Diversity and Culture in Child Mental Health Care
No. 118; Updated January 2019
American families come from diverse cultural and ethnic backgrounds. Each person’s background affects the way he or she views the world and gets help for physical or mental health problems.
Many parents get advice and support from family, friends, and faith leaders when their child is struggling. When a mental health professional is needed, it is important to find someone who understands that culture can affect your child’s behavior, development, diagnosis, and treatment. This is called culturally informed or culturally competent care. Other phrases that can be used to describe cultural competency are 'cultural sensitivity' or 'cultural awareness.'
Culture influences how we understand and respond to behavior. Cultural competency is important for considering the following areas of family life:
- Behaviors that are common and “normal” in one culture even when they are not in others
- Ways to manage everyday problems that can occur between a child and parents or others
- Religious beliefs, practices, and events
- Family customs and traditions
- Conflicts that arise between parents and children if the child is spending more time with friends than with family
- Different ways of expressing emotions and problems
Children and families from culturally diverse groups have unique needs that are not always met by our current health care system. They may have more difficulty finding health care providers or be at risk for higher rates of medical or mental health conditions. Some children have to adjust to having different values at home and school, particularly if their parents were raised in a different culture. A culturally aware mental health professional will try to understand and help address these sources of stress.
Families may want to see a mental health professional who has a similar background or who knows about their culture. Some ways that families can find a clinician who shares their cultural background include:
- Talking with members of your cultural community
- Consulting with spiritual or religious leaders, school counselors, or teachers
- Checking newspapers, magazines, or websites
- Checking with your local or public state mental health agency
Your mental health professional may come from a different culture or background. You can help your clinician to understand your culture by bringing up the following subjects:
- Cultural values and religious beliefs
- Languages spoken at home and school and different family members’ preferred language
- Traditional medicines or treatments
- Parenting practices and discipline methods
- The role of family and community in your child’s life
- What is expected of children at different ages in your culture
- How and when feelings are shown in your family and community
- Your family’s immigration or transition experience to the new culture
- Losses and trauma from a youth’s immigration or transition
- Factors that make it difficult for your family to obtain mental health care, including transportation, finances, and cultural beliefs
- Conflict between your child and older generations of the family
- Your child’s cultural strengths
Some things that your mental health professional can do to provide culturally competent care include:
- With permission, working together with your cultural, community, or religious organizations
- Supporting parents and caregivers in using behavioral management skills that are in line with their beliefs and values
- Including family members who are “non-blood relatives” in the evaluation and treatment when requested by family or child
- Recognizing the types of therapy and medications that work best in youth from specific diverse groups
- Appreciating and recognizing cultural biases and how they can interfere with treatment
If your mental health provider does not speak your preferred language, you and your family will need an interpreter. Hospitals and many mental health agencies have access to interpreters (for spoken language) and translators (for written language). Interpreters have been trained to communicate exactly what you and the professional say, and to respect your privacy. It is best not to use friends or family members as an interpreter. It is especially important not to have your child act as your interpreter.
Regardless of what language you speak, a mental health professional with cultural sensitivity will better understand your family’s point of view and can also offer guidance that takes into account your family’s values and beliefs. The more information you can provide to your clinicians to increase understanding about your family’s cultural background and value system, the more the professional will be able to help you to develop a plan to help your child.
The following are some additional resources to use in your search for a culturally sensitive mental health provider: