Culturally competent mental health disaster response
Among the many lessons learned from Hurricane Katrina is that of the need for mental health care professionals to educate themselves in cultural competence and sensitivity. As related to mental health care in disasters, culture refers to “a common heritage or set of beliefs, norms, and values.” Here are some important concepts to keep in mind about culturally sensitive disaster mental health care:
- The term “culture” is as applicable to whites as it is to racial and ethnic minorities. Culture is about shared meanings.
- Today’s America, and Georgia, is unmistakably multicultural, and because there are a variety of ways to define a cultural group (e.g., by ethnicity, religion, geographic region, age group, sexual orientation, or profession), many people consider themselves as having multiple cultural identities.
- Culture influences the origin, course, and response of various mental and medical processes, as can be seen in culture-bound syndromes. In short, culture counts.
- Culture influences all aspects of mental health in disaster response: stress, coping, resiliency, and help-seeking.
- Culture is a concept not limited to patients or clients or consumers, but also applies to the professionals who treat them. Every group of professionals embodies a “culture” in the sense that they too have a shared set of beliefs, norms, and values. Unfortunately, this means that mental health care providers may understand and involve themselves with struggles in ways that sometimes diverge from their clients’ or patients’ views, especially when the cultural backgrounds of the consumer and provider are dissimilar, and this divergence of viewpoints can create barriers to effective care.
So it is essential that mental health care professionals develop cultural competency through the following steps:
- Develop and maintain a current and projected profile of the cultural composition of your Georgia community as it relates to mental health care during disasters. This should describe the community’s composition in terms of race and ethnicity; age; gender; religion; refugee and immigrant status; housing status; income and poverty levels; percentage of residents living in rural versus urban areas; unemployment rate; language and dialects; literacy level; and number of schools and businesses. Include in the profile information about the values, beliefs, social and family norms, traditions, practices, and politics of local cultural groups, as well as historical racial relations or ethnic issues. Gather information in consultation with community cultural leaders who represent and understand local cultural groups. Identify potential cultural influences in your area of Georgia as they relate to disaster response.
- Complete a self-assessment of cultural awareness and sensitivity in general and specific to mental health care to identify areas for potential growth.
- Educate yourself about some common cultural influences as they relate to mental health care during times of disaster. There is a wonderfully comprehensive list of websites here.
- In your disaster planning enlist cultural brokers (persons with cultural backgrounds similar to your anticipated disaster service constituency) to bridge, link, or mediate among persons of different cultural backgrounds for the purpose of reducing conflict or producing change.
- Participate in and provide ongoing cultural competency training, not just once but on an ongoing basis, to facilitate your understanding and response to various cultural influences on mental health care during times of disaster.
- Ensure that your mental health services are accessible, appropriate, and equitable during times of disaster. Identify and take steps to overcome the reluctance of various ethnic groups to use your services because of mistrust or service barriers such as racial and ethnic discrimination, language barriers, transportation issues, and the stigma associated with health-care services.
- Cultivate empathy, the ability to feel your way imaginatively into the others’ experience, as a pathway toward being culturally sensitive. As expressed by a nurse serving in post-disaster relief,
“I would never want to remove the idea that there is a definite importance to cultural competence. But I also believe there was something within me as a nurse, as a woman, as a mother, that allowed me to care for those patients. I couldn’t speak Spanish, but I still felt like I conveyed the message that ‘I am going to figure out what it is you need or die trying.’ I feel any nurse who has that compassion can develop the cultural competence.”
Web Links
This page provides links to more resources, guides, and surveys relevant to cultural competency.
This National Association of Social Workers document outlines the standards for cultural competence and explains how to reach the standards in practice.
This site is a comprehensive guide for healthcare providers on taking cultural diversity into account when providing quality care.
This is another guide for developing cultural competency.