Competent Mental Health Care Research Articles

Mental Health Needs of Asian American Older Adults: Bridging the Inequity Gap.

The mental health needs of Asian American older adults are complex and multifaceted. Despite their rich diversity, Asian American older adults face significant challenges, including mental health stigma, cultural stress, limited English proficiency, and historical trauma. In addition, the coronavirus disease 2019 pandemic reignited preexisting anti-Asian attitudes of hostility, discrimination, blame, and scapegoating. The historical context of Asian immigration to the United States, impact of race-based discrimination, and recent resurgence of anti-Asian hate crimes impact mental health in Asian American older adults. Thus, there is a need for a culturally sensitive and competent mental health care workforce, culturally tailored interventions, and family involvement. In the context of research and policy, it is critical to prioritize increased funding and research focus on culturally tailored instrument development, interventions, and policy initiatives informed by recent findings to safeguard this population from hate crimes and discrimination. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 11-15.].

Indirect effect of negative evaluations of therapy on the association between racial stress and posttraumatic stress disorder symptoms in pregnant Black persons.

Black pregnant individuals are at disproportionate risk for posttraumatic stress disorder (PTSD) compared to other groups. A wealth of literature suggests racial stress contributes to this inequity, but cultural and structural mechanisms, such as perceived barriers to mental health treatment, underlying the relationship between racial stress and PTSD symptoms remain understudied. Negative evaluations of psychotherapy and stigma represent potential mechanisms, though no previous studies have examined these associations. To address this gap, we tested an indirect effect of racial stress on PTSD symptoms through perceived barriers to mental health treatment in pregnant Black individuals. Mediation analyses were used to assess an indirect relationship between racial stress and PTSD symptoms through perceived barriers to mental health treatment. At the bivariate level, racial stress was significantly associated with PTSD symptoms (r = .20, p = .03) and negative evaluations of therapy (r = .22, p = .02), but not with stigma (r = .140, p = .147). Negative evaluations of therapy were also associated with PTSD symptoms (r = .43, p < .001). There was an indirect effect of racial stress on PTSD symptoms through a negative evaluation of therapy, β = .08, SE = 0.04, CI [0.01, 0.18]. More specifically, racial stress was associated with a more negative evaluation of therapy, which was in turn associated with more PTSD symptoms. Results highlight the need for accessible and culturally competent mental health care for pregnant Black individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

THE PERCEIVED PSYCHOLOGICAL WELL-BEING OF LGBTQ INDIVIDUALS IN MALAYSIA

This study explores the psychological well-being of lesbian, gay, bisexual, and transgender (LGBTQ) individuals in Malaysia, focusing on their experiences of identity formation, societal understanding, and the impact of prevailing attitudes on their mental health. Through qualitative methods, including in-depth interviews with nine participants from the LGBTQ community in Kuantan, Pahang, this research delves into the personal narratives of two lesbians, two gay individuals, two bisexuals, and three transgender persons, to understand the complexities of living as an LGBTQ individual in a society marked by religious and legal considerations. .The findings reveal that participants recognized their LGBTQ identity during adolescence, often, navigating societal expectations discreetly to avoid backlash. Despite challenges, participants demonstrated resilience and found support within familial and community networks. Notably, the study highlights a shift towards greater understanding of LGBTQ individuals in Malaysia, potentially reducing instances of psychological distress within the community. This research underscores the importance of supportive environments and the need for culturally competent mental health care for LGBTQ individuals. It also calls for further studies to include broader societal perspectives and professional insights to enrich the discourse on LGBTQ mental well-being. This study contributes valuable insights into the evolving landscape of LGBTQ perceptions and the factors influencing the psychological health of LGBTQ individuals in Malaysia.

A first intervention to support the mental health of transgender individuals in Eastern Europe

Abstract Background Transgender and gender-diverse (TGD) people in Romania experience high discrimination and related dysphoria, while gender-affirmation resources are scant. TGD Romanians report significant emotional distress and no access to competent mental health care. This pilot tested the feasibility, acceptability, and early efficacy of the first evidence-based mental health intervention implemented in Eastern Europe, using cognitive behavioral therapy within an identity-affirming framework. Methods Eligible TGD individuals (e.g., ≥ 18 years old, symptoms of past-90-day depression and/or anxiety) were recruited through community outreach. Participants completed a baseline (BL) assessment, were assigned to one of two trained psychologists, attended up to 16 1-hr virtual counseling sessions, and completed a 5-month follow-up assessment. Participants reported demographics, mental health (e.g., anxiety, depression), and identity-related psychosocial experiences (e.g., gender identity congruence). Analyses were conducted using paired sample t-tests and Wilcoxon rank sum tests to compare pre-post intervention scores. Results Of 24 participants enrolled (40% transgender female, 43% transgender male, 17% non-binary; M age=25.1, SD = 6.53), 22 were retained at follow-up. Significant reductions occurred from BL to follow-up in depression, anxiety, and psychological distress (p &amp;lt; 0.001), alcohol-related problems, gender identify rumination and difficulties with emotion regulation (p = 0.05). Satisfaction with the intervention was high. There were no changes in suicidal ideation, assertiveness, transgender congruence, gender identity acceptance, and emotion regulation. Conclusions This first intervention to support TGD Romanian's mental health shows promise and can be further studied in a randomized controlled trial. Its implementation across similar high-stigma, low-resource countries can provide critical mental health support in settings lacking such resources.

