Culturally Competent Mental Health Care

Akshay Krieg, Lisa N. , Richey, Geetha Jayaram, M.D., Vani Rao, M.D.
Culturally Competent Mental Health Care is a topic covered in the Johns Hopkins Psychiatry Guide.

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DEFINITION

  • When discussing cultural competence, it is important to first define what culture is; according to the DSM 5, culture refers to systems of knowledge, concepts, rules, and practices that are learned and transmitted across generations.[1] Culture includes language, religion and spirituality, family structures, life-cycle stages, ceremonial rituals, and customs, as well as moral and legal systems. Cultures are open, dynamic systems that undergo continuous change over time; in the contemporary world, most individuals and groups are exposed to multiple cultures, which they use to fashion their own identities and make sense of experience.
  • The term "cultural competence" helps place this broader concept of culture into a more clinical setting. Specifically, cultural competence is defined as the ability of individuals to establish effective interpersonal and working relationships that supersede cultural differences by recognizing the importance of social and cultural influences on patients, considering how these factors interact, and devising interventions that take these issues into account.[1]
  • The census estimates that by 2044, the U.S. will become a “majority minority” country as no race or ethnic group will comprise greater than 50% of the nation’s population.[2] Consequently, the practice of cultural competence is becoming increasingly important as cultural groups view and treat mental illness differently, which beckons the need for more individualized approaches.
  • Within these cultural groups, it is also important to avoid oversimplified understandings of these populations and consider a patient in the context of their age, socioeconomic status, disability, gender identity, sexual orientation, language, religion, etc.[3]
  • Cultural competence is a complex and nuanced term; this module will offer some preliminary guidance by outlining 4 clinically applicable components:
    • Awareness of one’s own cultural worldview
    • Attitude towards cultural differences
    • Knowledge of different cultural practices and worldviews
    • Cross-cultural skills
  • By incorporating culturally competent practices, providers can overcome cultural disconnects and provide treatment that consistently helps and works for the patient.

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DEFINITION

  • When discussing cultural competence, it is important to first define what culture is; according to the DSM 5, culture refers to systems of knowledge, concepts, rules, and practices that are learned and transmitted across generations.[1] Culture includes language, religion and spirituality, family structures, life-cycle stages, ceremonial rituals, and customs, as well as moral and legal systems. Cultures are open, dynamic systems that undergo continuous change over time; in the contemporary world, most individuals and groups are exposed to multiple cultures, which they use to fashion their own identities and make sense of experience.
  • The term "cultural competence" helps place this broader concept of culture into a more clinical setting. Specifically, cultural competence is defined as the ability of individuals to establish effective interpersonal and working relationships that supersede cultural differences by recognizing the importance of social and cultural influences on patients, considering how these factors interact, and devising interventions that take these issues into account.[1]
  • The census estimates that by 2044, the U.S. will become a “majority minority” country as no race or ethnic group will comprise greater than 50% of the nation’s population.[2] Consequently, the practice of cultural competence is becoming increasingly important as cultural groups view and treat mental illness differently, which beckons the need for more individualized approaches.
  • Within these cultural groups, it is also important to avoid oversimplified understandings of these populations and consider a patient in the context of their age, socioeconomic status, disability, gender identity, sexual orientation, language, religion, etc.[3]
  • Cultural competence is a complex and nuanced term; this module will offer some preliminary guidance by outlining 4 clinically applicable components:
    • Awareness of one’s own cultural worldview
    • Attitude towards cultural differences
    • Knowledge of different cultural practices and worldviews
    • Cross-cultural skills
  • By incorporating culturally competent practices, providers can overcome cultural disconnects and provide treatment that consistently helps and works for the patient.

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Last updated: August 6, 2020