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Medical Self Advocacy

Culturally Competent Care

America's population is rapidly becoming more diverse. The cultural competence of our health care providers is important to enhancing positive health care outcomes. Culturally competent care brings together a combination of attitudes, skills and knowledge that allows health care providers to better understand and take care of people whose cultural backgrounds, sexual orientation, religious beliefs or gender are different from their own.

Medical care that lacks cultural competence has caused well-documented disparities in access to services and in quality of care for many individuals and communities. State health care systems' efforts to improve the cultural competence of services were graded in the NAMI Grading the States 2009 report. Some states demonstrated more sophisticated thinking about the issue than others. It is clear that the mental health care system has a long way to go to equip a workforce to be culturally competent. NAMI and other advocates must continue to press for a health care workforce that meets the needs of all who rely on the system for care. You should be open about any personal, cultural, spiritual or religious issues. You should inform yourr provider if you have certain cultural needs or preferences to support your own unique recovery.

People of Color

People of color face additional heart health challenges. For example, there is a higher rate of diabetes among Asian American, African American, Native American and Latino individuals. This additional risk is important to know before planning to proactively manage weight through diet and exercise, especially if taking antipsychotic medications as a part of a treatment plan. Antipsychotic medications differ widely in how much they increase the risk of diabetes. If you take SGAs, learn more about monitoring your health risks and discussing these with your health care provider.

There is a great deal more to learn about how culture and biology relate to psychiatric medication dosages. The number of ethnic minorities in research has been historically low, which hampers efforts to address this important issue. There is some evidence that Asians may require lower doses of antipsychotics. There is also evidence that African Americans have historically been given higher doses of antipsychotics. The right medicine dosage cannot yet be determined based on race or ethnicity.

Diet and alternative treatments are also an area of interest with culturally competent health care, and there is a great deal more to learn. For example, Ginko Biloba, which is used often in Hispanic food, can have effects on the metabolism of other medicines such as anticonvulsants (seizure medicines), antidepressants and even blood thinners. You should be talk openly to your health care providers about your diet and medicines that you are taking.

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