Psych CASC / OSCE · Public and community psychiatry
Engaging an Aboriginal patient who distrusts mainstream services — CASC communication station
MRCPsych/FRANZCP-style communication station: respond to distrust grounded in prior discriminatory experience, avoid defensiveness, and co-design a culturally safe plan with community-controlled partnership.
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Station brief
Format. Communication station, approximately 7-10 minutes after reading time. You are the psychiatry registrar; the patient is seated with you. An Aboriginal Health Worker is available if the patient wants them.[2]
Candidate instructions. Respond to her statement without defensiveness. Acknowledge the specific service failure, validate her experience as rational and documented in the literature, and negotiate a plan that may include the Aboriginal Medical Service as front door or partner. Do not lecture about cultural competence, do not promise what you cannot deliver, and do not treat the AMS suggestion as a rejection of care.[1][2][3]
References5ShowHide
- [1]Ben J, Cormack D, Harris R, et al. Racism and health service utilisation: A systematic review and meta-analysis PLoS One, 2017.PMID 29253855
- [2]Curtis E, Jones R, Tipene-Leach D, et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition Int J Equity Health, 2019.PMID 31727076
- [3]Panaretto KS, Wenitong M, Button S, et al. Aboriginal community controlled health services: leading the way in primary care Med J Aust, 2014.PMID 24938346
- [4]Bauer AM, Alegría M Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: a systematic review Psychiatr Serv, 2010.PMID 20675834
- [5]Kirmayer LJ, Brass GM, Tait CL The mental health of Aboriginal peoples: transformations of identity and community Can J Psychiatry, 2000.PMID 11056823