Cultural competency and cultural humility (Reading)

We expect learners to have an increased awareness of their own beliefs, biases, and assumptions about LGBTQI+ persons and of the inclusiveness of their services, behaviours and methods. Inclusivity is not an “add-on”, and creating an inclusive practice is not only about building skills and methods that can be added as a plus to make our established methods and routines more friendly. Mental health professionals need to rethink their basic assumptions that form their practices, and the new thinking and skills should be present in all of their work – even with persons with less challenging social identities.

You can familiarise yourselves with several models that help with thinking critically and with a more collaborative, inclusive approach about mental health. All of the frameworks can be quite helpful, but they also can have drawbacks or lead to less than ideal outcomes if applied without due care.

• Cultural Competency: This framework has grown from social work and nursing. Cultural Competency is “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations”. Its central thesis is that practitioners should learn the norms and frameworks of the persons they interact with. If applied without reflexivity, it can lead to generalisations and the upholding of the distinction between “us” and “them”, “default” and “different”.
• Cultural Humility: The concept of cultural humility was developed by Melanie Tervalon and Jann Murray-Garcia in 1998 to address inequities in the healthcare field. Cultural humility goes beyond the concept of cultural competence to include lifelong commitment to reflexivity and self-awareness and the rebalancing of common power-dynamics. This framework decenters the practitioner as expert, and reconceptualises clients and service users as experts in themselves. If applied without deep consideration it can lead to putting the burden and responsibility of educating practitioners on the people they are supposed to serve.

A few resources

• Cultural Competence In Health and Human Services | NPIN. (n.d.). Retrieved 25 October 2021, from https://npin.cdc.gov/pages/cultural-competence
• Greene-Moton, E., & Minkler, M. (2020). Cultural Competence or Cultural Humility? Moving Beyond the Debate. Health Promotion Practice, 21(1), 142–145. https://doi.org/10.1177/1524839919884912
• Grubb, H., Hutcherson, H., Amiel, J., Bogart, J., & Laird, J. (2013). Cultural Humility with Lesbian, Gay, Bisexual, and Transgender Populations: A Novel Curriculum in LGBT Health for Clinical Medical Students. MedEdPORTAL, 9, 9542. https://doi.org/10.15766/mep_2374-8265.9542
• Treatment (US), C. for S. A. (2014). Introduction to Cultural Competence. In Improving Cultural Competence. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK248431/