Contemporary Issues in Clinical Mental Health

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In an increasingly globalized world, diverse populations – those that differ in ethnicity, religion, economics, beliefs, and experiences – are coming together under conditions marred by anger, fear, and distrust. Mental health services play a pivotal role where these experiences intersect, whether in hospitals, clinics, the legal system, the criminal justice system, schools, or workplaces. Everyone involved in the delivery of these services must be aware of the issues that could complicate them.

Contemporary Issues in Clinical Mental Health

Dr. Anthony Marsella recently outlined twelve critical issues for mental health professionals working with diverse populations in Psychology International for the American Psychological Association. Here are some of the highlights.

Variations Between Professional and Patient

Where previously in the United States, professionals and patients were mostly from similar cultural backgrounds and may have differed only in social class, education, or gender, today’s services must also consider cultural variations. This requires a new attention to cultural sensitivities, and includes potential differences in ethnicity, gender, gender preference, sexuality, language, and religion.

A New Spectrum of Patients

Many at-risk populations are relatively unfamiliar to mental health service providers, including migrant workers, undocumented immigrants, refugees, asylum seekers, and those who are confronting issues with gender identity and/or sexuality. These patients bring unique needs and challenges requiring complex but accessible resources and services.

Assessment and Testing Methods

Linguistic, conceptual, and normative equivalencies for any client assessments or tests must be developed for them to be valid. Standardized western testing methods pose potential risks for issues with language, concepts, and norms for other populations. And without an equivalence, “there can be many errors in service provision decisions, especially those related to classification, diagnosis, therapy, and medications.”

Cultural Competency

Reliance on the delivery of mental health services that is rooted in western assumptions of knowledge and practices can introduce a range of problems. Mental health services must be responsive to ethno-cultural differences in “etiological and causal models of health and disorder, patterns of disorder, standards or normality, and treatment alternatives.”

Available, Accessible, and Acceptable Mental Health Services

Working with diverse and at-risk populations will mean dealing with poor, undereducated, and non-English speakers who are in urgent need of acute care. Therapies must include a range of services, including medical, educational, financial, transportation, and housing and the delivery methods must be set up to be available, accessible, and appropriate for the communities they serve. While this concern applies to all mental health patients, the ethno-cultural therapy encounter is especially demanding.
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