Each patient is their own universe: Building cultural competence
It’s crucial for journalists covering mental and behavioral health to understand the role cultural competence plays in reducing health disparities and addressing systemic barriers.
That was a central theme of a session at AHCJ’s fall summit — the cultural mismatch between a patient and a health care professional that can potentially lead to misdiagnosis and inadequate treatment. And it’s clear from research, said Renuka Rayasam, senior correspondent for KFF Health News, the session’s moderator.
For example, Black Americans are often misdiagnosed with mental health conditions. One study found that Black men specifically are overdiagnosed with schizophrenia, Clinicians were “mistaking what could be seen as sort of basic survival skills in their community as a psychotic symptom,” Rayasam explained.
So, what is cultural competence? And how can it be achieved in mental health care?
Panelist Linda Lausell Bryant, a clinical professor and associate dean for academic affairs at the NYU Silver School of Social Work, defined cultural competence as “the ability to understand and appreciate people from cultures other than yours.”
But she cautioned attendees that cultural competence is not a destination; it’s something that has to be worked on daily. “We’ve all been swimming in the waters of a national history that has some pretty serious issues around race, and we’re all impacted by that,” she said.
Humility and cultural sensitivity
Hector Colon-Rivera, medical director of the Asociación Puertorriqueños en Marcha, Inc. Behavioral Health Program, said he approaches cultural differences between him and his clients with humility. As a Puerto Rican clinician in Philadelphia, he said he learned about the sports culture of the city, for example, so he could better relate to patients.
“It’s not only speaking the language, it’s understanding and getting some background information,” he said.
When it comes to cultural sensitivity within health care, Colon-Rivera said the “system is broken.” The COVID-19 pandemic highlighted the alarming scarcity of medical educational resources available in Spanish at a time when the Hispanic population was dying at high rates from the disease.
Taking action
Panelists shared the following solutions to address the lack of cultural competence in mental health care:
- Advocate for integrating cultural competency training into all aspects of health care professional education.
- Empower patients to ask providers about their cultural competency.
- Create and implement programs to build pipelines for drawing more underrepresented groups to the mental health profession.
Panelists also acknowledged that therapy methods must accommodate cultural differences.
“This Freudian Western therapy doesn’t work with everyone,” Bryant said. “We need to think about integrating differently, [and] allowing the patients to bring in: What approaches do they value? What do you do to cope? When people are coming in, they’re more than the sum total of their problems.”
