc., were selected as suhtlects for both riternal and external scrutiny. - With the acceptance.of this theme, it was possible fo discuss the contri utions of psychiatry and other mental health professions in a broad r context.including, but also going beyond, issues Of traditional individual therapy. However, it is in fact our intensive study of the one- .,- to-one encounter which enables psychiatrists to offer a Afferent kindof Positive, input into the delivery of various types of human services. We stress the importance of considering the impact on the individUal in 1* delivery of services. For'exampl .. who el.e has ever thought to teach Ad encourage handshaking liatityn .service Aeliverers (welfare workers, physicians, lawyers, parole officers) and their- clients? Who else encour-, ages kindergarteri and primary grade teachers to hold their pupils on their laps? Who else would drearn of making it imperative for a surgeon, judge or lawyer to shake hands with his client before beginning a case? Certain trepidations to inaugurate any encounter or relationship is characteristic of the human,being. The common, the frequent and the familiar produce a 'natural response to approach, embrate, accept and .enjoy. The unfamiliar, thedifferent, --the unusual or the bizarre produce - r 4- III the opposite reeponse; there is a tendency to avoid, to refuse and to reject. The same, the familiar, the common and the frequent are primitively but pOwerfully evaluated as "good"; the different, the un- familiar, the Uncommon, and thti infrequent are similarly evaluated is "bad." This tendency becomes apparent when individuals- come in contact with differing cultuits producing what has.. popularly been referred to as cultural "shock." Are psychiatrists susceptible to the same forces? We- are trained to ,Overcome this tendency and trained to deal with' the uncommon, the uniisifil, even the bizarre. However, the training of psychiatriits-ahd other mental health professionals focuses on indiVidual variation. What appears tn ohirs to be uncommon or strange in individuals becomes to us what is expected and familiar. Yet, when encountering a persohwbo presents not;only his unique individuality, but also a different .cultural identity, the same anxiety may be aroused in us: The joint meeting was an unusual opportunity for participants to learn more about culturally diverse peoples and more about themselves.. It brought together peer s. and neighbors who, through differences.in language; cultural and .ethnic origir, represent within themselves the different', the uncommon, the opposite, and same bf which may have been described by members :of "other" groups as. bizarre. We came to identify our many similarities and to acknowledge and appreciate our differences, as-individuals and as members, of different kinds of groups (including, among others, different' nationalities, ethnic groups, and professional identifications) through the process of encounter. By con- . tact, communication and increasing familiarity, we havelessened the impact and anxiety of the first encounter. Although repegtion is the matrix of perfection: progress feeds on new experiences. Encounter with the new, the different, and the uncommon is what .produCes intellectual. .and emotional eross-pollination. In closing, this experience bore such:richness that we.,havebeen the subject of honors, applause, congratulations And embraces "froni all cardinal points, so much sO that the encounter tbgether with its success, became overkvhelming. We cannot, hoWever, afford to be humble, for we must share the pinnacle, with so many in so
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