Fourth Edition, September 2011

Cultural competency
The understanding of the social, linguistic, ethnic, and 
behavioural characteristics of a community or popu-
lation, and the ability to translate systematically that 
knowledge into appropriate practices in the delivery 
of behavioural health services; assessment includes 
network providers’ policies and readiness to address 
the cultural needs of members
Delusions
Delusions are psychotic symptoms of particular types 
of mental illness, such as schizophrenia. They are fi rmly 
held beliefs which are not held by other members of 
the person’s social group. Those who experience delu-
sions may off er bizarre explanations for experiences or 
circumstances. For example, they may believe they are 
being spied upon, followed, poisoned or that they pos-
sess great unrecognised talent.
Depression 
A lowering of mood which includes feelings of sad-
ness, despair, and discouragement, ranging from mild 
to severe, and is sustained over a period of time. Mild 
depression is an emotional state that many people 
experience during their life. Severe depression is a 
serious mental illness producing symptoms such as 
slowness of movement, loss of interest or pleasure in 
most activities, sleep and appetite changes, and agita-
tion. People experiencing severe depression will have 
intense feelings of worthlessness and may experience 
delusions; for example, a person may believe they are 
the cause of the world’s problems. Severe depression 
can lead to suicidal ideas and actual suicidal actions.
Diagnosis 
A medical term meaning the identifi cation of symp-
toms which are consistent with a particular illness or 
disorder. Specifi c tests and a medical examination 
can sometimes prove that physical illness is present. 
Diagnosis of a mental illness, however, is based on 
interviews with the client and others who know them, 
and on clinical observations. In Ontario, a mental 
health diagnosis may only be made by a physician or 
psychologist.
Disinhibition
Freedom to act according to one’s inner drives or feel-
ings, with less regard for restraints imposed by cultural 
norms; removal of an inhibitory, constraining, or lim-
iting infl uence, as in the escape from higher cortical 
control in neurologic injury, or in uncontrolled fi ring 
of impulses, as when a drug interferes with the usual 
limiting or inhibiting action of GABA within the central 
nervous system.
Disorientation
A symptom of some illnesses which aff ects the per-
son’s ability to know where he/she is, have some idea 
of time of day, date, and year, and remember familiar 
people.