Everyone has a unique worldview formed by their culture, race, sexual identity, beliefs, and values. As we go through life, our perceptions and experiences are filtered through our worldview, informing how different events, environments, and people impact us.
Our culture can strongly influence how we think about mental health conditions and what we think of ourselves (and others) for needing support with our mental health. Cultural differences can affect which treatments or type of support works for us—and whether we seek help for our mental health.
To ensure that people from all backgrounds, ethnicities, and groups get appropriate mental health treatment, they must have access to culturally sensitive and context-specific care. Below, let’s explore how culture can affect mental health and the importance of culturally sensitive and context-specific mental health care.
How does culture affect mental health?
Mental health can affect anyone, regardless of their appearance or where they’re from. However, the culture to which someone belongs can play a significant role in how mental health impacts them. Culture includes ethnicity, sexual identity, and even the presence of a disability.1
For example, Black people in the United States may share certain cultural factors that can help define mental health and support wellbeing. Family, community, values, and expression through spirituality or music are big parts of many Black cultures and can be important for supporting mental wellbeing.2 Another shared experience is being subject to racism, discrimination, and inequity in day-to-day life, all of which can take a toll on a person’s mental health. Black people often face systemic challenges to accessing safe, equitable healthcare—in the U.S., only 1 in 3 Black adults with a mental health condition receive treatment.3
Asian Americans and Pacific Islanders (AAPI) tend to have a strong sense of ethnic and communal identity, which can benefit mental health. Communal identity is linked to lower suicide risks. It is also considered a notable predictor of mental resilience in the face of discrimination.4 At the same time, many AAPI people may find it difficult to balance their family’s traditional cultural values and expectations with the pressure of finding their unique identity and fitting into American society. AAPI people also face barriers to accessing support for their mental health, including language barriers, immigration status, faith and spirituality, lack of health coverage, and stigma and shame.
Hispanic5 and Indigenous6 people also face distinct cultural challenges that create disparities in access to and the quality of mental health care available to them. For all of these ethnic groups, finding culturally-competent mental health providers is an added obstacle on top of all the other barriers they face.
The impact of being LGBTQAI+ on mental health
Many LGBTQAI+ people face disparities due to socioeconomic and cultural conditions that negatively impact their mental health. Discrimination, prejudice, harassment, family rejection, coming out, and denial of civil and human rights can lead to worsened mental health conditions for LGBTQ people—especially for those of color or for those who live in poverty.7
Due to these traumatic experiences, LGBTQ adults and youth have higher rates of homelessness, substance abuse, and suicide. LGBTQ adults are twice as likely to experience a mental health condition than heterosexual people.8 Transgender people are almost four times as likely to experience a mental health condition than cisgender people.9
The LGBTQ community encompasses a wide range of individuals that belong to subcommunities, each of which faces its own unique challenges and rates of mental health conditions. Additionally, each individual has other identity factors like race and socioeconomic status that can impact their access and quality of mental health care.
The impact of mental health on people with disabilities
Sixty-one million people in the United States live with a disability10; many face discrimination and unequal access to housing, employment, insurance coverage, and medical care. Additionally, many people with disabilities experience physical challenges, like immobility or pain and social isolation, which can significantly affect their mental health.11
People with disabilities face many barriers to effective and accessible mental health care. These barriers range from reliable transportation and communication barriers to a lack of integrated care and dismissed mental health symptoms due to their disability.11 The dehumanizing treatment of people with disabilities by medical providers—called ableism—makes it even harder to receive safe, effective, and culturally-sensitive treatment.12
What is culturally-sensitive mental health care and why is it important?
Culturally-sensitive mental health care is defined simply as “care that meets the social and cultural needs of diverse patient populations.”13 Culturally-sensitive care, also called culturally-competent care, helps reduce mental health disparities and ensures that everyone receives care that considers cultural influences.
Some of the practices that culturally-competent mental health providers adopt include14:
- Asking non-judgmental questions to better understand an individual’s beliefs around and understanding of their mental health condition.
- Respecting the individual’s readiness and willingness to accept a diagnosis and using terms that meet them where they are (such as “stress” instead of “anxiety”).
- Becoming familiar with a person’s religious observations or cultural customs and how they may impact how they get support for their mental health.
- Using a professional interpreter to translate and reduce the language barrier when a provider that speaks their language isn’t available.
Culturally-sensitive care appropriately addresses the cultural differences that impact someone’s mental health and reduces the barriers to accessing high-quality, equitable care caused by those differences. Culturally-competent providers will help their patients feel respected and supported while meeting them where they are on their mental health journey.
What is context-specific mental health care and how does it improve outcomes?
Context-specific care goes hand-in-hand with culturally-sensitive care; it requires an awareness of the social and cultural factors that influence an individual, as well as an understanding of how to effectively treat the individual in the context of those factors. Context-specific mental health care addresses the context of someone’s life, beyond their identity. This includes a variety of social determinants of health including a person’s income, their job stability, the area they live in, the quality of food they can access, their level of education, and whether they have reliable transportation and stable housing.
Even before they’re layered with the complexity of cultural factors, these core social needs can have an extreme impact on an individual’s mental health. In fact, social determinants contribute to 80% of a person’s health outcomes, while the health care they receive accounts for just 20%.15 To provide truly effective and equitable mental health care, people need to be treated with both sensitivity to their culture and within the context of their circumstances and environment.16
What role do employers have in supporting culturally-competent mental health care?
Employers offer health benefits to improve the wellbeing of their workforce. Happy, healthy workers are more likely to have better health outcomes, which helps employers reduce the total cost of healthcare. But organizations won’t realize the full ROI of mental health benefits without identifying and addressing the cultural and social factors that influence the mental health of diverse employees.
Employees belonging to vulnerable populations, including lower-income workers and marginalized groups, face disproportionately high rates of chronic conditions, including mental health conditions. People in these groups often delay care until it becomes urgent or life-threatening, which leads to higher healthcare costs for both the employee and the company.
When mental health care lacks competence in addressing cultural and social factors, the cycle of reactive care, poor health outcomes, and higher healthcare costs will continue. Employers who offer culturally-sensitive and context-specific mental health care can enjoy the benefits of healthier, happier employees, improved health outcomes, and reduced healthcare costs.
Our clinical and business leaders build our EAP and mental health solutions based on principles proven to improve the health of a diverse population of members. Learn more about our approach to mental health care.