To highlight one such approach, Borelli et al. describe a community participatory research project that used a “collaborative and emic process” to develop and implement an intervention to mitigate sociocultural risk in Latine families. Additionally, less than 10% of interventions reported using a specific cultural adaptation framework to guide their process. The review found that all but one of the CHW-delivered interventions were implemented with at least one type of cultural adaptation, suggesting that cultural adaptation of interventions is the norm rather than the exception in this service delivery model. When content was added to interventions 17, 42, 45, 74, it was selectively added based on the specific interests and needs of the population. For example, one intervention increased the number of sessions due to a lack of support groups for Spanish-speaking women in the area , while another added informal meetings or events to build community . Other interventions encouraged CHWs to use their own words 59, 60 or familiar metaphors 49, 74 to increase interventions’ cultural relevance.
Youth with these challenges often struggle to understand legal terminology, charges, or formal court proceedings, potentially leading to unjust outcomes such as wrongful admissions of guilt (Snow, 2019; Sowerbutts et al., 2021). These findings align with previous research highlighting the high prevalence of oral and written language difficulties among youth in the justice system. The studies used comprehensive, standardized assessments to measure language abilities such as the Clinical Evaluation of Language Fundamentals and the Peabody Picture Vocabulary Test. Their findings revealed that youth in the justice system have significantly lower oral language skills, averaging 1.26 standard deviations below their non-offending peers.
A bottom-up approach was used, and components and strategies have been extracted from practice instead of deriving interventions from theoretical concepts of cultural competence. Anderson at al. (2003) stated in their review that no sufficient evidence was found to determine the effectiveness of workforce diversity, use of interpreter services, patient-provider matching, use of culturally and linguistically appropriate health education materials and culturally specific settings. This approach is problematic, because it gives no information on whether the health intervention, the culturally competent components or a combination of both can be determined to be effective. Commitments to change were related to changes in practice, beliefs or attitudes and to continuing education related to culture and culturally competent care. In order to improve healthcare for migrants, the “Migrant Friendly Hospital Initiative” in Geneva (Switzerland) decided to give to all new staff members a brief presentation of the initiative and about interpreter services during their mandatory orientation day.
Conducting a thorough culturally-informed assessment is a cornerstone of delivering culturally responsive care. This approach not only enhances the therapy experience but also promotes mental health equity and reduces disparities in care. Mental health practitioners need to be well-versed in culturally responsive assessment techniques. Integrating cultural awareness and social justice principles into counseling approaches is essential for mental health practitioners to provide high-quality care. Understanding the cultural significance of these support systems is vital for mental health practitioners. It can prevent people from seeking the needed support for their mental health issues or even talking about their struggles.
Traditional healing practices and spirituality often play a crucial role in many cultures’ understanding of mental health and healing. For instance, in collectivist cultures, the concept of self is often deeply intertwined with family and community, which can significantly impact therapy goals and approaches. Instead, culturally responsive therapists flexibly adjust their methods, incorporating culturally relevant metaphors, storytelling techniques, or even traditional healing practices when appropriate. “By elevating practitioner perspectives, her research offers critical insights for strengthening school-based mental health practice, informing policy and guiding future training for social workers and counselors.” Despite these strengths, Brown’s research identified systemic barriers, including restrictive policies, political climates, and inconsistent schoolwide training, which can limit culturally responsive practice.
Taken together, despite disparities, there is great heterogeneity in mental health and substance use disorders by age, region, gender, and tribal context. Mental health-related morbidities are 1.7 to seven https://www.mountaineers.org/blog/honoring-indigenous-peoples-through-education times higher among Native youth and adults for conditions including, but not limited to, substance use and posttraumatic stress disorders, and suicide (see Sarche & Spicer, 2008). Morbidity from mental health concerns are similarly elevated and help to elucidate a more nuanced and complicated picture. National Center for Health Statistics showed that premature deaths among AI/ANs was highest and increased each year from 1999 to 2014, primarily due to consequences of mental health and substance use disorders such as liver disease and cirrhosis, suicide, and injuries. AI/ANs face some of the greatest challenges to their health, mental health and well-being of any ethnic or racial group in the United States. History and current policy has borne out a unique relationship between AI/AN tribes and the federal government, including forced acculturation, warfare, and severely underfunded health services, leading to severe AI/AN health disparities” (p. S266).
According to a recent survey of companies across the U.S., 98 percent of respondents said they’d either implemented or planned to implement a mental health benefit as part of their compensation package. Research suggests that many Americans lack access to information that builds mental health literacy. Navigating the health care system can be confusing and time-consuming. Research has shown that when people are of the same race or ethnicity as their provider, they are more likely to stay engaged in treatment. For example, in one study, just 12 percent of Asian Americans said they’d mention their mental health challenges to a friend or relative, and only 4 percent would go to a psychiatrist or specialist for help. It permeates across ethnicities, gender identities, and backgrounds and deters people from getting needed support.