Master i helsefag Inger Dagsvold disputerer for ph.d.-graden i helsevitenskap og vil offentlig forsvare avhandlingen:
“Cultural adaption of mental health services to the Sami.
A qualitative study on the incorporation of Sami language and culture into mental health services.”
Kort populærvitenskapelig sammendrag av avhandlingen:
Research has indicated that the indigenous Sami population experiences more communication problems and is less satisfied with mental health services than the Norwegian majority population. The Sami people in Norway have a statutory right to receive equitable health services, adapted in accordance with Sami language and culture. However, there is limited research on the impact of culture and how to provide culturally and linguistically adapted mental health services to Sami patients. Hence, this thesis aimed to explore the significance of culture and language in mental health care as experienced by clinicians and Sami patients. The study is based on thematic analyses of individual interviews with clinicians and Sami patients in mental health clinics in northern Norway.
The study demonstrated that bilingual Sami patients’ language choice in different communication situations is influenced by a complexity of social and cultural factors. The participants reported extensive use of language switch both in everyday life and in therapy, indicating that a person’s status as a Sami speaker is not always a question of either-or. Sami patients may have different preferences for what they can talk about, in which language, in what way, and with whom. However, the results must not be confused with the idea that Sami-speaking patients do not need Sami-language therapy. Bilingualism, constant language awareness, exploration of language switch, and knowledge about Sami culture and history may enhance the understanding of Sami patients’ needs and preferences when in mental health therapy. The interviews with the clinicians demonstrated that identification of Sami patients’ language needs and preferences as well as offers of language-appropriate services are random. Also, the clinicians referred to Sami culture predominantly in terms of essentialised cultural traits, defining the Sami as “different”. The clinicians had several essentialist assumptions about Sami culture but provided limited descriptions of ways to incorporate cultural and linguistic aspects into clinical encounters with Sami patients. The incorporation of culture and language in
therapy was, for the most part, a “private matter”; in team discussions at the clinicians’ workplaces, Sami cultural issues were seldom included.
The study indicates that the incorporation of language and culture into mental health care is a complex process involving strategies at three levels; institutional systems and structures, health professionals’ cultural assumptions and analytical competence, and cultural assessment of interventions in mental health treatment.
Approaches to cultural adaption of mental health services depend on the underpinning notions of culture. In this study, essentialist, stereotypical descriptions of Sami culture dominated. However, stereotypical portrayals of Sami culture narrow the understanding of Sami identity, delimit the identification of Sami speakers and simplify possible impacts of culture within mental health care. A more dynamic understanding of culture as a continuum between common cultural traits and individual experiences and preferences can increase the understanding of the individual patient’s situation. Therefore, the question is not what culture “is”, but how culture unfolds in human encounters.
Knowledge of the particular elucidates the general; the study of the possible impact of Sami culture and language in mental health therapy might thus provide general insight into being a patient in need of health care. Also, focusing on Sami language and culture sheds light on the culture and structures inherent in the health care system.
Veiledere
Hovedveileder Førsteamanuensis Bodil Hansen Blix
Biveileder Dr.Psychol Snefrid Møllersen, Finnmarkssykehuset
Biveileder Professor emerita Torunn Hamran
Bedømmelseskomiteen
Associate Professor Per Axelsson, Umeå universitet, Sverige – 1. opponent
Professor Kari Dyregrov, Høgskulen på Vestlandet, Norge – 2. opponent
Førsteamanuensis Åshild Fause, UiT Norges arktiske universitet – leder av komité
Disputasleder
Førsteamanuensis Grete Mehus, UiT Norges arktiske universitet
Prøveforelesning over oppgitt emne holdes kl. 10.15, samme sted: “Mental helseperspektiv i urfolks- og norsk forskning de siste 10 år”