Ethnic variations in the initial phase of mental health treatment: A study of Sami and non‐Sami clients and therapists in northern Norway

Abstract

Several studies indicate that mental health and mental health service vary with ethnicity. Ethnically linked social differences affect these results. We examined the multiethnic population in northern Norway where social inequalities between the Sami and the non-Sami population are not prominent. Clients (N=347) and therapists (N=32) in outpatient treatments reported demographics, ethnicity and the therapeutic alliance. Clients also reported pretreatment psychosocial status, service utilization and the type of help requested. Therapist recorded clinical and diagnostic assessments and treatment plans. The Sami and non-Sami client groups were similar in demographics and pretreatment psychosocial characteristics. However, the therapists prescribed more sessions and more socially focused interventions when clients were Sami. Verbal therapy was more often used by the non-Sami therapists. Alliance ratings were positively correlated only between Sami therapists and their clients, and Sami therapists rated the largest initial clinical improvement. Clinics located in the high Sami density areas offered their clients more therapy sessions, than in clinics in the high non-Sami density areas. Ethnic similarity between client and therapist were associated with more frequent use of medication and less frequent use of verbal therapy.

Ethnic discrimination and psychological distress: A study of Sami and non-Sami populations in Norway

“…This is mainly because the Sami are officially considered and registered as Norwegian citizens, making it difficult to produce data on them as a distinct population. The few studies to date have not found differential levels of mental health among Sami adolescents or adults compared to their counterparts in the general population (Bals et al, 2010; Kvernmo, 2004; Møllersen, Sexton, & Holte, 2005). A previous study with the same sample as that in the present report found that Sami used less sleep medication that the general population, which may indicate less frequently occurring or less severe psychological ailments in Sami populations (Bakken, Melhus, & Lund, 2006).…”

The confidence in health care and social services in northern Sweden – a comparison between reindeer-herding Sami and the non-Sami majority population

“…In the same geographical setting it has been indicated that mental health and mental health services vary with ethnicity. Therapists prescribe more therapy sessions and more socially focused interventions when patients are Sami, and ethnic matching between patient and therapist indicated increased therapeutic success rate [17,18].…”

Effects of client and therapist ethnicity and ethnic matching: A prospective naturalistic study of outpatient mental health treatment in Northern Norway

“…The minor differences in our study between the Sami and the non-Sami client group would seem to indicate that client ethnicity has limited impact on treatment utilization and response to treatment in absence of social inequity between ethnic groups. Furthermore, a cultural awareness among the therapists may have shaped treatment to be more in correspondence to the clients' culture (10,29). If this is correct, the mental health services of Finnmark County have succeeded in developing services that are culturally responsive.…”

“…Social dysfunction was addressed with three questions addressing social functioning in public situations, with friends and family, and at work (29). These were recorded on a 5-point scale and taken together formed a measure of global social dysfunction (Cronbach's alpha 00.68).…”