What Is Cultural Competence in Mental Healthcare?

Wondering how culture impacts care and how cultural competence can make a difference? Read on to learn more.

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Everyone should be able to be seen, understood, and respected when they’re seeking healthcare. Unfortunately, this isn’t always the reality, especially for people from diverse cultural backgrounds. 

It’s no secret that there are inequalities in healthcare, particularly here in the United States. These inequalities range from differences in access to care and quality of care to disparities in diagnosing and treating conditions in different socioeconomic and ethnic groups. 

The issue is serious: In a multi-country survey, the U.S. ranked lowest in healthcare equity by income and by racial and ethnic background. One practice that can help combat mental health inequity is for providers to develop cultural competence — but what exactly does that mean? Read on to learn more about cultural competence, cultural humility, and why these principles are so important in mental healthcare.

What is cultural competence in healthcare?

Put most simply, cultural competence is all about considering and respecting a patient or client’s background and culture throughout their treatment.  

“It is the ability of providers and organizations to effectively deliver services that meet the social, cultural, and linguistic needs of patients,” says Na’Keora Bryant, MSCP, a Charlie Health Group Facilitator. “It involves understanding how cultural background influences health beliefs, behaviors, and communication styles.”

It’s important to note that culture doesn’t just refer to ethnicities; it also refers to groups like the LGBTQIA+ community, who also face inequalities in healthcare. Furthermore, cultural competence should include understanding intersectionality, or how a person’s multiple marginalized identities may overlap and shape their experiences in society. One example of this is how sexual orientation might intersect with being a person of color, resulting in further challenges for the individual. 

3 key components of cultural competence

“Some key components of cultural competence include awareness of self and culture in question, willingness to learn and accept, valuing, and attitude towards said cultures,” says  Cecilia Masikini, MT-BC, a Creative Arts Therapist at Charlie Health. Diving deeper into these:

1. Awareness

In many cases, awareness is the first step to make space for cultural competence, says Masikini. “Awareness of our own biases and potential gaps in knowledge about different cultures allows space for cultural competence to be cultivated,” she says.

2. Willingness

Once you develop this awareness, you must be willing to create space for others, Masikini says. “Willingness creates motivation for one to move past the potentially uncomfortable conversations to make space for empathy and behavioral change,” she explains.

3. Attitude

The attitude you have towards others is key. “This is important because it shapes how a person approaches, understands, and interacts with people from different cultural backgrounds,” says Masikini. “Knowledge and skills matter, but without the appropriate attitude, they are often ineffective.”

What is cultural humility in healthcare?

Going a step further, cultural humility keeps you humble and modest as you examine your own cultural competence, knowing that there’s room to learn, grow, and improve.

“Cultural humility is a commitment to self-evaluation and self-critique,” Bryant says. “It means recognizing and challenging imbalances in the patient-provider dynamic and developing mutually beneficial partnerships with communities. It’s having a posture of learning and connection.” The concept of cultural humility also includes being able to admit you don’t know something and being willing to learn from clients. 

What is the difference between cultural competence and cultural humility?

The key difference is that cultural competence mostly refers to being aware of cultural differences so providers can give clients better care, while cultural humility is more of an ongoing mindset to learn, reflect, and stay open.

“Cultural competence often implies achieving a certain level of knowledge about specific cultures, which can sometimes lead to stereotyping,” Bryant says. “Cultural humility emphasizes that one can never be fully ‘competent’ in another’s culture.” In other words, cultural competence focuses on what you’re aware of and know, while humility focuses on how you acknowledge and approach what you don’t know.

“Humility focuses on the provider’s ongoing process of learning, being open to feedback, and recognizing the patient as the expert on their own experience,” Bryant adds. 

What is the importance of cultural competence in mental healthcare?

Cultural competence and cultural humility are absolutely key in healthcare, including mental healthcare. People of every single nationality and culture can experience mental health struggles, and it’s important for providers to have an awareness and knowledge of different cultures.

“In mental healthcare, cultural competence is vital because mental health is deeply intertwined with cultural context, values, and stigma,” Bryant says. “A provider lacking this competence risks misinterpreting symptoms, dismissing important cultural factors influencing distress, or recommending interventions that are inappropriate or inaccessible to the client’s background.”

