As mental health clinicians, providing culturally competent care is essential to our practice.
Recognizing the way that we are different from our clients and speaking to those differences, which may include race, gender identity, sexual orientation, socioeconomic status, religion, or disability status, is a crucial first step when working with a client who is struggling with anxiety or OCD. This is especially true when working with a client who identifies as a minority, as minorities may have specific barriers to treatment that need to be addressed to provide effective care. This article will explore what it means to provide culturally competent care for minorities and discuss strategies for increasing minority mental health awareness among clinicians.
Why Culturally Competent Care Matters in Mental Health
Culturally competent care – which is defined as the ability to give care to clients with diverse values, beliefs, and behaviors and to consider their social, cultural, and linguistic needs – is crucial to providing quality mental health services to individuals from diverse backgrounds. It’s important to understand the specific life experiences our clients have had that may contribute to their current mental health problems. For example, members of marginalized groups may experience discrimination, trauma, and systemic barriers to resources and opportunities. These factors can contribute to a range of mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorders, and other mood disorders.
Ultimately, providing culturally competent care is about treating every person with respect and understanding. By taking the time to learn about our clients’ backgrounds and experiences, we, as clinicians, can create a safe and supportive environment for our clients to heal and grow.
Common Mental Health Issues in Minority Communities
Different communities may have specific stressors that are important to acknowledge. According to the Health and Human Services Office of Minority Health, Black Americans are 20% more likely to experience serious mental health problems than the general population due to various factors. Among Latinos, there may be a cultural stigma that prevents clients from accessing mental health treatment: only 20% of the Latino community who experienced symptoms of a mental health disorder talked to a primary care provider about their symptoms, and only 10% contacted a mental health professional, according to the Anxiety and Depression Association of America. People who are a part of the LGBTQ+ community are three times more likely to experience mental health problems than the general population.
When we, as clinicians, understand our clients’ cultural norms and values, we can develop a more personalized treatment plan that meets the unique needs of each individual. It can lead to better treatment outcomes and greater client satisfaction. Individuals from minority communities may have experienced discrimination or racism in the past, which can understandably lead to distrust of the mental health system. By demonstrating an understanding and appreciation for a client’s culture, clinicians can help to establish a strong therapeutic alliance with their clients.
By understanding the challenges faced by minority communities, clinicians can develop culturally sensitive treatment plans that address the unique needs of their clients. This approach involves not only acknowledging cultural differences but also finding ways to celebrate them and incorporate them into the treatment process.
Barriers to Accessing Mental Health Services for Minorities
Despite the high prevalence of mental health issues in minority communities, many individuals from these groups face barriers to accessing the care they need. These barriers can include social stigma around mental health, a lack of trust in the medical system, and language or cultural differences that make it difficult to communicate effectively with mental health providers.
Additionally, mental health services may not be readily available in the areas where many minorities reside, leading to a lack of access to care altogether. These challenges can lead to serious health disparities in minority populations, which is why it’s so important for mental health clinicians to understand and address these barriers.
As part of the continuing education for mental health providers, understanding that these barriers exist and even the simple act of acknowledging them when shared by a minority client supports the building of mutual trust and aids in creating a supportive environment. Investigating ways to include outreach programs that bring mental health services to the communities that need them within your own part of the world is a step you can take to reduce barriers in your sphere. Another simple strategy is providing language translation services and hiring staff representing the cultures and communities being served.
Here are a few working examples of recent client interactions:
A client of mine, a Latina in her late 20s, came to see me because she was friends with another former client of mine. She confided that it had taken knowing that her friend had seen me for her to be willing to see a therapist, and even then, she was visibly guarded with me for our first few sessions.
She is a first-generation living in the United States. Like many recent immigrants, her mother has a history of trauma, a low education level, and a mistrust of mental health providers. My client’s first language was not English, but she had graduated from high school in this country, and we communicated in English without a language barrier.
As I provided psychoeducation to her about anxiety, I also found resources in Spanish that she could share with her mother, and it was a big help when her mother learned that treatment was possible. I made sure to share plenty of other sources of information with my client, from podcasts to books, so that she could see that the treatment we were doing was long-standing and well-respected.
I helped her connect with our local NAMI support groups, and finding a Spanish-speaking group was another milestone for her to feel supported and accepted by her community. Ultimately, she found therapy to be very helpful, and we completed our individual work as she was well enough only to need the peer support of her NAMI group.
In another case, I worked with a young adult who identified himself as being mixed-race, who came in to see me while he was living at home and unemployed after graduating from college. It was immediately clear that he had panic disorder, and interoceptive therapy was extremely helpful to him. However, he still found it hard to apply for and then keep a job even when panic attacks no longer controlled him.
We did some cognitive work, and he realized that he was sending himself self-defeating messages about his abilities and the possibility of being able to live a successful life because the black men in his immediate family had either been incarcerated or worked in jobs that were well below their educational level, all of which he identified as being due to systemic racism. I recognized with him the truth in those difficult stories but noticed that this was not his current reality.
I asked him to see if his broader family had any other role models, and at home, he found a picture of a family reunion that had been held several years before. In looking at that photo of what he called his “beautiful rainbow family,” he found several men who inspired him.
He began to focus his job search on companies with social justice missions. He ultimately got a full-time job with benefits and a mentor within the company who supported his goals for personal and professional growth. He left therapy a thriving young man, living in a group apartment with people who shared his goals and beliefs.
