Monthly Archives: March 2012

The JICC in Sefad at the Ziv Medical Center

Even though the JICC is focusing on the Jerusalem area, we find more and more cases in which the expertise we gained in the city is important in capacity building in other places. One example was today, when some 20 members of the senior administration staff of the Ziv Medical Center in Sefad gathered for a unique workshop on cultural competency, facilitated by the Jerusalem Intercultural Center (JICC). The workshop was organized by Dr. Sarah Nissim, Deputy Director of the Nursing School and Cultural Competency coordinator for the hospital. Dr. Nissim had asked the JICC to present cultural competency to the senior managers, before they began to assimilate the principles in the hospital. Sarah, who is a veteran colleague of the JICC in cultural competency, sought to engage the JICC to facilitate the assimilation of cultural competency principles in the hospital, as per the Ministry of Health directive, in the 2012 work year.

Dr. Shapiro Klein, Deputy Director of the hospital and Dr. Sarah Nissim (Cultural Competency coordinator) began the workshop with opening remarks.

The JICC in Sefad at the Ziv Medical Center

At the beginning of the day the participants shared their experiences of intercultural encounters in the different departments. Thus, for example, one person detailed the difficulties dealing with a Druze girl with an eating disorder. Another doctor spoke about the difficulty working with the Haredi community and its rabbis, despite the dialogue that takes place from time to time between local rabbis and medical staff. We saw the huge difference between the Jerusalem hospitals that deal with diverse communities within the Jerusalem region, as opposed to Ziv, which deals with diverse communities over a vast area (mostly the upper and eastern Galilee and the Golan Heights), which requires a different type of communication with the different community heads.

As such, the first ‘theoretical’ part of the workshop dealt with tools and ways to bridge the gaps between cultures. These tools followed a clarification of the concept of ‘cultural dimensions’, and an analysis of dialogues between patient and caregiver in which different cultural values are presented.

The second part provided practical tools for professional medical interpretation, as well as practical suggestions on how to relate to non-professional interpreters, through movies and analysis of case studies, from Israel and around the world. Immediately after lunch the participants practiced their knowledge of intercultural issues – a specially-trained actress played a Haredi and Palestinian patient in two separate scenarios.

Role play

This workshop was used as a kickoff to the process of assimilating cultural competency principles into the hospital, which will be led by Dr. Sarah Nissim. Part of the plans discussed with her include a workshop for bilingual staff members to overcome the communication problems with the Ethiopian community and training of facilitators from among the hospital staff to establish a set mechanism of training medical staff at the Ziv Medical Center in Sefad.

Cultural Competence and Mental Health – Beginning to work with the Jerusalem Center for Mental Health

We are on the verge of yet another transformative process in the field of cultural competency. On March 14 – 15, the JICC was invited to present its introductory cultural competency workshops to 70 senior managers from the Jerusalem Mental Health Center, at its annual management conference at the Dead Sea. This Mental Health Center includes hundreds of staff who are responsible for 300 hospital beds (active and extended stay departments) over 2 campuses (Kfar Shaul and Eitanim), Mental Health Centers in west and south Jerusalem, in Ma’ale Adumim, Mevasseret Zion and in Beit Shemesh. The Center also serves the Arabic-speaking population from East Jerusalem. The focus on cultural competency at the annual conference is a kickoff to the process of making the Jerusalem Center for Mental Health culturally competent. The Jerusalem Center was the first mental health center in Israel to commit, through the JICC help, to assimilate principles of cultural competency throughout its system of care.

Mental health services are a special challenge for cultural competency, since most care is based on verbal communication. At the same time, it is important to note that public mental health services are required comply with the Ministry of Health directive (February 2011) on cultural competency, as other health care organizations. In this conference the issue was introduced to the senior management, including department directors, as well as those in key roles, before cultural competence is being assimilated in all departments. The spotlight given at the conference is the result of many meetings between the JICC and the Jerusalem Center administration, as well as with the Jerusalem Foundation, to explain its importance in psychological care.

Practicing Dialogue

Throughout the first day the participants told stories about intercultural challenges and events they had encountered. In addition, Dr. Hagai Agmon-Snir, JICC Director, presented a workshop on intercultural communication and cultural dimensions and how awareness of this subject influences mental healthcare.

During the second day the participants were exposed to the importance of professional interpreting in therapy sessions, and shared examples, from Israel and around the world, of therapy being compromised because of language barriers. Senior staff understood the need and seemed willing to change the existing situation (which today uses non-professional and unskilled interpreters) to make the services more accessible. The day included a fascinating discussion about the boundaries of multiculturalism (“How much should I give up my professional and personal values in order to adapt the therapy session to the patient that comes from a culture that is entirely different than mine?”).

Workshop of the Jerusalem Center for Mental Health March 15, 2012

It was obvious that the 2 days of the conference were a first taste, and that this will be a long process that will require close cooperation between the JICC and the Jerusalem Center for Mental Health. The process will include training the medical and administrative staff in CC skills, and training bilingual staff in a medical interpretation, as has been done in other Jerusalem hospitals (Bikur Holim, Alyn, Hadassah) and HMOs. We believe that the products of this lengthy process can be a prototype for similar accessibility processes in other mental health centers around Israel.