Exploring Ways to Enhance Culturally Humble Mental Health Practices for Asian Americans and Latino Populations

Access to mental health services is a well-known challenge for ethnic minorities such as Asian Americans (AAs) and Latino Americans due to cultural and contextual factors. Shame and stigma surrounding mental illnesses, suppression of emotions to maintain balance, language barriers, and feeling that their sociocultural concerns are not understood by mental health providers who may be perceived as lacking in cultural knowledge are among the factors that hinder access to appropriate care. Cultural humility is an approach to working with clients from diverse backgrounds in professional settings. It requires acknowledging cultural differences and involves learning, communicating, making decisions, and offering help. As a lifelong commitment to self-evaluation and self-critique, cultural humility promotes equity in the client-worker relationship, aims to develop mutually beneficial clinical and advocacy partnerships with communities, and involves maintaining an other-oriented interpersonal stance. However, mental health professionals may find it challenging to practice cultural humility when working with clients from different cultures, and there is a scarcity of information regarding providers' experiences of cultural humility. The pilot study aims to explore the experiences of mental health professionals and gain insights into their perceptions of the attitudes, skills, and challenges of providing culturally humble services to this population.

This cross-sectional qualitative exploratory study adopts a phenomenological research design in Northern California. Using purposive and snowball samplings, the study involves ten mental health professionals who have worked with clients from both AA and Latino-American backgrounds for at least two years. All participants hold a master's degree in either social work or psychology. Of the participants, 78.8% have worked in mental health settings for more than five years, and half of the participants are male. The participants are almost evenly distributed between AAs (50%) and Latino-Americans (40%), with 10% from other backgrounds. The study utilized online individual in-depth semi-structured interviews to gather data.

The thematic analysis identified four overarching themes. Participants reported that cultural humility goes beyond cultural competence and requires a lifelong commitment to self-reflection, self-critique, and a willingness to change one's approach (Theme 1). Participants stressed the importance of cultural openness, emphasizing non-judgment, recognizing personal biases and preconceptions, and learning from clients as key values and skills and noted that this is more crucial than having cultural knowledge (Theme 2). The primary practice skills involve a client-centered approach, building therapeutic relationships to understand their unique needs and experiences, and developing tailored care plans (e.g., different generations and English proficiency levels require different approaches, even if they share the same ethnic and contextual background) (Theme 3). Additionally, the intricacies of practicing cultural humility often pose a challenge, and hence, more meticulously structured and comprehensive training is imperative to develop and sustain this approach (Theme 4).

This pilot study provides insights into how mental healthcare providers understand and apply culturally humble practices. The results indicate that more effective training on cultural humility and more research are needed to enhance its impact on the quality of care and to assess the impact of cultural humility on client satisfaction, retention, and treatment outcomes.