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Cultural Competency and the Healthcare Experience

Brenden Hargett, PhD, LPC, LCAS, NCC — July 6, 2018 — 5 min read
One in five adults in the U.S. face a mental health condition each year. African-Americans are 10 percent more likely to experience serious psychological distress than the general population. Yet at the same time, less than a quarter of them seek mental health treatment.

These kinds of statistics may look familiar. Most of us have heard about issues involving access to community mental healthcare. However, in North Carolina, the problem is often less about access and more about engagement in their healthcare. Too often, the real problem is that people don’t remain in care once they begin.  
While the specific reasons for not returning to a behavioral health specialist may vary, if a person doesn’t feel their providers understand and value them, chances are good that they will not return for treatment. Cultural competency is one way to address this.
What’s cultural competency?
Simply put, cultural competency is when providers understand the cultural influences that might affect a person’s health outcomes. They offer information and services that are respectful of the individual’s health, beliefs, practices, needs and cultural background.
It’s important for providers to distinguish between race and culture, and consider both as they move patients towards wellness. The African-American experience is a prime example, because this experience in unlike any other group of people in the U.S. I’m talking about all the history, impressions, background and life events that have been passed on throughout generations. These not only contribute to underlying belief systems, they also contribute to our unique needs as patients. Understanding cultural competency and applying the principles is critical when treating complex populations because it allows for better understanding of the patient’s needs.
The more providers know about someone, the better they can treat the whole person.  For example: Let’s say someone walks into a doctor’s office with extreme anxiety. The provider should ask, what is contributing to that anxiety? Is it really a diagnosable condition that medication will help address? Or is the anxiety caused by a traumatic experience — such as historical relationships with law enforcement— that might require a completely different course of treatment?
An advocate can help
One of the first steps to becoming more aware and engaging people in treatment is breaking down the barriers, stigmas and distrust that might push them away. On the part of providers, it requires a genuine desire to learn and appreciate different perspectives. It also means educating people using accurate and culturally relevant information. Providers should share research findings, for example, from studies that reflect the patient’s cultural background. Dr. Edward Morris discussed the importance of an integrated approach to conceptualizing, evaluating and diagnosing African Americans from a culturally sensitive perspective.  His approach centers on understanding the worldview of those seeking services and applying this to those being served.  When providers operate from this perspective, they respond from a person-centered perspective that is helpful in maintaining cultural sensitivity.
To further ensure cultural needs are met, I encourage patients to find a healthcare advocate.
An advocate is someone who can help you navigate the healthcare system. They can find local providers who work to understand you, such as those who are professionally trained in cultural competency, who are involved in the local community, and who understand the impact of a historical context on perceptions and interactions.
An advocate can also share examples of people who have received excellent treatment and the positive impact it has made on their physical and mental health. There are many groups and resources in North Carolina that have advocates who can help you navigate the local behavioral healthcare system, from cultural competency to mental health first aid. Here are just a few:
  • Promise Resource Network a Charlotte-based advocate group and peer-run organization. It employs people in recovery to partner with individuals, families, communities and organizations to advance recovery from emotional distress, mental health and substance use challenges. 1-704-390-7709.
  • Mental Health America of Central Carolinas is a voice of hope for persons affected by mental illness and driven to enhance the local mental health services’ delivery system through a variety of programs. For more information, you may contact or 1-704-365-3454.
  • The National Alliance on Mental Illness (NAMI) is a national mental health organization committed to supporting and bettering the lives of those with mental illness, with a local North Carolina chapter. It offers free referral, information and support via its help line: 1-800-451-9682 or
  • Cardinal Innovations Healthcare  is a North-Carolina-based managed care organization focused on helping people with complex needs get access to the services they need.  A crisis hotline is available 24/7 at 1-800-939-5911. Hotline staff can discuss immediate needs, dispatch a mobile crisis team for face-to-face help, recommend appropriate services, help you understand eligibility for you or a loved one, or work with you to schedule an appointment with a provider. 
Better care through greater understanding
The combined cultural experiences of a community are passed from generation to generation. Historical trauma, beliefs and influences exist — and thus impact the psyche and the needs of even the youngest patients today.
Cultural competency and the delivery of culturally competent interventions can play a key role in helping to ensure that mental health professionals understand how someone’s cultural background may affect the issue for which they’re seeking treatment. A genuine desire to build bridges and trust can go a long way toward engaging patients — and making sure they continue to get the care they need to be well.
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