Aspects of Culturally Competent Care We Don’t Discuss

By Jennifer L. Warren

NEWBURGH – “O.k., so talk to me: How many of you are feeling uncomfortable right now?” Dr. Agathe C. Pierre-Louis asked as she intensely surveyed participants. Hands quickly shot up, as others slowly followed, creeping upward as their heads swayed, right to left and front to back, taking stock of the results.

Pierre-Louis, a local Clinical Psychologist had just earlier asked the room full of people who predominantly work in the social services- health field, the biggest bias or judgment they have had about the BIPOC (black, indigenous, people of color) population they serve. The anonymous replies, recorded on folded up pieces of paper and placed in a container were randomly selected and read off by Pierre- Louis, then visually displayed on the front board.
“Even though I knew some of this existed, I’m shocked by what I see,” one person uttered. Another added, “Seeing this just makes me really sad.”

Louis-Pierre herself looked at the words and phrases occupying the board- “financially and educationally disadvantaged,” “lazy,” “unsafe” “accepted their lot” and “given up,” and added more fuel to that discomfort pot.

“Your story is in here; it’s a big part of it,” affirmed Louis-Pierre. “If you put all of this in front of someone before you have ever met them, then how can you help them; how do they stand a chance?”

The hands-on, “invasive” exercise had an overriding purpose: Unveiling the covert- and sometimes overt- biases and stereotypes we possess in order to move closer to culturally competent care, particularly toward the BIPOC, traditionally dismissed communities. The “Healing Conversation,” part of the ongoing Equity Series, held at Mount Saint Mary College’s Desmond Center for Community Engagement & Wellness, Thursday afternoon, was purposefully held in July, BIPOC Mental Health Month, in collaboration with the Orange County Human Rights Commission.

“This Series is about hoping to have real talk around health care issues,” said Orange County Legislator and Executive Director Center of Community Engagement & Wellness at MSMC, Genesis Ramos, as she welcomed in guests. “We all need knowledge to discuss our continually evolving needs, and we are all in this together.”

Pierre-Louis, a Haitian immigrant, spoke of her rocky personal journey when she came to the United States. Providing specific examples of the way she was ostracized in elementary school, she learned early-on about one of the biggest yearnings people on the outside possess.

“I don’t think I learned anything when I came here in the fifth grade, but I do remember to this day how the students treated me and made me feel,” Pierre-Louis recalled. She continued, “Marginalized people just want to be seen or heard,” said the dynamic speaker Pierre-Louis. “This is one of the main reasons I see people come into my office.”

She then challenged her audience to reflect back upon why they entered their chosen helping fields. Words such as “advocacy,” “helping people,” “empathy,” “purpose,” “personal experience” and “healing” flooded the front board.

The term culturally competent care was then flashed on the screen: “People and systems respond respectfully and effectively to the whole person in a manner that recognizes them.”
“I see you, and you see me,” gleaned Pierre–Louis as she elaborated upon this ideal concept all health care workers should all be striving for in order to best assist all their clients.

Barriers- including cultural, societal and self stigmas as well as poor cross-cultural communication between providers and patients was further discussed. Reluctance of many in the BIPOC community to seek mental health help due to distrust, weakness, misdiagnosis and taboo connotations further provided in depth subject matter filling the over two hour conversation.

“A lot of these perceptions are actually coming from home,” said Pierre-Louis. “Cultural humility is the key.”

The other gateways to culturally competent social work that Pierre-Louis wanted her audience to keep at the forefront included; being aware of social work values, possessing self-awareness in their personal and cultural values and beliefs, realizing the power of language and the destructiveness of assumptions. At the epicenter of much of the ability to do this is making self-care a priority.

“Self-care is not about getting your nails and eyebrows done, but what conversations you are having with yourself, doing the psychological care; it’s all about self awareness,” Pierre-Louis urged participants. “You can only take care of others if you take care of yourself.” Pausing and reflecting deeply, the Clinical Psychologist took a deep breath, exhaled, and added, “Love on yourself.”