Cultural competence and metaphor in mental healthcare interactions: A linguistic perspective.

Abstract

The aim of this study is to understand how Spanish-speaking patients conceptualize mental health issues. This study uses a linguistic perspective to focus on how 23 Mexican-origin patients and their doctor talk about mental health during psychiatric interviews conducted in Spanish and how they negotiate cultural barriers. This work analyzes when the doctor and his patients reference metaphors (e.g. feeling "empty," feeling "low"). Metaphors are pervasive in all cultures and languages and reveal important information about people's attitudes and feelings about a range of conditions and circumstances. This work demonstrates the role of metaphor and linguistic analysis in uncovering culturally based constructions of mental health. The results reveal that the doctor and patients reference different sets of metaphors, which, at times, causes miscommunication. Practitioner awareness of how patients use metaphorical expressions in health is crucial for promoting advanced cultural and linguistic competence and ultimately, patient-centered care. The main findings have implications for health communication with minority groups such as Spanish-speaking Latinos/as in the United States. Practitioners working with Spanish-speaking patients should be familiar with how Latinos/as conceptualize health and how to avoid or repair confusion caused by cultural barriers.