Do culturally appropriate mental health interventions have to be culturally specific? University of New Mexico Sociology Professor Jessica Goodkind says no.
In her article, Is cultural appropriateness culturally specific? Intersectional insights from a community-based participatory mental health intervention study conducted with diverse cultural groups, published in the American Journal of Community Psychology, Goodkind studied 290 refugee participants who resettled in New Mexico from around the world: Afghanistan, Iraq, Syria, the Great Lakes region of Africa (Republic of the Congo, Rwanda, Burundi). Goodkind says she was interested in what could broadly ensure mental health interventions/programs could be culturally appropriate without necessarily being culturally specific. While there has been a growing movement over the last several decades to make mental health interventions culturally specific for different groups, research shows it can be a very time and resource-intensive process to adjust to a particular group of people.
“I don’t want to devalue culturally grounded interventions based on people’s specific cultural values and experiences, but I don’t think it’s the only way to deliver a mental intervention that is effective for people,” she said. “If we attend to broader factors related to shared experiences, we can do culturally appropriate mental health interventions that are not specific, which opens us up to reaching more people.”
In the paper, Goodkind describes those broad factors as recognizing racism and discrimination and how that impacts a person’s mental health while also de-centering dominant U.S. culture. Also, she emphasizes the importance of creating an egalitarian spaces to put the principles into action while recognizing the complexity of different aspects of people's identities, and thinking about how we create spaces for everybody to share their perspectives and cultures.
“If we want to use our resources in a way where we can have mental health interventions that feel culturally appropriate for many different people, then we must think about those common factors most refugees and immigrants face," she said.
Goodkind says how we think about culture has changed; while before it was more directly linked to race, ethnicity and national origin, now we recognize that cultures have to do with additional intersecting aspects of our identities, like sexual orientation, religion, and age, among other factors. She believes that this focus is missing in some efforts to make mental healthcare culturally appropriate, adding that we must mobilize and partner with communities to improve mental health instead.
“So rather than people like me, who haven’t had experiences of being a newcomer, saying 'here is what you need,' let's talk to people and say, 'what is it that you need to improve your mental health? You survived these hard experiences, and you have that knowledge. How can we partner together to address your stressors?” she said.
Goodkind has been doing mental health research in partnership with refugee and immigrant communities for more than 25 years, studying the different factors causing distress in the lives of refugees and immigrants both pre-migration and post-resettlement. It started in 1993, when she worked with a group of Hmong refugees from Laos, in a camp in Thailand, helping them prepare to resettle in the United States. Once they arrived in North America, Goodkind said the conditions were extreme.
“There are a lot of challenges people face in a new country, learning a new language, finding a job and a safe place to live, enrolling their kids in school. So I saw those stressors and I wanted to find a new way to use what I had learned during my time in a refugee camp and support them in the United States,” she said. "A lot of other research we have done has demonstrated that addressing those immediate economic and language stressors right away contributes to better mental health."
After that, the Refugee and Immigrant Well-being Project (RIWP) was born, a community-based mental health intervention for refugees resettled in the United States, first implemented as part of Goodkind's dissertation at Michigan State University in 2000. She brought the project to The University of New Mexico in 2004, where it has grown tremendously, expanding to more refugee groups from Liberia, the Great Lakes region of Africa, Syria, Afghanistan, Latin America, and Iraq.
“Refugees and immigrants coming here bring so much experience and wisdom but most people in the U.S. don’t take the time to get to know them, so I wanted to create a space for newcomers to share their knowledge. Then I saw this as an opportunity for university students to learn more from them," Goodkind said. “Newcomers from all of these different parts of the world can learn from one another and have a lot of common experiences.”
One project has evolved into numerous research articles demonstrating the significant positive impact RIWP has on the mental health of refugees, immigrants, and other newcomers and the importance of addressing social determinants of newcomers’ mental health. The project has also led to the creation of a class at UNM that Goodkind has been offering since 2006. Health and Social Inequalities is a two-semester sociology course available to both undergraduate and graduate students (SOCI 346, 347, 525). It provides an opportunity for students to participate in the Refugee and Immigrant Well-being Project, partnering and learning with newcomers and community-based organizations.
Goodkind also serves as the Associate Chair of UNM's Department of Sociology and a Board Member of United Voices for Newcomer Rights (UNVR), a partner organization in the study.
