Cultural psychiatry in Flanders, Belgium: an exploratory focus group study and position statement

BACKGROUND: As in other European countries, mental healthcare in Belgium has to deal with the increasing cultural diversity that exists within society. However, commitment of the Belgian healthcare system toward cultural diversity remains weak, and clear guidelines on culturally competent psychiatric practice are still lacking. METHODS: Three focus groups with professional caregivers, three with adult patients, and one with young adults in the transition age were organized. The seven focus groups each consisted of 5-10 participants. Two brainstorming sessions with a total of 15 experts were organized a priori to delineate focus group topics. Data analysis software MAXQDA 24 was used for thematic analysis. RESULTS: The thematic tree consists of the central theme "culturally sensitive mental healthcare" with five main themes (i.e., vulnerable population, language barrier, mental healthcare stigma, spirituality/religion, Western vs non-Western frame of reference). These themes are further stratified into a number of subthemes and one overarching theme (i.e., diversity policy). The themes have resulted in six recommendations to improve cultural psychiatric care. These recommendations underscore the vulnerability of the target patient population, specific training needs, the need for professional interpreters and intercultural mediators, the place of religion and spirituality in therapy, reflexivity as core competence, and the need to establish reference centers. CONCLUSIONS: The six recommendations provide a scientifically sound base to develop focused and effective mental health policies at the governmental, organizational, and patient level. Continued attention to the importance of cultural sensitivity in mental healthcare provision remains important, particularly in countries that are lagging behind.