Culturally Competent Care: Is 'FUBU' the (only) Way to Go?
Adia Harris, Contributing Writer
We know the drill.
When seeking health care—physical or mental—it’s all about finding providers within our budget or HMO, with an office close to home or work that can see us when our schedule allows. However, should this be our only criteria in our quest for care? What about finding providers based on their ability to understand who we are as people?
This question actually might be more important than you think, and it’s at the crux of what is considered culturally competent care.
Q: What is Culturally Competent Care?
A: The term culturally competent care (CCC) is defined as healthcare providers’ ability to effectively deliver health care services that can meet the social, cultural and linguistic needs of patients.
Cultural aspects that can be considered by health care professionals determining a patient’s care needs may include but are not limited to:
• sexual orientation
• class/socioeconomic status
• religious/spiritual orientation
Q: Why is CCC Important to Mental Health?
A: A patient’s willingness to seek and participate in treatment is vital to improving mental health outcomes. This is statistically significant, considering the mental health disparities that do exist for minority groups.
For example, according to National Association for Mental Illness (NAMI), African Americans are 15 percent less likely seek help than white counterparts even though they are 20 percent more likely to suffer from serious psychological stress than the general population.
At OIB we wanted to explore the reality of CCC even further. So, we asked around. Below are some cultural care related questions and answers posed and answered by individuals within the African American community:
Q: When seeking a mental health care provider are there aspects about you or your background you think are important for them to understand about you? If so, how do you believe a provider’s knowledge of these things would help them to care for you?
A: I think a mental health professional's understanding and respect toward cultural, racial, and religious beliefs of a patient cannot be understated. As a young African American woman, I’ve constantly heard negative terminology associated with seeking treatment for mental health. I was often afraid when seeking a provider that they wouldn’t understand or appreciate the impact racial and cultural beliefs played in my openness to seeking treatment and involving my family and friends in my recovery. Regardless of the race, ethnicity, sexuality and religious beliefs of the patient or provider, a common understanding of personal, family and friendship networks and overall community beliefs as the relate to the individual’s treatment is needed.
--Lauren Carson, mental health advocate and founder of Black Girls Smile
Q: Do you think having a therapist that has a similar background to a patient is important? Why or why not?
A: It depends.
It’s easy to assume working with a therapist from a similar background as your own may be more comfortable for you, perhaps because you assume they may have an easier time understanding your experience and the factors that come into play. You don’t have to explain so much to them, they get the big picture and the nuances, and they’re not so judgmental. Often, that is the case.
Sometimes however, a similar background does not necessarily lead to automatic understanding. Sometimes, working with someone different from you can be a good connection and an enlightening experience; the differences that exist can actually be helpful.
You certainly want a “good match” between therapist and client. So much of therapy rests on the effectiveness of the relationship. Trust and respect are built with mutual responsibility on both the part of the therapist and the client. If similar background is important to you, you have a voice, and a choice. You certainly don’t want someone who questions everything, doesn’t get you at all, is very judgmental or exhibits disdain for you or your group. Trust your gut. You can always find another therapist.
-- Rhea Gordon, PHD, Licensed Psychologist
Q: Have you had any health-related experiences where you felt misunderstood by a healthcare provider? If so, what could have made it a better experience?
A: When I was a senior in college I had another bad depressive episode. I was prescribed an antidepressant that seemed to work very well until I started my [menstrual] cycle. I was super irritable and emotional. After suffering another month, I went back to my psychiatrist for an explanation and she told me to see my OBGYN. I went to see the OBGYN and was essentially told to talk to my psychiatrist. After a few times going back and forth, we realized that my hormones on birth control was the cause.
We doubled my antidepressant dosage during that week, and I finally felt balanced. I hate that I had to go back and forth so many times. As a female, there should be more thought and care about reactions between birth control and antidepressants.
--Camryn Triplett, Communications Officer for Silence the Shame; in treatment for major depression
Q: Would you have any reservations about seeing a therapist or a behavioral health specialist for mental, social and or physical issues you face in life? If so, what would they be?
A: I would be very open to speaking with a therapist of some kind. I believe many people my age have a tough time navigating many social issues. We live in an age of information and have access to a world of experiences at our fingertips. In my opinion, this could make it tough to find a sense of purpose or identity. If I am seeking mental health, I would really just want someone to be a clinical expert who practices based on research. Having someone who can relate outside of clinical therapy is just a bonus.
--Harry Karambizi, Web Developer; has never sought mental health care
Defining Your Mental Health Culture
Based on research and the responses we received, the reality may be that there is no such thing as the perfect provider or treatment for everyone. However, as the prevalence of mental illness continues to increase within our communities, it is imperative that we, especially as individuals of color, understand the value culturally competent care can bring to treatment.
Here are two great resources for seeking CCC mental health care:
How to Interview Your Therapist -- Psychology Today