denigrating messages to people of color or marginalized groups. Data shows that LGB participants perceived counselors and psychologists as more culturally competent if they demonstrated: inclusive intention, awareness of heteronormativity, knowledge about issues impacting LGB people, and openness to diversity (Bishop, Crisp, & Scholz, 2022). This finding shows that it is not sufficient to be open to diversity; it also requires that we have some knowledge of issues that impact this population. If you are a counselor working with the LGBTQ population, you should be aware of heteronormativity. Heteronormativity is the belief system that heterosexuality and binary gender roles are the only norms that exist and can be applied to every individual in society. However, how does heteronormativity impact the lives of LBGTQ individuals? LGB participants perceived counselors and psychologists who were younger or LGB to be more culturally competent. Based on the results, recommendations for counselors and psychotherapists include recognizing the importance of creating a safe space and demonstrating affirming care to LGB people. Cultural competence impacts patient outcomes. Cultural competence improves communication, which keeps patients safer. Clear communication allows healthcare providers to collect accurate medical information. It also encourages active dialogues in which patients and providers can ask questions, correct misunderstandings, and build trust. Studies have shown that the absence of culturally Diversity influences when and how patients seek care. How individuals seek care varies from culture to culture. Most mental health practitioners communicate with potential clients using text, email, websites, and social media. Some populations may be disadvantaged if they are not familiar with the technology. For instance, older adults may be less likely to use the internet, search, and use social media. Not all individuals in this country own cellular phones, or if they do have a cell phone, it may not be a smartphone. Individuals from other countries or older adults might not be proficient at using text messages or sending emails. In other words, they might not have access to the technology needed to contact providers. Factors such as having internet service in your home or owning a computer are possibilities. Thus, seeking help from a provider could take longer. Socioeconomic (SES) status is also a factor that influences how individuals seek mental health care. Both poverty and inequality have been demonstrated to be toxic to our mental health, resulting in higher levels of mental illness among the poorest, most excluded, and most marginalized people all over the world. Low SES is associated with adverse situations like living in high-crime areas, environmental exposure, and chronic health conditions like heart disease, obesity, and diabetes. Unfavorable living conditions and chronic poor health often translate into inadequate mental health. Data shows that Americans living in families that earn less than $35,000 a year are four times as likely to report being nervous and five times as likely to report being sad all or most of the time compared to those living in families earning more than $100,000 a year (NCCAA, 2022). Can you consider whether these differences exist regarding mental health symptoms and income levels?
competent care can lead to preventable mistakes and adverse events (Tulane University, 2022). Cultural competence improves the patient experience. Healthcare environments that show an awareness of and respect for differences create more satisfying patient experiences. When providers adjust treatments to meet patient needs and preferences, patients notice, and their overall experience improves. If a healthcare provider uses medical jargon unfamiliar to a patient or makes assumptions about them because they use public health insurance, the patient may likely feel frustrated. Conversely, if clinicians show nonjudgmental openness in response to differences, actively listen, and try to verify that patients have understood them, their patients are more likely to feel satisfied with their care. Self-Assessment Question 4 Which of the following is an example of heteronormativity? a. Disproportionate media representation of heterosexual couples. b. Preference for biological pronouns. c. Healthcare discrimination. d. Parental disapproval of LGBTQ+ children. e. All of the above. Income, or the ability to pay for certain elements, is directly associated with health and mental health outcomes. Evidence-Based Practice: Systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Note : From “Racism and poverty are barriers to the treatment of youth mental health concerns,” by Castro-Ramirez, F., et al., 2021. Journal of Clinical Child & Adolescent Psychology, 50(4), 534-546. SES levels impact one’s awareness of mental health services. “While most Americans seek treatment, a large portion of the population has wanted to but did not seek treatment for themselves or loved ones (29%) - partly due to not knowing where to go if they needed this service” (National Council for Mental Wellbeing, 2022). SES levels impact one’s access to mental health services. Data reveals that almost 70% of the uninsured population is poor, and 18% of the nonelderly population do not have health insurance. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for significant health conditions and chronic diseases (Hailun, 2019). Additionally, 11% of U.S. adults with mental illness had no insurance coverage in 2020. Of U.S. adults with serious mental illness, 11.3% had no insurance coverage in 2020 (NAMI, n.d.). See Figure 6. Individuals from lower-income families with certain types of health insurance could experience difficulties finding providers who are able and willing to care for them. With limited providers come long waits for treatment and barriers such as distance, location, and transportation to treatment.
Impact of Cultural Beliefs on Mental Health Diagnosis and Treatment Culture, Help-seeking, and Access
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Book Code: SWTX1525
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