Newsletter. Ensuring good mental health care across differences

Newsletter No. 1 April 2023 Ensuring good mental health care across differences

04.04 2023

Overview of content:
Ensuring good mental health care across differences
How to improve mental health support for minorities?
Be aware!
Further reading
Download the manual

Dear colleagues

Several studies have documented inequalities regarding access to mental health for persons who belong to different minority groups in the contexts of war, conflict, or migration, as well as the lack of training and awareness among professionals or helpers who provide psychological support to these groups.  The lack of knowledge about cultural identities can end up deteriorating people’s mental health.

According to the OHCHR, a minority is any group of persons which constitutes less than half of the population in the entire territory of a State, whose members share common characteristics. Usually we speak about the four categories, national, ethnic, religious and linguistic and often a combination of any of these. Minorities shall equally enjoy all of the human rights of the nine core human rights treaties, in particular, protection of existence as minorities; non-discrimination; the enjoyment of their own culture, religion, and language; effective participation in cultural, religious, social, economic and public life; effective participation in decision-making; the maintenance of their own associations; and the maintenance of contacts and relations across frontiers (About minorities and human rights | OHCHR). It is important that helpers and others collaborating with and supporting individuals belonging to different minorities, take these aspects into account. If not, they may be at risk of stereotyping, and not understanding and the mental health service may become inappropriate or without value. The person may feel invalidated, abused, misunderstood, and even oppressed by persons whose intention is to provide care.

It is therefore important to improve cultural competencies. Health systems often adhere to a monocultural or ethnocentric values, and as a result the support can become inadequate, revictimizing the survivor, or condition them to a kind of “normality” that does not responds to the cultural identity of the minorities.

Mental health professionals or helpers are not immune to the biases, stereotypes, and judgmental values from the majority. This is the first step to improve access to mental health for minority groups around the world. Traumas caused by wars and conflicts are often added to other traumas caused by discrimination. By understanding this, we can provide adequate support.

How to improve mental health support for minorities in contexts of war, conflict, and migration?

Strategies for dealing with ethnic inequalities within mental health care require us to carry out evaluation at an individual level, as well as to look at the systemic and structural obstacles to good and meaningful interaction by looking at the use of the existing health care service.

Other strategies to address ethnic inequalities when providing psychological health care to persons who belong to a minority group is to break down the different obstacles such as prejudices, misconception based on language barriers and non- verbal language barriers based on cultural misunderstanding.
In addition, providing competency about cultural identity and cultural awareness, as well as being aware of own positioning within the majority society is of the essence.

With regard to systemic and structural obstacles these have to be worked with at a political and administrative level. This may include improving the delivery of mental health services for minority groups by including institutional adaptations that can promote justice in the health care system, guidelines that reduce administrative and linguistic barriers to care, and practices that improve patients’ knowledge of rights and duties as participants in the care process.

In many parts of the world, access to mental health care is scarce and unstable, but awareness of the obstacles is one of the important steps to improve the situation. Regardless of the precariousness of health care systems, professionals and/or helpers must be aware of the need to take cultural identity into account and try to understand how culture affect the way we look at psychological problems. This essential for foreign humanitarian workers giving psychosocial support in contexts of war, conflict or forced migration. And it is a way of ensuring that they have access to the core human rights referred to above.

Be aware!

There is a need for culturally competent helpers that are conscious and sensitive to their own ethnic and cultural heritage, their own values, and judgments regarding others. Helpers that are aware that their worldviews are just one of many. They are sensitive of their own backgrounds, experiences, and biases, and how this influence psychological processes. Culturally sensitive helpers make constant efforts not to impose their biases on diverse groups. They strive to work within a diverse population with sufficient training and cultural knowledge.

A conscious helper is comfortable with the differences that exist between themselves and others and realizes that discomfort with differences can make it difficult to have an effective therapeutic relationship.

In addition, they respect the religion and spiritual beliefs of others. They avoid making critical assessments of individuals whose belief systems differ from their own. They are aware that we live in a pluralistic environment and that they are part of a multicultural society.
Culturally aware mental health carers with knowledge about minority family and community structures can make a vital difference.

Here you will find literature related to this topic, in addition to practical tools to improve as helpers inside and outside minorities groups in context of war, conflict, and migration.


Here you will find information and resources about this topic

Understanding ethnic inequalities in mental healthcare ...

2022National Library of Medicine

Evidence regarding the presence and persistence of ethnic inequalities in mental healthcare is well established. The reasons for these inequalities and lack of progress in diminishing them are less understood. This meta-ethnography aims to provide a ...

Psychological Treatment of Ethnic Minority Populations

2003American Psychological Association,

The call for cultural competence in mental health practice has been a frequent theme voiced by the four major ethnic minority psychological associations. In an effort to address concerns and provide assistance to service providers, these four associa...

Mental Health of Children of Immigrants and Ethnic Mino...

2013Birmingham Children's Hospital NHS Foundation Trust

This paper aims to review immigration trends in Europe and identify problems and needs of immigrant and ethnic minority children and youth with respect to mental health services.

Supporting the Mental Health of Minorities

2022Danielle Ellis, B.Sc.

Sexual, gender and ethnic minorities have faced significant health-related difficulties, especially in terms of mental health. In the past decade, many studies have been published focusing on the mental health scenario for these groups. There is a ne...

Racial and Ethnic Disparities in Mental Health Care: Ev...

2008National Library of Medicine

In the mental health arena, unlike general health, health care disparities predominate over disparities in mental health per se. Strategies to improve health care in general, such as improving access to care and improving the quality of care, would d...

About minorities and human rights

2005 UN

An ethnic, religious or linguistic minority is any group of persons which constitutes less than half of the population in the entire territory of a State whose members share common characteristics of culture, religion or language, or a combination of...

Why is Cultural Competence Important in Mental Health C...

2022Why is Cultural Competence Important in Mental Health Care?

Cultural competency means that, as a provider, you are able to interact effectively with people of different cultures, by incorporating their unique beliefs, behaviors, and needs into their diagnosis and treatment plan. Simply put, a culturally compe...


All manuals can be downloaded from the MHHRI website

There are three different manuals, which respectively address working with women, with boys and men, and with children who have experienced sexual violence.

The manuals are translated into several languages. The page numbers in each manual remain the same across languages. This allows survivors and helpers to work from copies in their preferred language and read the same content on the same pages. It also makes it easier to teach participants when participants and trainers work in more than one language. The manuals include a toolbox. Survivors can use it individually to regulate their own emotions through grounding exercises or in collaboration with a helper. Helpers can also use grounding exercises to take care of themselves as helpers.

We appreciate feedback and comments 

Welcome to our new subscribers, we hope you will find our content useful. The Mental Health and Human Rights Info Newsletter is a newsletter with the aim to provide insight on a certain subject across the scope of our work; human rights violations in war and conflict areas and mental health. Our intention is to deliver a newsletter as a short “lecture” where you can find relevant information regarding a specific subject from a mental health perspective. You will receive our newsletter 5 times a year.

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Sincerely yours,
Take care – and we are wishing you all the best.

Sincerely yours,

Mental Health and Human Rights Info