Finally, there is also systematic review evidence from LMICs that Honoring Indigenous peoples through education supports (mostly cross‐sectional, but extending to longitudinal) associations between poverty and depression in adulthood42. Birth cohort evidence from the UK also suggests that children growing up or transitioning into poverty are more likely to experience mental health problems by age 11, independent of maternal mental health63. Higher levels of wealth and income enable access to key determinants of positive mental health, including adequate and safe housing55, sufficient food security54, and effective health care. Strong socioeconomic gradients have been observed for an array of mental health outcomes in HIC45 and LMIC settings42.

How do cultural beliefs influence mental health and illness?

This piece truly underscores the power of centering culture in mental health care while also reminding us that healing is holistic, communal, and rooted in the wisdom of our ancestors. The ongoing discussion on transcultural psychiatry, integrating biomedical and traditional practices and specialised clinical formulations, can improve mental health service delivery in a global society. The published studies selected were based on inclusion and exclusion criteria surrounding cultural competency in clinical practice in the context of global mental health. The challenges in providing mental healthcare in an ethnically diverse society exist within the limited frameworks of psychopathologies.

Community Developed Resources

Hence, we drew upon the ecological validity model to anchor our focus on cultural adaptations, while also referencing the FRAME adaptation categories to further inform our approach to coding adaptations. In contrast, although the IS FRAME includes a category for cultural adaptations, it does not denote specific types of cultural adaptations, which limits the scope for understanding the details of these modifications. Additionally, this model was developed to guide EBT adaptation for minoritized groups, and was first conceptualized for Latine populations, making it particularly relevant for the focus of this review. To this latter end, implementation science (IS) and cultural adaptation models are important to consider given that EBTs rarely fit perfectly within real-world implementation contexts and that cultural adaptation is common in intervention delivery 15, 20, 25, 72. While they may often not have specialized degrees in healthcare, CHWs have a wealth of localized knowledge and lived experiences specific to their community’s needs, giving them unique insight into how best to respond.

While cultural metrics such as Hofstede’s dimensions (Hofstede et al., 2010) or Gelfand’s tightness-looseness (Gelfand et al., 2021) can describe broad cultural tendencies, applying these frameworks to intervention design requires further empirical work. First, the analogy should not overshadow structural and resource determinants, such as infrastructure, workforce capacity, and policy environments, which also shape whether interventions succeed (Bulthuis et al., 2020). Both upward and downward movements can alter the overall airflow in which interventions operate. Political change can also generate powerful cultural shifts, as seen in societies that have undergone independence or regime transformation, where new policies, freedoms, and national identities redirect the prevailing cultural wind. Interventions aligned with today’s cultural wind may therefore need re-orientation in the future.

Such has been the transformation that promoting mental health and well‐being is now identified as a specific outcome in the United Nations (UN) Sustainable Development Goals12, alongside targets to tackle various social determinants of health – including poverty, inequality, gender equality, and social justice – by 2030. First, unprecedented increases in public awareness and advocacy about mental health, well‐being and illness, albeit concentrated in the Global North, have raised political pressure on institutions and governments to act to address the global burden of psychiatric morbidity2. There is now compelling evidence that the risk of developing any mental health condition is inextricably linked to our life circumstances2, meaning that a higher burden of population‐level psychiatric morbidity is disproportionately experienced by those closer to the margins of our societies. Social determinants of health represent the most modifiable set of targets for intervention currently available to prevent the onset of mental health problems and disorders, and to promote positive mental health in our populations. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health.

• Some traditions, such as those around gender roles or marriage, may be harmful to mental health.
• We strengthen the cultural responsiveness and inclusivity of Australia’s mental health and suicide prevention services.
• The Culture as Wind analogy serves this function by offering a simple yet powerful visualisation of cultural alignment.

Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review

This discouragement can lead to lower engagement with treatment options and worse health outcomes. Using culturally appropriate assessment tools, such as the Multigroup Ethnic Identity measure, can facilitate a strengths-based approach in treatment. Studies indicate that heightened exposure to discrimination and racism can exacerbate mental health conditions, resulting in increased prevalence rates of issues like anxiety, depression, and PTSD among these populations.

Ethnic community members should be key actors in formulating MH interventions to ensure cultural compatibility and enhance utilisation. Also, studies included in this review were those conducted from 2010 to 2020, which can be a limitation. The qualitative study allows for an in-depth understanding of the experiences of ethnic minority groups on MH service utilisation. The MH service should be tailored and delivered to avoid stigma to the end-users of patients.