Community and Social Psychiatry (including Cultural and Regional Perspectives)
Core concepts
Understand the shift from institutional to community care, deinstitutionalization, and the components of community mental health services (assertive community treatment, case management, supported employment, early intervention). Know social determinants: poverty, unemployment, housing, migration, stigma, and social isolation. Cultural psychiatry: culture-bound syndromes (e.g., koro, amok, latah, zar), cultural formulation (DSM-5 Cultural Formulation Interview), and the role of family and religion in Arab and regional contexts. Understand stigma reduction, mental health literacy, and the treatment gap in low- and middle-income countries. Know the principles of recovery-oriented care and peer support. Consider how collectivist family structures, gender norms, and religious beliefs shape presentation and help-seeking in the region.
Traps
Do not pathologize culturally normative beliefs or practices. Culture-bound syndromes are not confined to their culture of origin. Distinguish stigma (societal) from self-stigma (internalized). Community care is not simply 'less hospital' - it requires resourcing and coordination.
Rule of thumb
Use the cultural formulation: identify the cultural identity, the explanatory model, the stressors/supports, and the cultural factors in the clinician-patient relationship.