The United States has always been noted for its rich cultural mix. However, this diverse mix is one of the reasons that health disparities arise, especially in mental health care. To reduce the risk of this, it is imperative that the mental health/health care community rises to the challenge and provides health care services that reflect the communities they serve – or these patients will be left behind.
Defining cultural competence
The Georgetown Health Policy Institute defines cultural competence as “the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients”, and while it is possible to define the problem, it is one that has proved difficult to prevent. Study after study shows these disparities. In 2008, a study showed that although efforts had been made to address this imbalance, little had changed over the years. And while the researchers investigated racial and ethnic qualities, rather than other demographics, it does illustrate the issue well.
Six years later, a further study published in the American Physiological Association Journal, argued the need for a primary care service that “includes mental health screenings and treatments that consider a patient’s language and cultural background”. Although the studies referred to in this article relate to ethnic minorities, this is by no means the only area of concern. Inequalities in mental health care affect all minority groups throughout the US.
Addressing the care gap
We know the problem only too well but what can be done to try to resolve it? Organizations like Mental Health America (MHA) have addressed this pressing issue. In its position statement, MHA detailed several measures that should be implemented by organizations offering mental health services including:
- Having standards in place to ensure hiring/recruiting of leadership and staff who have cultural and linguistic competency
- The drawing up of a cultural and linguistic competency plan that reflects the community
- The establishment of health care plans that consider cultural beliefs
- Regular training in cultural and linguistic competency
- Access to interpreters to overcome linguistic challenges
In addition to the above points, health care facilities should establish firm cultural competence policies. The importance of respect for cultural differences should also be instilled upon staff, and when bias is recognized, it needs to be addressed. On their own, these measures won’t prevent all inequalities – and there will always be room for improvement – however, they are a positive step in the right direction, and when implemented they can improve health outcomes.
Despite numerous studies highlighting the lack of cultural and linguistic competency in mental health care – and the many calls for changes to be made -– there is still an absence of cultural and linguistic competency in the health care sector. These calls to action from MHA and others should be heeded if patients from all walks of life are to get the equal access to mental and medical health care.