Clinical appeal of Cultural Formulations in Rural Mental Health: A Manual

The term ‘culture’ although popular in Indian lay health terminology, remains alien to psychiatric vocabulary in the country. Its usage is primarily as an epidemiological variable within Social Psychiatry. This chapter argues that for ‘cultural sensitivity’ in a rural context, to be relevant and effective for both professionals and patients, it is necessary to re-examine the cultural identities of mental health professionals themselves, in their clinical encounters with rural Indian patients. The chapter also examines how mental health clinicians could find practical ways of engaging with her rural patient. Through a discussion of what is culture, emerging theory in clinical anthropology, recent developments in the field of cultural formulations, together with a clinical case vignette that suggest alternatives to enhance the outcome of traditional doctor-patient encounters, the chapter proposes avenues that offer both theoretical and practical value to both patients and health professionals. The case vignette has been extracted from field notes of ethnographic enquiries conducted by the authors in contemporary rural mental health settings in northern India.