This section describes the development, functioning and evaluation of three specialized cultural consultation services at the Jewish General Hospital (JGH), the Montreal Children's Hospital (MCH), and H么pital Jean-Talon (HJT).
All three services developed in response to demographic changes over the past 10-20 years in Montreal, which has seen a large increase in cultural diversity.
Each clinic was initiated by a psychiatrist with extensive experience in the area of transcultural psychiatry, whose particular perspective shaped the orientation of services, along with input from the other professionals and social scientists working with each group.
- The JGH has used a consultation-liaison model and emphasized integrating the perspectives of medical anthropology with conventional psychiatric, cognitive behavioural and family systems perspectives.
- he MCH has emphasized a pluralistic approach and focused on providing flexible services for immigrant and refugee children, especially those who have suffered organized violence. It has worked closely with schools and community organizations to integrate community resources and perspectives.
- The HJT has adapted an ethnopsychoanalytic model that uses a multicultural group of clinicians and people accompanying the patient to reframe the problem from multiple points of view, and mobilize the cultural frames of reference of the patient and his or her entourage.
Despite the "specialized" nature of the services, their common goal has been to work within the broader psychiatric structure and collaborate with existing services. While the conceptual models of the services were initially broad, tentative and open, all three services have evolved significantly over time as they learn from and adapt to their various milieus, collaborators and patient populations.