Abstract
Background: While the proportions of ethnic groups differ in multicultural societies, their distribution in patient and carer populations may show greater diversity. Mental health needs across cultural groups often vary and the need for increased awareness and sensitivity has been stressed. The challenges and limitations faced by the psychiatrist (therapist) working with ethnic minority patients has also been an area of focus in psychiatry and the social sciences. However, there is a paucity of material on the Black or ethnic minority psychiatrist working with patients in a predominantly White multicultural society.
Method: Through discourse and clinical vignettes of same (Black-Black) and cross-cultural (Black-White) dyads, the challenges posed to both therapist and patient are described. The role of ethnic and cultural similarity or difference in the therapeutic process is also discussed. Emphasis is placed on the meaning of “difference” (ethnic, gender, age, social class etc.) as a substrate of clinical transactions. Questions are raised about what the patient may be trying to communicate or the psychiatrist trying to resist. The varying perceptions and their challenges to the Black psychiatrist are also highlighted.
Conclusion: The Black/ethnic minority psychiatrist may find him/herself in a unique position oscillating between being perceived as either “Black”, “White” or shades of grey.