Cultural Diversity and Mental Health Treatment

1
Cultural Diversity and Mental Health Treatment

• Concerns needing to be addressed by mental health
  policies

2
Changing Demographics

• 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 1900s, most immigrants came from Europe
  and Canada now they come from Latin America and
  Asia.

3
Help-seeking behavior

• 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.

4
Ethnic minorities are more at risk

• 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 of whites are uninsured
• 26 African Americans are uninsured
• 38 of Latinos are uninsured
• 23 of Asian Americans are uninsured

5
Appropriateness of services

• Ethnic minorities more likely to be misdiagnosed.
  Behavior that is normal in some cultures may be
  seen as pathology if the evaluator doesnt
  understand the culture.
• Ethnic minorities more likely to drop out of
  treatment, especially after the first session.

6
Culturally relevant services

• Increase cultural competence of all mental health
  professionals.
• Hire mental health professionals who are members
  of ethnic minority groups.
• Develop culturally sensitive programs.

7
Effect on outcomes

• 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.

8
Culturally appropriate programs

• 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
• In addition, attention needs to be paid to the
  social, economic, and political problems of
  ethnic minorities.
• E.g., empowerment models

9

• 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.

10
Problematic issues

• What causes mental illness?
• Biological dysfunction? If so, why bother with
  cultural relevance?
• How do you adapt mental health services to
  diverse cultural groups?
• What assumptions do you make about culture? Is
  it primarily rooted in tradition, historyor is
  it more accurate to think about culture as very
  much shaped by social factors, institutions,
  power relationships?

11
Socioeconomic Status

• 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.

12
Purposes and Functions of Mental Health Services
in Society

• Maintaining order and conformity--social control?
• Protecting society
• Protecting people who have mental disorders
• Complementary to market Improve peoples
  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?

13
Service Models

• Clinical services model (medical model)
• Primary purpose of mental health services is to
  alleviate symptoms of psychological distress for
  individual
• Social welfare model
• Mental health services need to address broader
  range of community services sees mental health
  problems as caused by social problems
• Empowerment model
• Mental health services need to address
  psychological, economic, political, and social
  barriers through empowering people