Preparedness of final year medical students in caring for lesbian, gay, bisexual, and transgender patients with mental illness.

Lesbian, gay, bisexual, and transgender (LGBT) individuals have a higher prevalence of mental illness compared to the general population. Discriminatory behaviour from mental health care providers impedes access to culturally competent mental health care. Undergraduate psychiatry education plays an important role in adequately preparing medical doctors to care for mental illness in LGBT patients. This study aims to assess the knowledge, attitudes and clinical preparedness of final-year medical students in caring for LGBT patients after completion of their psychiatry rotation. Faculty of health sciences at a large public university in Gauteng. This was a cross-sectional study using an anonymous self-administered questionnaire. The questionnaire comprised demographic data, the lesbian, gay, bisexual, and transgender development of clinical skills scale (LGBT-DOCSS) and questions relating to their subjective knowledge and preparedness in LGBT mental health care. The LGBT-DOCSS is a validated tool consisting of three subscales: basic knowledge, attitudinal awareness, and clinical preparedness. Data from 170 final-year students were used in the analyses. Participants scored within the low range for clinical preparedness and basic knowledge subscales but high in the attitudinal subscale. Gender, sexual orientation and academic background were associated with higher overall scores and higher basic knowledge and attitudinal awareness scores. Final-year medical students were not adequately prepared in caring for LGBT patients with mental illness as indicated by the LGBT-DOCSS. This study identifies a gap in undergraduate psychiatric training in providing culturally competent mental health care for a vulnerable population.

The patient population of a no-cost, student-run LGBTQ + mental health clinic: A case for equitable and trauma-informed care

Introduction LGBTQ + individuals experience disproportionately high rates of mental health disorders. Subpopulations of this community experience unique risk factors and barriers to accessing care. Method This study analyzes chart review data of patients (n = 49) of an LGBTQ+-specific, student-run, free mental health clinic in NYC between March 2019 and July 2021. Result Most common diagnoses were mood disorders (55%) and anxiety disorders (53%). Eighty-eight percent of patients reported experiencing lifetime traumatic events; 20% of patients met criteria for PTSD. Conclusion Further research is needed to characterize vulnerable subpopulations to create equitable, accessible, and competent mental health care resources for the LGBTQ + community.

Queer(ing) Healing: Reimagining Wellness through Drama Therapy during the Dual Pandemics

Queer(ing) Healing: Reimagining Wellness through Drama Therapy during the Dual Pandemics

Surveillance for Violent Deaths - National Violent Death Reporting System, 42 States, the District of Columbia, and Puerto Rico, 2019.

Surveillance for Violent Deaths - National Violent Death Reporting System, 42 States, the District of Columbia, and Puerto Rico, 2019.

Asian American Mental Health: Looking Beyond the COVID-19 Pandemic

Asian American Mental Health: Looking Beyond the COVID-19 Pandemic

Achieving culturally competent mental health care: A mixed-methods study drawing on the perspectives of UK nursing students.

This study aimed to examine the degree of cross-cultural competency among UK mental health student nurses, and the care delivery challenges arising from their internalized cultural assumptions. This study adopted a mixed-methods design. Participants were final-year nursing students in the United Kingdom. The results revealed participants had a moderate level of cultural awareness and competency but highlighted many challenges to providing cross-cultural care arising from the meanings, enablers, and values they attributed to culturally competent mental health care. As cultural competency is considered an essential characteristic of effective nursing care, greater attention should be paid to how student nurses assimilate cultural awareness to develop confidence in their day-to-day practice.

Culturally competent mental health care

Culturally competent mental health care

Mental Health Care of Older Adults: Does Cultural Competence Matter?

