title: What can we talk about, in which language, in what way and with whom? Sami patients' experiences of language choice and cultural norms in mental health treatment.
abstract: BACKGROUND
  The Sami in Norway have a legal right to receive health services adapted to Sami language and culture. This calls for a study of the significance of language choice and cultural norms in Sami patients' encounters with mental health services.
  
  
  OBJECTIVE
  To explore the significance of language and cultural norms in communication about mental health topics experienced by Sami patients receiving mental health treatment to enhance our understanding of linguistic and cultural adaptation of health services.
  
  
  METHODS
  Data were collected through individual interviews with 4 Sami patients receiving mental health treatment in Northern Norway. A systematic text reduction and a thematic analysis were employed.
  
  
  RESULTS
  Two themes were identified:(I) Language choice is influenced by language competence, with whom one talks and what one talks about.Bilingualism was a resource and natural part of the participants' lives, but there were limited possibilities to speak Sami in encounters with health services. A professional working relationship was placed on an equal footing with the possibility to speak Sami.
  
  
  CONCLUSIONS
  Sami patients' language choice in different communication situations is influenced by a complexity of social and cultural factors. Sami patients have varying opinions about and preferences for what they can talk about, in which language, in what way and with whom. Bilingualism and knowledge about both Sami and Norwegian culture provide latitude and enhanced possibilities for both patients and the health services. The challenge for the health services is to allow for and safeguard such individual variations within the cultural framework of the patients.
authors.affiliation: Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway.|Centre for Sami Health Research, The Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway; inger.j.dagsvold@uit.no.
authors.forename: Inger
authors.initials: I
authors.lastname: Dagsvold
authors.affiliation: Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway.
authors.forename: Snefrid
authors.initials: S
authors.lastname: Møllersen
authors.affiliation: Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway.|Centre for Sami Health Research, The Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Vigdis
authors.initials: V
authors.lastname: Stordahl
mesh_terms: D003081:Cold Climate; D003142:Communication; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy*; D008603:Mental Health / Q000208:ethnology*; D009664:Norway; D044382:Population Groups / Q000208:ethnology*; D036301:Qualitative Research; D012016:Reference Values
keywords: Norway; Sami; cultural norms; culture; experiences; language; mental health; qualitative