As noted in this module, most healthcare providers, including mental health providers, are not provided with training to understand and assess underlying determinants of health. Thinking about how to practice in a culturally safe manner can feel intimidating. Additionally, many mental health providers have experienced unparalleled challenges while serving during the pandemic, and may feel exhausted and burdened already.
Under these circumstances, trying to think about the social determinants of health during your assessments may feel overwhelming. It is important to remember that even small changes can have a big impact.
Here are some ideas to help shift thinking and communication and build a culturally safe practice.
| IF | CONSIDER |
| Client is non-responsive when asked about personal history. | Building trust is an essential first step when establishing a therapeutic relationship. If your client appears uncomfortable or unable to respond to direct, history-taking questions, try building a rapport by asking alternative questions which may be easier for the client to answer. For example: “Can you tell me about things you enjoy doing?” or “How was traffic getting here?” |
| Client has been a no-show twice in the past six weeks. | “Are you comfortable telling me what happened when you were not able to come for your appointment?” |
| Client appears to be overly dependent on parental approval. | “Can you tell me more about parent-child relationships in your culture? For example, what sort of traditions and expectations are considered typical when children interact with their parents?” |
What will I change — both for myself and for those in my care?
We have given a few examples in the table above. Can you think of another one of your own based on your experience or observations?