Cultural Competency and Community Engagement in Psychiatric Practice

Clinicians face real limits in addressing the systemic inequities that shape patients' mental health, Dambreville emphasized. Embedding care within a larger system—referring patients to care coordination, financial assistance, or help navigating the school system—extends what any 1 provider could offer on their own, she said. Many patients remain unaware such resources exist.

Dambreville argued that mental health care could not be confined to the clinic room. "Mental health and mental health care does not exist only in the clinic or the patient room. I think it really exists in communities."¹ She pointed to churches, schools, and parks as spaces where conversations touching on mental health already occurred, often without that label attached. Raising mental health literacy within these settings, she said, allowed community members to recognize distress and point people toward help without needing a formal diagnosis themselves.

Addressing disparities also required clinicians to examine their own biases. Dambreville said "the work is to really self-reflect and do our best to not perpetuate those harms as clinicians."² She described this self-reflection as central to avoiding harm—asking whether discomfort with a topic, fear of causing offense, or avoidance of a difficult question kept a clinician from fully engaging a patient. That reflective work, she said, created the conditions for patients to build the trust needed to feel seen and heard.

Dambreville distinguished the value of workforce diversity from the cultural competence required to use it effectively. Increasing diversity within the behavioral health workforce addressed 1 structural barrier, but a diverse workforce operating within a system that was not culturally responsive would still fail to deliver competent care, she said. Cultural competency and cultural humility, she noted, tended to surface in workforce-composition discussions, though the two issues required distinct, ongoing attention. Building a more representative workforce and reforming systemic structures were both necessary, difficult undertakings, according to Dambreville, and neither could substitute for the other in achieving equitable psychiatric care.

Dr Dambreville is a licensed adult and child clinical psychologist and assistant professor of psychiatry at Mount Sinai Hospital and the Icahn School of Medicine.

References

1. Kirmayer LJ, Jarvis GE. Culturally responsive services as a path to equity in mental healthcare. Healthc Pap. 2019;18(2):11-23.

2. Delfish M, Chadha P. From competence to humility: advancing culturally response mental health care. Psych News. 2025;60(1).