Reprinted from the "Culture" issue of Visions Journal, 2014, 9 (4), p 4
Norm: A belief held by a group about how to behave in a particular situation. A bit of jargon until you realize it’s also the root of a word that we encounter pretty often: normal.
As you’ll read in the guest editorial, this issue of Visions had an ambitious goal: we wanted to look at our Culture theme broadly. Of course, culture has always been bigger than ethnicity. It’s about identity, belonging and informal understandings about how things are done. It’s also about who defines what is normal, and whose well-being is impacted as a result.
Like the idea of ‘normal,’ stigma is relative. Stigmas are embedded in culture, and both stigmas and culture can change—ideally for the better. It would serve the mental health field well to study the culture and stigma shifts in areas like cannabis, tobacco, drinking and driving, cancer or LGBT rights.
How many times have we heard—as service providers or family members—the phrase, ‘you just don’t get it.’ It may be that we’re poor listeners but it’s just as likely that we are from a very different cultural group from the speaker. Maybe it’s a generation gap, or a gender gap, or a class gap, or a disability gap, or an ethnicity gap. Or a combination of gaps. We simply don’t have the shared history, understanding, language, or ways of being. But even if we did in one area, we can’t be a member of every culture. So we need to find ways to bridge the gaps. Respect, humility, curiosity, and empathy go a long way in improving understanding and providing culturally competent care.
Teach-back is one technique to help in understanding. For example, a family doctor might ask a patient at the end of a visit to summarize what they understood. Teach-back reduces misunderstandings and aids memory. In planning and reading this issue, it strikes me that it would serve all mental health and addiction professionals to do teach-back in reverse. That is, to listen to their clients share their realities from their cultural perspectives and at the end of a visit, summarize what they have learned in a way that makes sense to and honours the client.
About the author
Sarah is Visions Editor and Director of Mental Health Promotion at the Canadian Mental Health Association’s BC Division