Defining Mental Health Practitioners’ LGBTIQ Cultural Competence in Thailand

Abstract

This study investigated what competencies are crucial for mental health practitioners’ culturally competent practice with LGBTIQ clients in Thailand. The study used two-round Delphi methodology to aggregate views of mental health practitioners with expertise on LGBTIQ issues (n = 14), and of LGBTIQ individuals who had used mental health services (n = 13). Participants proposed competencies in Round 1 through interviews or an online questionnaire, and rated these competencies’ importance in another online questionnaire in Round 2. Forty-one knowledge competencies, 35 awareness/attitude/belief competencies, 14 skill competencies and 35 action competencies were rated. Among key themes were understanding gender/sexual diversity as well as issues affecting LGBTIQ people and their families, and being able to assist on these issues; accepting gender/sexual diversity, respecting clients’ self-determination, and communicating this to clients; being aware of the impact of one’s beliefs, attitudes, identities and values; recognizing and rejecting stereotypes; being open, humble, and willing to learn more; knowing how to use feminist counseling techniques and other specific techniques; refraining from offending actions; social justice action; and obtaining information sensitively. Developing these competencies is likely to improve mental health services’ appropriateness for LGBTIQ clients and should be included in mental health practitioners’ training in Thailand.

The relationship between sexual and gender stigma and difficulty accessing primary and mental healthcare services among LGBTQI+ populations in Thailand: Findings from a national survey

“…in-patient accommodation based on SGM identity). A recent study has sought to define cultural competencies for SGM among mental health practitioners in the Thai context (T. T. Ojanen et al, 2021), where acceptance of sexual and gender diversity, feminist counselling techniques, and respect of selfdetermination, among other competencies, were identified as being crucial components (T. T. Ojanen et al, 2021). Furthermore, a systematic review has demonstrated the benefits of SGM-specific educational curricula for healthcare professionals (Sekoni et al, 2017).…”

The relationship between sexual and gender stigma and suicide attempt and ideation among LGBTQI + populations in Thailand: findings from a national survey

“…This model has been successful in delivering systematic training and certification to lay providers in providing point-of-care HIV/STI testing, uptake of pre-and post-exposure prophylaxis (PrEP/PEP), as well as treatment service linkages, and individual case management [37]. Augmenting and integrating suicide prevention efforts in KPLHS could be an effective strategy in this setting and should be considered along with expanding culturally-sensitive mental healthcare services for SGM in Thailand [39], including SGM-specific counselling services [14].…”

The Culturally Competent Healthcare Professional: The RESPECT Competencies from a Systematic Review of Delphi Studies

“…In addition to generating competencies from reviewing the literature, some scholars have conducted a Delphi study to identify the competencies needed to ensure cultural competence in healthcare [16][17][18]. However, these studies indicated both similar and different competencies, and they did not seem to agree on the number of necessary core competencies.…”

“…However, these studies indicated both similar and different competencies, and they did not seem to agree on the number of necessary core competencies. Some generated only a few competencies or skills [16], while others suggested more than one hundred [18]. Delphi studies have been used many times in the healthcare scholarship, as they rely on expert opinions and follow a structured and controlled procedure to reach safe conclusions on the items that experts reach a consensus on.…”

“…In support, experts in Jirwe et al's [29] study reached a consensus on having a humane outlook, showing respect, being open to cultural differences, showing interest in the patients' views, having good verbal and non-verbal communication, and respecting patients' wishes and the fact that their families might wish to be involved. Other relevant competencies were politeness [17], communicating sensitively [30,37], ensuring trust [37], participating in or seeing the practices of other cultures [27,28,31,36], accepting gender and sexual diversity [18], ensuring equality and justice, and promoting health literacy [33]. Furthermore, Chae et al [30] presented experts' opinions about the importance of exploring and valuing the patients' ideas, while Johansson et al [32], Ziegler, Michaëlis, and Sørensen [17], and Deardorff [27] talked about active listening, and Forkhzadian et al [33], Jirwe et al [29], and Deardorff [27] talked about the importance of being curious and asking questions.…”