Perspectives of family members participating in cultural assessment of psychiatric disorders: Findings from the DSM-5 International Field Trial

Abstract

Despite the important roles families play in the lives of many individuals with mental illness across cultures, there is a dearth of data worldwide on how family members perceive the process of cultural assessment as well as to how to best include them. This study addresses this gap in our knowledge through analysis of data collected across six countries as part of a DSM-5 Field Trial of the Cultural Formulation Interview (CFI). At clinician discretion, individuals who accompanied patients to the clinic visit (i.e. patient companions) at the time the CFI was conducted were invited to participate in the cultural assessment and answer questions about their experience. The specific aims of this paper are (1) to describe patterns of participation of patient companions in the CFI across the six countries, and (2) to examine the comparative feasibility, acceptability, and clinical utility of the CFI from companion perspectives through analysis of both quantitative and qualitative data. Among the 321 patient interviews, only 86 (at four of 12 sites) included companions, all of whom were family members or other relatives. The utility, feasibility and acceptability of the CFI were rated favourably by relatives, supported by qualitative analyses of debriefing interviews. Cross-site differences in frequency of accompaniment merit further study.

Acknowledgements

This paper is a product of the Cultural Committee of the Group for the Advancement of Psychiatry, which is a US organization of nationally respected psychiatrists and other physicians dedicated to shaping psychiatric thinking, public programmes, and clinical practice in mental health.

Declaration of interest: The field trial was funded in part by the American Psychiatric Association. The authors have no other conflicts of interest to report. The authors alone are responsible for the content and writing of the paper.