Mental health in primary care: ways of working ? the impact of culture

This article reviews the literature to bring together aspects of culture and its impact on ways of working in mental health in primary care. It describes a case from primary care that demonstrates the complexity of developing cross-culturalformulations. It argues that if comprehensive and effective management of cross-cultural patients is to take place in general practice, primary care clinicians should take into account the cultural experience of the patient they are managing, including their social situation. Such patients often present with multiple somatic complaints. In order to provide holistic care it  recommends the use of a tetra-axial diagnostic classification and culturally sensitive questioning through professional interpreters as necessary.