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 high-risk 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. 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
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 selfsufficient?
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