Mental health doesn’t exist in a bubble. Whether someone seeks help and how they approach treatment is often intertwined with their culture and what’s part of their cultural norms. For example, mental health stigma is often more prevalent in non-white cultures. Research suggests stigma may especially persist in Black, Latino, and Asian communities, where community members might view mental illness as a sign of weakness rather than a health concern. 

Additionally, the National Institute on Minority Health and Health Disparities reports that ethnic minorities are half as likely as white people to get mental health treatment — and they’re also more likely to drop out of treatment. This is why it’s so important for providers to consider culture and meet people where they are, taking their individual backgrounds into account, to help them get the treatment they need and stay in treatment. 

Considering culture in treatment

Someone’s culture shapes how they experience and cope with the world, Masikini says. This includes how people understand and respond to mental health, symptoms, and treatment, she adds. 

Cultural differences can also influence factors like how comfortable someone feels opening up to a therapist. “For example, in African American communities, historical experiences with discrimination in healthcare can lead to mistrust, making culturally sensitive communication especially important,” says Masikini. 

Here are three key considerations involving cultural diversity and mental health treatment:

1. Understanding symptoms

“Culture can shape how an emotion is expressed and read,” Masikini says. “Considering one’s culture may help avoid a potential misdiagnosis.”

2. Treatment effectiveness

When a provider considers a client’s culture, it might influence the course of treatment. “Tailoring interventions to match one’s values and communication styles can increase the likelihood that the client will follow through with the recommendations and benefit from care,” says Masikini.

3. Equity and ethical care

“Healthcare professionals have a responsibility to provide the most effective and ethical care to their patients,” Masikini says. “Ignoring potential barriers can contribute to disparities in care and outcomes.”

5 ways mental healthcare providers can develop cultural competence

Developing cultural competence isn’t a one-time achievement or skill you master in one sitting. It’s an ongoing process that providers should continue to develop throughout their whole career. “Without this continuing education and awareness, providers risk misunderstanding clients and providing ineffective treatment,” says Masikini.

Unfortunately, cultural awareness and cultural sensitivity aren’t things that all mental healthcare providers are taught. 56% of white healthcare providers report having no training in cultural competence. This can lead to cultural blindness — being “blind” to cultural differences and how these differences shape people’s care.

If you’re a mental healthcare provider and you want to become more culturally competent, here are some tips you can use.

1. Check yourself

Take a step back and be honest with yourself. The National Center for Cultural Competence offers a variety of self-assessments you can take to see where you’re at now and track progress over time. 

2. Seek ongoing education and cultural competence training

If you work for a clinic or larger organization, ask if they have any available training programs. Additionally, the U.S. Department of Health & Human Services offers a free online course called Improving Cultural Competency for Behavioral Health Professionals. The CDC also shares resources for external cultural competence training and related courses.

3. Consult with diverse providers

Bryant recommends seeking supervision or consultation from diverse colleagues. When you work with colleagues from different backgrounds, they may offer new perspectives and help challenge assumptions or misconceptions you may not even realize you have about a cultural group, for example.

4. Practice active listening

It’s very important to actively listen to clients without imposing assumptions, Bryant says. Truly listening to their stories can help you learn more about diverse cultural backgrounds and grow cultural knowledge. 

5. Maintain cultural humility

Approach your line of work and clients with a sense of curiosity, openness, and a growth mindset. Remember that you can’t be 100% competent in others’ cultures, and there is always room to learn. This also includes engaging in self-reflection about personal biases, Bryant adds. 

How to find a culturally competent therapist: Charlie Health can help

If you’re part of a marginalized group, working with a culturally competent therapist is key. But how do you find one? When browsing online directories of therapists, you can look for ones who specifically note that they have experience working with diverse populations. Additionally, if you have a consultation with them, you can ask them about their approach to culturally competent care, and/or if they have any experience working with people of your background. 

Additionally, Charlie Health has a wide network of culturally competent therapists delivering high-acuity treatment for kids, teens, and adults facing serious mental health conditions and substance use disorders. Our innovative treatment model combines clinical expertise, group connection, and measurement-based care to support long-term healing. With the right support, managing your mental health and relationships is possible. Fill out the form below to start healing today.upport, managing your mental health and relationships is possible. Fill out the form below to start healing today.