Cultural Diversity and Mental Health
Treatment
Concerns needing to be addressed by mental health
policies
Changing Demographics
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By 2025, 35% of U.S. population will be members of
ethnic minority groups.
Ethnic minority children will be 48% of all children residing
in the U.S.
Latino Americans are now the largest minority group;
African Americans are second
In early 1900’s, most immigrants came from Europe and
Canada; now they come from Latin America and Asia.
Help-seeking behavior
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Ethnic minorities less likely to seek professional
mental health treatment than whites.
For example, whites are 1 ½ times as likely
voluntarily to seek mental health care than are
African Americans.
Ethnic minorities are more at risk
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Ethnic minorities are more likely to belong to highrisk groups, such as the homeless or HIV-infected
people.
Ethnic minorities are more likely to lack health
insurance.
• 14%
• 26%
• 38%
• 23%
of whites are uninsured
African Americans are uninsured
of Latinos are uninsured
of Asian Americans are uninsured
Appropriateness of services
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Ethnic minorities more likely to be misdiagnosed.
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Behavior that is normal in some cultures may be
seen as pathology if the evaluator doesn’t
understand the culture.
Ethnic minorities more likely to drop out of
treatment, especially after the first session.
Culturally relevant services
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Increase cultural competence of all mental health
professionals.
Hire mental health professionals who are members
of ethnic minority groups.
Develop culturally sensitive programs.
Effect on outcomes
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Research shows that matching ethnic minority
clients with mental health professionals of the
same background helps:
• Drop-out rates are lowered
• More sessions are attended
• But, except for working with monolingual non-English
speaking clients, outcomes are similar, whether or not
there is a match.
Culturally appropriate programs
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Programs are culturally appropriate if they incorporate the
values, beliefs, worldview, and behaviors of ethnic
minorities into assessment and therapeutic activities.
• E.g., cuento therapy for Puerto Rican children
• Ethnotherapy
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In addition, attention needs to be paid to the social,
economic, and political problems of ethnic minorities.
• E.g., empowerment models
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Culturally appropriate programming has to go
beyond just incorporating cultural elements into
treatment; it should have a clear conceptualization
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of its purposes and methods.
More research on effectiveness is needed.
Problematic issues
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What causes mental illness?
• Biological dysfunction? If so, why bother with cultural relevance?
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How do you adapt mental health services to diverse
cultural groups?
• What assumptions do you make about culture? Is it primarily
rooted in tradition, history—or is it more accurate to think about
culture as very much shaped by social factors, institutions, power
relationships?
Socioeconomic Status
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Stressors make one more vulnerable to mental disorders.
Ethnic minorities tend to experience more stress as a
result of their social status.
However, there is much variation among members of
ethnic minority groups. Programs need to take these
differences into account as they develop services that are
sensitive to the needs of ethnic minorities.
Purposes and Functions of Mental Health
Services in Society
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Maintaining order and conformity--social control?
• Protecting society
• Protecting people who have mental disorders
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Complementary to market: Improve people’s ability to
compete and perform in the labor market/be economically
self-sufficient?
Compensatory to market: Contribute to achieving a more
equitable distribution of resources?
Service Models
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Clinical services model (medical model)
• Primary purpose of mental health services is to alleviate
symptoms of psychological distress for individual
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Social welfare model
• Mental health services need to address broader range of
community services; sees mental health problems as caused by
social problems
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Empowerment model
• Mental health services need to address psychological, economic,
political, and social barriers through empowering people