What Does it Mean to Be Culturally Competent in Psychiatry?

Race – at least the way that we recognize race in the United States – is largely a social construct. The concept of different “races” is not really supported in the science. Skin color, hair color, body shapes – these features may seem to vary in some form from person to person, but biologically there are almost no genetic or biological differences between humans – at least none that are explained directly by a person’s skin color or where their great grandparents were born.

But culture can be a very real difference between people. For example, there are some cultures where it is assumed that the children will care for their aging parents. There are some cultures where the elderly are believed to posses a level of wisdom that must be consulted before making decisions. There are some cultures that believe specific herbal solutions must be used to combat spiritual crises. There are some cultures that use a “head wobble” to communicate.

Different cultures have many different beliefs, habits, and behaviors. All three of these are relevant to the field of psychiatry.

What is Cultural Competency?

There is a joke where an American asks his Spanish speaking friend to write an essay for him, and the Spanish speaking friend writes a letter to his cousin instead, because “ese” means “cousin” in Spanish and is pronounced the same (es-ay). What we know we mean isn’t always what the other person knows we mean, and what we believe doesn’t necessarily fit into the other person’s reality.

Cultural competency means that a clinician has the knowledge, skills, and attitudes necessary to provide effective mental health care to individuals from diverse cultural backgrounds. It involves understanding and respecting the cultural beliefs, values, norms, and practices that influence a person’s worldview and mental health experiences. It involves adapting to these differences, so that – no matter a person’s culture or background – a psychiatrist can respectfully and correctly provide treatment.

Cultural competency doesn’t mean a person has to speak a different language or know all the cultural beliefs of every patient they treat. But it does mean that they have to have more awareness over what they say, what they’re choosing to provide, and what the other person may hear or understand based on their different culture.

Key aspects of cultural competence in psychiatry include:

  1. Cultural Awareness – Developing an awareness of one’s own cultural biases, assumptions, and values, and how they may impact interactions with individuals from different cultures. Recognizing the importance of cultural diversity and the influence of culture on mental health.
  2. Knowledge of Cultural Factors – Acquiring knowledge about various cultural groups, including their beliefs, traditions, family dynamics, social systems, religious practices, and cultural expressions of distress. Understanding how culture can influence the experience, expression, and interpretation of mental health symptoms.
  3. Effective Communication – Developing effective communication skills that consider language barriers, non-verbal cues, and cultural nuances. Being able to engage in culturally sensitive and respectful dialogue, actively listening to and valuing the perspectives of individuals from diverse backgrounds.
  4. Diagnostic Considerations – Recognizing that cultural factors can impact the presentation, diagnosis, and understanding of mental health conditions. Being aware of cultural variations in symptom expression, help-seeking behaviors, and the influence of cultural stigma and discrimination.
  5. Tailoring Treatment Approaches – Adapting treatment approaches to align with the cultural beliefs, values, and preferences of the individual. Collaboratively working with patients and their families to develop treatment plans that are culturally appropriate, respectful, and effective.
  6. Addressing Health Disparities – Recognizing and addressing the disparities and inequities that exist in mental health care access and outcomes for individuals from marginalized and underserved cultural groups. Advocating for culturally responsive policies and interventions.

Cultural Competency is also not something someone “has.” It is a commitment to maintaining cultural knowledge and continuing to evolve. There are many, many cultures – not only those that are referenced in media, but also sub-cultures, that are often evolving and require different tactics to learn and address.

But being culturally competent matters. As a psychiatrist in Dallas, where we have a wide range of cultures seeking mental health treatment, cultural competency is one of the ways that we at Aware Behavioral Health can support our patients and ensure that everyone is receiving the care they need and deserve.

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