The importance of cultural competence in mental health treatment

The U.S. population is becoming increasingly diverse, bringing a wider variety of issues to mental health care. Counselors need to understand the social structures and cultural differences that affect how their clients experience the world. This is known as cultural competence.

Culture includes the language, customs, beliefs, values, socioeconomic status, and institutions of specific racial, social, ethnic, and religious groups.¹ For counselors, cultural competence includes cultural knowledge and awareness in addition to clinical skills that are culturally appropriate. To be effective, counselors need to understand both the culture of the people they serve as well as their own attitudes and beliefs.¹

This article will explore what cultural competence in mental health services looks like, its benefits and best practices.

Understanding cultural competence in mental health care

Cultural competence is an important aspect of patient-centered care, which focuses on a patient's values and preferences rather than taking a standardized one-size-fits-all approach.²

There are five predictors that contribute to culture-related communication problems:²

• Linguistic barriers
• Different cultural values
• Racism and bias
• Cultural differences in patient preferences for provider-patient relationships
• Cultural differences in how health care is explained 

A person’s cultural background can impact their mental health and how they seek out and respond to treatment. For people with mental health challenges, obtaining access to timely, quality, culturally sensitive treatment can help them achieve the best possible outcomes.³

Cultural and linguistic competence in mental health

Language barriers can interfere with effective mental health treatment and lead to broken trust, misunderstandings, and misdiagnoses. Clients need to receive mental health counseling in a language they are comfortable using. If you don’t speak the client’s preferred language, you can use translation services and tools, but you must make sure that they’re accurate and effective in a clinical setting–especially for nuanced fields like mental health.⁴

Beyond language, adapting your treatment approaches to cultural beliefs can make sessions more effective and engaging. Most psychological research has centered on studying white people in the Western world. Through cultural adaptation, you can tailor evidence-based practices to a patient's cultural identity in order to increase the relevance of your therapeutic skills.⁵

You can use questionnaires such as the Cultural Formulation Interview available in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make cultural assessments. This information can help you determine how to adapt diagnoses and treatments in light of cultural differences. Some treatments may only need slight adaptations. Cognitive behavioral therapy, or CBT, is considered a highly flexible approach, as is simply validating a client’s feelings in light of their cultural experiences.⁵

Adapting care across diverse treatment environments

Cultural competence training in counseling allows you to frame issues in ways that are relevant to clients across all treatment environments. You can take steps to incorporate cultural knowledge into your treatment planning by implementing strength-based strategies that reinforce cultural identity and resilience.¹ Long-term therapy may delve deeper, with therapists incorporating cultural understandings to address mental health issues sensitively and comprehensively. Psychiatric treatment, on the other hand, necessitates an awareness of how cultural perspectives influence views on medication and diagnosis, tailoring medical interventions to suit cultural needs. During a crisis intervention, cultural competency can help you provide interventions that are effective and appropriate, so the people involved feel respected, heard, and supported during vulnerable and stressful times.¹

Although each discipline approaches cultural competence slightly differently, the core objective remains the same: to provide culturally respectful and effective care. This unified approach not only enhances treatment outcomes but also promotes a more inclusive health care environment.

What are the benefits of multicultural competence counseling?

People from marginalized or minority groups can often feel misunderstood and unseen in their daily lives and are frequently victims of racism and microagressions. Mental health professionals who take cultural diversity into account can be easier for patients to communicate with and trust. Culturally competent counseling also plays a crucial role in breaking down the stigma associated with mental health, particularly in communities where mental health issues may be taboo or misunderstood.

By learning how to treat clients with diverse backgrounds you not only increase the number of clients you can see and provide more accurate diagnoses but you can contribute to healing for whole communities and vulnerable populations.⁶

Best practices for implementing cultural competence

Even with the best intentions, respecting cultural diversity isn’t always simple or easy. "Cultural humility" is the belief that cultural competence isn't a final goal to be reached and finished but an ongoing process.⁷ One way to practice cultural humility is to engage in continual cultural competency training, education and self-reflection to gain the skills you need. Here are some best practices for attempting cultural humility and improving your cultural competency so you can serve your clients better:⁸

• Embrace diversity as an asset and strength, not just something to be tolerated
• Reflect on any personal biases and prejudices you have and work to overcome them
• Learn how different cultural factors influence behavior and beliefs
• Respect the practices of different cultural groups regarding social norms during your interactions
• Consider the dynamics of how cultural practices can affect personal and professional relationships when people live or work together
• Take responsibility for preventing bias and prejudice against others in your health care environment

To institutionalize cultural competence and encourage it at a community level, behavioral health providers can focus on the following:⁸

• Identify cultural barriers within your practice, like not having translators easily accessible to providers and patients
• Actively recruit minority staff to make your team of providers reflect the diverse populations you serve
• Organize cultural awareness training for all staff and encourage diverse cultural encounters
• Use marketing campaigns to promote and recognize culture-specific values
• Incorporate language support in all areas of operations that include patient contact

Counselors can develop their cultural competence through professional development programs, such as diversity-focused conferences, or through ongoing education, such as obtaining a master's degree in mental health counseling. Regardless of which approach you choose, you’ll start with a thorough self-assessment that will help you understand how extensively culture shapes your daily experiences.⁹

These exercises include thinking about how your ancestors lived, how your family functions as part of a group, and how you’re inclined to process the world around you. You can use these exercises to identify your own biases so you can work on eliminating them. They can also help you develop curiosity about other cultures that you can explore for deeper understanding.⁹

You should also spend time learning about different cultures through books, particularly memoirs, so you can better relate to other cultures. Learning another language and traveling can also be a wonderful way to get hands-on experience with other cultures.⁹

Make it a point to interact with diverse cultural groups, both professionally and personally. In addition to clinical work and volunteer experience, seek out opportunities to interact socially. Only seeing specific groups in situations where they need help can color your perceptions.⁹

Shape the future of culturally competent care with OCU’s online program

Another important reason to become culturally competent? To close gaps in mental health care and make accessing mental health services easier for minority groups and vulnerable patients with unique cultural identities. You can prepare to serve diverse communities with culturally competent practices in Oklahoma City University’s Master’s of Education in Clinical Mental Health Counseling. The rigorous curriculum covers evidence-based counseling procedures, behavior pathologies, family and group interventions, social and community behaviors with an emphasis on cultural competency training. Become a trusted source of support for your community. Contact one of our admissions outreach advisors today to learn more.