By addressing the barriers to accessing mental health services for minorities, we, as representatives of the mental health community, can become ambassadors of the importance and need to maintain their mental health and well-being.
Tips for Building Cultural Competence
- Recognize Your Own Biases: As a mental health professional, it’s important to understand and acknowledge any biases you may hold. These biases may be conscious or unconscious, and they can influence your clinical decision-making and interactions with clients. By being aware of your biases, you can take steps to challenge them and provide more culturally responsive care.
- Build Rapport with Clients: Building rapport with your clients is key to establishing trust and fostering a positive therapeutic relationship. Take the time to get to know your clients and their cultural backgrounds, including their beliefs, values, and customs. Ask open-ended questions and actively listen to their responses.
- Respect Boundaries: Different cultures have different expectations around boundaries and privacy. It’s important to respect your client’s boundaries and understand their comfort level with physical touch, eye contact, and personal space. This can help build trust and prevent misunderstandings.
- Use Appropriate Language: Be mindful of the language you use when communicating with your clients. Avoid using jargon or clinical terminology that may be unfamiliar or confusing to them. Additionally, use gender-neutral language and avoid making assumptions about your client’s sexual orientation or gender identity.
- Collaborate with Interpreters: If you do not speak your client’s native language, it’s important to work with professional interpreters to facilitate communication. Avoid relying on family members or friends to interpret, as they may not be impartial or may have difficulty translating complex clinical concepts.
Ultimately, providing culturally competent care is about treating every client with respect and understanding. By taking the time to learn about our clients’ backgrounds and experiences, clinicians can create a safe and supportive environment for our clients to heal and grow.
Strategies for Addressing Cultural Differences in Treatment
Culturally competent care involves tailoring treatment to meet the specific needs of each individual client. This means that, as clinicians, we should strive to understand and address cultural differences to provide effective treatment. Think of it as the elephant in the room: address it, and move on to the reason for being there in the first place.
Here are some strategies that can help address cultural differences in treatment:
- Listen and acknowledge cultural differences: Clients from minority communities may have different cultural beliefs and values regarding mental health. It is important to listen to their concerns and to acknowledge their cultural perspectives as you develop your treatment plan.
- Use culturally appropriate language: When discussing mental health, it is important to use language that the client can understand. For example, using technical terms may not be appropriate for someone with limited English proficiency. If need be, consider having a translator app available.
- Incorporate the client’s family: In some cultures, mental health issues are seen as family matters. It may be helpful to involve the client’s family in treatment if the client is comfortable with this.
- Be aware of cultural norms: Cultural norms may impact the way that clients express themselves and may impact treatment goals. Clinicians should be aware of these cultural norms to provide effective treatment.
- Be open to alternative treatment methods: Some clients from minority communities may prefer alternative or traditional treatment methods. As clinicians, we should be open to exploring these methods if they are safe and effective.
While you may not try each and every method, use them as a guide in your quest to understand cultural differences better and consider ongoing continuing education to support better the minority groups represented in your area.
Supporting Multicultural Competence in Your Practice
As part of providing effective mental health care for minority populations, we as mental health providers should be equipped to address the cultural nuances that may affect our clients. Here are some ways to support multicultural competence in your practice:
- Participate in Diversity and Inclusion Training: Invest in diversity and inclusion training for yourself. Such training could include education on cultural biases, sensitivity training, and overcoming implicit bias.
- Foster a Supportive Environment: It’s essential to create an environment that’s welcoming and safe for minority clients. This includes designing a comfortable waiting room with artwork, décor, and other elements that showcase different cultures. Staff members should also be encouraged to speak different languages, and translation services should be available if needed.
- Promote Community Engagement: Building relationships with minority communities and organizations can help increase trust in mental health centers. Consider partnering with community leaders or hosting educational events in the community to promote mental health awareness and reduce stigma.
- Evaluate Outcomes: As part of your mental health care practice, we should continuously evaluate our services’ effectiveness with different populations to improve our care quality. Collecting data about the demographic backgrounds of clients and their treatment outcomes will help identify areas that need improvement.
Resources for Further Learning and Development
In order to provide culturally competent care to minority clients, it’s important to continually educate yourself and stay up-to-date on the latest research and best practices. Here are some resources to help you further your knowledge and development in this area:
- The National Alliance on Mental Illness (NAMI) offers resources on cultural competence and diversity in mental health treatment. Their Cultural Competence Standards for Healthcare Providers is a helpful guide for mental health clinicians.
- The International Obsessive Compulsive Disorders Foundation (IOCDF) has a series of blog posts by mental health activists who share their personal journeys to end stigma within their communities.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) has a Cultural Competence Self-Assessment Checklist for Mental Health and Addiction Professionals that can help you identify areas where you may need further development.
- The National Latino Behavioral Health Association offers webinars, conferences, and other resources specifically for mental health professionals working with Latino populations.
- The Asian American Psychological Association provides resources for mental health professionals working with Asian American communities, including guidelines for culturally sensitive care and a directory of Asian American mental health professionals.
This is an ongoing learning curve. However, by continuing to learn and grow in our understanding of cultural competence in our own communities, we can better serve diverse groups of people and create the change that leads to better outcomes for all clients.