Minority and limited English proficiency seniors are consistently found to have multiple health care disparities, including higher incidence and prevalence of various mental health conditions. The purpose of this paper is to review current literature on culturally competent mental health care for older adults. The US population is aging and becoming increasingly more diverse. Minority and underserved groups of seniors are known to suffer from lower health literacy, limited English proficiency, and poorer health care outcomes. Quality mental health care is particularly dependent on being able to deliver services that are culturally and linguistically component. Federal agencies, accreditation and regulatory bodies, and mental health advocacy groups all offer online resources to facilitate and empower providers and mental health care organizations to enhance their ability to provide culturally competent services. There is evidence that cultural competence training improves provider awareness of disparities and cultural needs of a given target population. There are also trends that suggest that culturally competent care improves patient satisfaction and perceptions of providers. Future research is needed to further define the degree to which culturally competent care, and which aspects of that care, can reduce disparities and improve patient outcomes.

Culturally competent health care for sex workers: an examination of myths that stigmatize sex work and hinder access to care

Sex workers are individuals who offer sexual services in exchange for compensation (i.e. money, goods, or other services). Within the United States, the full-service sex work (FSSW) industry generates 14 billion dollars annually there are estimated to be 1–2 million FSSWers, though experts believe this number to be an underestimate. Many FSSWers face the possibility of violence, legal involvement, and social stigmatization. As a result, this population experiences increased risk for mental health disorders. Given these risks and vulnerabilities, FSSWers stand to benefit from receiving mental health care however a constellation of individual, organizational, and systemic barriers limit care utilization. Destigmatization of FSSW and offering of culturally competent mental health care can help empower this traditionally marginalized population. The objective of the current review is to (1) educate clinicians on sex work and describe the unique struggles faced by FSSW and vulnerability factors clinicians must consider, (2) address five common myths about FSSW that perpetuate stigma, and (3) advance a research and culturally competent clinical training agenda that can optimize mental health care engagement and utilization within the sex work community.

How do mental health practitioners operationalise cultural competency in everyday practice? A qualitative analysis

BackgroundDespite continued policy and research emphasis to deliver culturally competent mental healthcare, there is: (1) limited evidence about what frontline practitioners consider to be culturally competent care and; (2) what helps or hinders them in delivering such care in their everyday practice. The aims of this article are to address these gaps.MethodsQualitative in-depth interviews were conducted with 20 mental health practitioners working with immigrant patients to explore their understandings and experiences of culturally competent care. Interviews were conducted between September 2015 and February 2016 in the state of Victoria, Australia. Data were thematically analysed.ResultsThere were common understandings of cultural competence but its operationalisation differed by profession, health setting, locality, and years of experience; urban psychiatrists were more functional in their approach and authoritarian in their communication with patients compared to allied health staff in non-specialist mental health settings, in rural areas, with less years of experience. Different methods of operationalising cultural competence translated into complex ways of building cultural concordance with patients, also influenced by health practitioners’ own cultural background and cultural exposures. Limited access to interpreters and organisational apathy remain barriers to promoting cultural competency whereas organisational support, personal motivation, and professional resilience remain critical facilitators to sustaining cultural competency in everyday practice.ConclusionWhile there is need for widespread cultural competence teaching to all mental health professionals, this training must be specific to different professional needs, health settings, and localities of practice (rural or urban). Experiential teaching at tertiary level or professional development programs may provide an avenue to improve the status quo but a ‘one-size-fits-all’ model is unlikely to work.

Session 324 - Culturally Competent Mental Health Care for Kupuna: An Updated Diverse and Inclusive Curriculum

Session 324 - Culturally Competent Mental Health Care for Kupuna: An Updated Diverse and Inclusive Curriculum

Kenneth Fung, M.D., Brings Culturally Sensitive Psychiatry to Toronto’s Asian Community

Kenneth Fung, M.D., Brings Culturally Sensitive Psychiatry to Toronto’s Asian Community

