How can cultural humility in therapeutic settings improve patient outcomes?
Napoleon B. Higgins, Jr, MD, and Rona J. Hu, MD, presented on the impact of cultural differences on health disparities and unequal access to care at the 2021 Neuroscience Education Institute (NEI) Congress Friday, November 5, in Colorado Springs, Colorado.
In their presentation, titled “Nurturing Cultural Humility in Mental Health Care,” Higgins and Hu discussed the impact of history on current mental health care outcomes; the effects of racism on mental health; the ways oppression, racism, access barriers, and other sociocultural factors lead to health disparities and mental health sequelae; and the importance of cultural humility in mental health care settings. They reported that, due to many historical incidents of racism and oppression over the years in mental health care, patients from minority communities have often been excluded from research studies; diagnostic assessments have not been sensitive for minority populations; diagnostic and treatment algorithms often pay little attention to diversity; not as much is known about the differences in the ways individuals from different cultures may express symptoms of mental illness; and, therefore, many patients from minority communities may distrust the medical system. This lack of information about—and trust from—these communities is problematic in part because there is predicted to be a 90% increase in racial and ethnic minorities by 2050, according to the United States Census Bureau.1
In order to improve outcomes with patients from minority communities, Higgins and Hu suggested that practitioners recognize their privilege and the historical role of privilege in oppressive systems; recognize their own biases and stereotypes, and the ways these impact reactions to microaggressions and other cultural issues in therapeutic settings; and practice cultural humility, which Higgins and Hu defined as a willingness and lifelong dedication to learn from patients about their experiences by asking questions—rather than making assumptions—while acknowledging their own embeddedness in culture(s).1 “We don’t want to make assumptions—we always want to ask and be inquisitive,” Higgins said during the presentation. “When you show that you’re inquisitive, it shows interest, not ignorance. When you ask the question, it shows that you’re interested in that person’s story.”
Higgins is president and CEO of Bay Pointe Behavioral Health Service, Inc., and South East Houston Research Group; medical director of the Hold My Hand Residential Treatment Center; and a staff psychiatrist in the Prairie View A&M University Student Center. Hu is a clinical professor in the Stanford Medical Center Department of Psychiatry and Behavioral Sciences, and associate dean of Academic Affairs at the Stanford University School of Medicine.
1. Higgins, Jr. NB, Hu RJ. Nurturing cultural humility in mental health care. Presented at 2021 NEI Congress. November 5, 2021.