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This would impact and fracture behavioral health systems relied upon by People with HIV and vulnerable communities. This risks forcing People with HIV out of housing prematurely—destabilizing care and increasing transmission risks. Merging HOPWA (the Housing Opportunities for Persons With AIDS Program) with HUD’s Continuum of Care and capping services at two (2) years would slash $532 million from combined program budgets. The Administration’s FY26 budget proposal would dismantle core components of the nation’s HIV response and weaken public health infrastructure at home and abroad. These include canceling policies that supported LGBTQ+ rights, cutting off funding for programs that serve LGBTQ+ communities, and limiting access to gender-affirming care—especially for transgender youth and transgender individuals as a whole. Since taking office in January 2025, President Trump has taken a series of actions that remove or weaken health protections for LGBTQ+ people.

In doing so, treatment developers may design supports to assist CHWs in making cultural adaptations in ways that maintain treatment integrity and CHWs’ ability to rely on their lived expertise to inform treatment decisions. Relatedly, grey literature was not included, which may introduce bias toward published articles that describe statistically significant intervention outcomes. Hence, empirical evidence is necessary to inform and guide future CHW mental health intervention research.

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In contrast, person-centered definitions focused on customizing care for each individual. In our focus groups, participants assigned deviations from expected clinical norms for trust, eye contact, family structures, or therapeutic disclosure to racial or ethnic differences. Clinicians and administrators mentioned patient concerns around the clinician’s culture. The limits of patient enlistment appeared with respecting patient wishes. First, how important it is to have both things medications and psychotherapy in their treatment. Clinicians and administrators saw explanations from clinicians as opportunities for patient psychoeducation.

Cultural Competence in Mental Health Training Programs in USA

Eleven interventions (34%) attended to Latine-specific values, principles, and orientations (Table 1). Some interventions were also delivered in local churches, a context familiar to those who practiced religiosity/spirituality 27, 41, 64. This not only increased feasibility and ease of delivery for CHWs, but also represented a community space that was seen as more accessible to clients if they had an established connection with the organization. Moreover, community advisory boards or committees were used to bring these different perspectives together (e.g., 49, 54, 68).

All groups agreed that patients bring challenges to culturally competent care. Two patients and a single clinician—but no administrators—defined culturally competent care as fighting stigma. For inclusion, patients had to receive mental health services at the hospital, provide written informed consent after an explanation of study procedures, and self-identify as a racial or ethnic minority. No published study has examined AAFP Mental Health Month Resources patient perspectives on clinician cultural competence in mental health or compared perspectives across stakeholders. These disparities highlight long-standing inequities and underscore the need for strong, community-based solutions that ensure timely, culturally responsive mental health services for all young people.

• Other study types included controlled before and after studies 53–60, historically controlled studies 61–63, cross-sectional studies 64–67, cohort studies 68, 69 and incidence studies 70, 71.
• CHWs, who often share these cultural reference points, may draw on generational knowledge, historical narratives, and shifting sociopolitical realities in ways that enrich their work.
• In a meta-analysis, Smith et al. (2006) found that multicultural education—when based in theory and research—was effective in increasing self-reported CC among mental health professionals, though effect sizes were small.
• Focus Group Interview Protocol The protocol that we developed included five main questions.
• To deliver individualized, patient-centered care, a provider must consider patients’ diversity of lifestyles, experience, and perspectives to collaborate in joint decision making.