The increasing presence of culturally different clients in European health services constitutes an important challenge for the effective delivery of care. Cultural competence has been proposed as a general approach for improving services, which requires changes at both institutional and clinical levels. The majority of cultural competence models have been developed in the United States and as such may require adaptation for use in Europe. The key constructs of culture, ethnicity and race underlie important philosophical perspectives in cultural competency models. How these constructs, particularly race, are understood to relate to health and healthcare is of considerable importance in both the development of the competency models and their application and acceptability, which are not always the same, in a given context. Clinical cultural competence consists of specific knowledge, skills, and attitudes that function together to provide an individualised, culturally sensitive and appropriate treatment. Knowledge about cultural specifics is less important than awareness of the different ways in which culture, race, and the migratory process can affect psychosocial functioning and mental health treatment. Given the complex play of racial bias and ethnic discrimination, cultural self-awareness is the key to effectively overcoming barriers that are often unseen but which can severely limit the effectiveness of the therapeutic relationship. Although there has been a very promising start, cultural competence in mental health needs to be further defined, adapted, and researched for effective application in the European context.
Francisco Collazos, Adil Qureshi