APA Foundation Recognizes Leaders in Minority Mental Health

Back to table of contents Previous article Next article Association NewsFull AccessAPA Foundation Recognizes Leaders in Minority Mental HealthLindsey McClenathanLindsey McClenathanSearch for more papers by this authorPublished Online:24 Jun 2016https://doi.org/10.1176/appi.pn.2016.7a14AbstractThe awards honor individuals and programs that are making a difference in improving the care of underserved minority members with mental illness.The 2016 APA Foundation Awards for Advancing Minority Mental Health were announced at the annual benefit of the American Psychiatric Association Foundation, held in conjunction with APA’s 2016 Annual Meeting in Atlanta in May.Gathering for a photo after presentation of the APA Foundation Awards for Advancing Minority Mental Health were (from left) Ranna Parekh, M.D., director of APA’s Division of Diversity and Health Equity; Saul Levin, M.D., M.P.A., APA CEO and medical director and chair of the Foundation’s Board of Directors; Altha Stewart, M.D., a member of the APA Board of Trustees; award winners Kenneth Fung, M.D., Nubia Lluberes-Rincon, M.D., and Olga El Sehamy and her son, Alex El Sehamy; and Uyen-Khanh Quang-Dang, M.D., M.Sc., a member of the APA Foundation’s Board of Directors. Parekh, Stewart, and Quang-Dang presented the awards.David HathcoxThe awards, created in 2003, recognize psychiatrists, other health professionals, and organizations that have undertaken innovative efforts to raise awareness of mental illness in underserved minority communities, increase access to care, overcome cultural barriers to care, and improve the quality of care for underserved minorities, particularly those in the public health system or with severe mental illness.Here are brief descriptions of this year’s winners:Kenneth Fung, M.D., of Toronto is a co-founder of the Asian Initiative in Mental Health Program (AIM) at the Toronto Western Hospital. This program serves the local, underserved Cantonese- and Mandarin-speaking communities and is a training ground for medical students and residents interested in cross-cultural psychiatry. In addition to his efforts to increase culturally competent mental health care through AIM, Fung provides psychiatric consultation and training to minority mental health care service organizations. Also, he has engaged with local media to promote mental health and advocate for stigma reduction in local minority populations and has co-led numerous research studies.Nubia Lluberes-Rincon, M.D., of Freedom, Pa., is pursuing a fellowship in forensic psychiatry to allow her to help close the gap between psychiatric services and the correctional system in the United States. Lluberes-Rincon, a former APA Diversity Leadership Fellow, has spent time providing mental health education to the Hispanic community in Texas and creating a documentary on bipolar disorder. In West Virginia, where African Americans, LGBT, and other minority groups are in need of additional support, she re-established electroconvulsive therapy at a hospital serving these populations and provided community education to fight stigma surrounding mental illness.Deaf and Hard of Hearing Program of Lifeline Connections of Vancouver, Wash., provides high-quality treatment and support for people who are deaf and have a substance use disorder, allowing equal access to treatment in American Sign Language (ASL), the clients’ first language. This dynamic eliminates complications and barriers that a third-party interpreter may introduce to the therapeutic relationship and therefore improves treatment outcomes. The program offers both individual and group counseling and hosts an alumni program to help clients live sober lives. The Deaf and Hard of Hearing Program has clients who have been sober and in recovery for many years. Adelante of Suffolk County Inc. in Central Islip, N.Y., serves local low-income families, many of whom are Hispanic. In order to address the mental health of its clients, Adelante runs a Supported Housing and Behavioral Program in which all staff are bilingual (English-Spanish) and able to provide care in the clients’ first (and potentially only) language. Adelante collaborates with Alcoholics Anonymous and a local clinical facility offering treatment for adults with serious mental illness. Additionally, the Supported Housing and Behavioral Program offers pre-vocational services to prepare their clients for employment and training in life skills to provide a holistic approach to the overall well-being of the individual. ■More information on the Awards for Advancing Minority Mental Health can be accessed here.Lindsey McClenathan is the development officer in the APA Foundation. ISSUES NewArchived

Promoting Cultural Competent and High-Quality Mental Health Care Services to Asian-Americans

Promoting Cultural Competent and High-Quality Mental Health Care Services to Asian-Americans

Psychiatrists Want to Do More for Toronto’s Growing Immigrant Population

Even when immigrants report mental health issues, many may have a tough time accessing culturally competent mental health care.

American Indian identity in mental health services utilization data from a rural Midwestern sample.

The governing bodies for psychiatry, psychology, and social work all publicly support culturally competent mental health care and have called for increased awareness of the importance of racial, ethnic, and cultural identity in mental health treatment and outcomes. However, since 1960 the population of people identifying as American Indian in the United States has grown faster than can be explained by birth rates, raising questions about the personal meaning of identity for newly self-designated American Indians. For this research, interviews were conducted with 14 self-identified American Indian clients receiving rural mental health care services in the Midwest. The goal was to assess clients' cultural connection to their racial identity and to understand what impact their American Indian identity had on their mental health care experiences. A modified Consensual Qualitative Research (CQR) method was used to develop the interview protocol and code responses. Interview data revealed that clients primarily based their racial identity on family stories of an American Indian ancestor and the majority did not feel their identification as American Indian was relevant to their mental health care. Regardless of lack of cultural connection, participants often reported feeling personal pride associated with identifying as American Indian. Implications for both researchers collecting self-reported race data and for mental health practitioners who might serve self-identified American Indian clients are discussed.