Clinical Relevance: There is a growing need for individualized, culturally-sensitive treatment strategies

  • The COVID-19 pandemic intensified the urgency to overhaul global mental health strategies.
  • Experts urge clinicians to take an individualized and culturally sensitive approach to mental health care.
  • This shift in thinking requires a large scale change in professional training and policy.

The onset of the COVID-19 in 2020 was a watershed moment that put mental health providers around the globe to the test.

In the first year of the pandemic alone, rates of anxiety and depression surged by over 25 percent. Even as the virus began to recede, alarmingly high levels of mental health distress signals from patients continued to accelerate. A worldwide shortage of mental health professionals added to the crisis, stirring up a dire need for reform and a total rethink of the mental healthcare sector.

Many clinicians came to the conclusion that a “one size fits all” approach to mental health wasn’t working. After all, why should an anxiety treatment that’s effective for a secretary in Albuquerque be the go-to solution for a mechanic in Auckland? Different cultures, different challenges — perhaps they required different solutions. 

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A United Front 

“The scientific and mental health community pulled together and started collaborating for the greater good and against the pandemic that threatened everybody,” said Brigitte Khoury, an APA Presidential Citation recipient for her  contributions to global mental health.  Add to this, increasing mobility and virtual communication among both patients and professionals, and the urgency of addressing mental health concerns on a larger yet more personalized scale slowly began to take root. 

“Almost every psychologist in the world will be dealing, at some point in their life, with people who are not from their own culture,” Khoury pointed out. She is an advocate for breaking away from traditional frameworks to help mental health professionals better understand and address psychological issues at both an individual and policy level. This shift in mindset is not just preferable—it’s essential, she said.

Avoiding the Pitfalls

For decades, the dominant narrative in mental health care has mostly been about increasing the diagnosis and treatment of mental illness. “That makes for a good soundbite, but it doesn’t address the structural complexities of what often leads to emotional distress,” commented Lisa Cosgrove, a clinical psychologist who is a professor at the University of Massachusetts-Boston. She argues that these Western methods might not be universally applicable and can inadvertently sideline other potentially effective treatments, thereby limiting the scope of mental healthcare.

Cosgrove pointed out that focusing solely on biomedical models can narrow the professional view of patients. It can act as a barrier to effective treatment across different cultural backgrounds. Alternative models and thinking outside the conventional medical box can often yield better results.

Case in point: when researchers dug into the increasing farmer suicides in India, they found that structural policy changes to stabilize their income would be far more effective in curbing this trend than simply providing psychological therapies or medications. “It might be difficult to implement, but clearly psychotherapy or psychopharmaceuticals are not going to help decrease the suicide rate in India,” Cosgrove said.

Likewise in the U.S., programs like Housing First have had some success. By providing stable living environments, it has become a more effective solution than traditional psychological care alone. It’s an approach that has led to better mental well-being and stability for its participants over time. 

The Way Forward

Improving cultural awareness among providers is only start. The ultimate goal is to provide each individual with the right kind of care, tailored to their unique needs.

“I think global mental health is made for DEI [diversity, equity, inclusion], and now it’s catching up—finally—with everybody around the world,” said Khoury. This is not just a societal ideal, she added, but a practical necessity for effective mental health treatment on a global scale. In fact, the World Federation for Mental Health, the organization behind World Mental Health Day, made this year’s slogan, “mental health Is a universal human right.” 

Implementing such policy change, especially to scale, is easier said than done, Khoury cautioned. But progressive clinicians believe shifting the discourse can be as simple as training newly-minted mental health professionals to be humble, curious, and open-minded. 

“Now it’s outside the office, it’s off the couch, it’s all over the world,” Khoury said. “I think we need to prepare the next generation of professionals to be able to meet these needs.”