Cross-cultural working in community learning disabilities services: clinical issues, dilemmas and tensions.

Background  People with learning disabilities from minority ethnic communities face many layers of disadvantage. Providing services that are culturally appropriate and sensitive can be difficult.

Method  Through the use of clinical examples the issues, tensions and dilemmas raised for a community learning disabilities team in attempting to provide culturally sensitive services in an increasingly multicultural environment are discussed. Ways in which good practice can be more closely achieved are debated.

Conclusions  Conflicts between the principal service values of individuality, choice, promotion of mental health and normalization, whilst also respecting the beliefs and values of other religions and cultures, can raise tensions and dilemmas for learning disabilities services. The importance of sensitive and appropriate service configuration, sharing of good practice, and good staff training are emphasized.