title: Culturally sensitive mental health care: a study of contemporary psychiatric treatment for ultra-orthodox Jews in Israel.
abstract: BACKGROUND
  The literature describes psychiatric treatment of ultra-orthodox Jews as complex and challenging, in light of this community's unique characteristics and the ideological gap between ultra-orthodox patients and secular professionals. Recent data indicate that patient-centred culturally sensitive care contributes to the treatment outcomes among cultural minorities.
  
  
  OBJECTIVE
  To examine the effect of the level of a physician's religiosity and cultural sensitivity, as perceived by ultra-orthodox Jewish psychiatric patients, as well as the treatment venue (i.e. the distance of the treatment facility from the patients' community) on treatment outcomes (working alliance, medical adherence and the patients' social adaptation).
  
  
  METHODS
  The sample included 38 ultra-orthodox Jewish men and women receiving psychiatric treatment at the Lev Hasharon Mental Health Centre. The participants completed questionnaires about the physician's religiousness and cultural sensitivity, working alliance, medical adherence and social adaptation.
  
  
  RESULTS
  Working alliance was positively related to the treatment location, meaning that patients were more committed and involved in the treatment when it took place in a facility distanced from their community. Working alliance was also correlated with medical adherence. Regression analysis revealed that the doctor's acquaintance with religion and cultural sensitivity predicted patients' reported social adaptation level.
  
  
  CONCLUSIONS
  In contrary to common perceptions, ultra-orthodox patients are not necessarily reluctant to be treated by secular physicians. These patients prefer a discreet treatment far from their community's public eye. Their perception of a doctor who acknowledges and respects their religiosity positively affects the way that they perceive their social functioning. Culturally sensitive treatment enables patients to feel respected and acknowledged through their sociocultural affiliation, and not only through their disorder. It seems essential to train physicians about the importance of culturally sensitive treatment with this population.
authors.affiliation: 1Lev Hasharon Mental Health Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Stolovy
authors.forename: Yvan Moses
authors.initials: YM
authors.lastname: Levy
authors.forename: Adiel
authors.initials: A
authors.lastname: Doron
authors.forename: Yuval
authors.initials: Y
authors.lastname: Melamed
mesh_terms: D000328:Adult; D054521:Cultural Competency; D005260:Female; D006801:Humans; D007557:Israel; D007585:Jews / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D008605:Mental Health Services / Q000592:standards; D008875:Middle Aged; D012068:Religion and Medicine; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cultural sensitivity; mental health; ultra-orthodox Jews