Cultural safety or cultural competence : how can we address inequities in culturally diverse groups?

Mental health nurses who uphold the principles of cultural safety have awareness of the beliefs, understandings and practices of diverse communities, and use this awareness to sup-port health consumers to achieve the best possible outcomes (Harada et al., 2021). Culturally safe mental health nurses are encouraged to consider how their cultural biases could impact mental health consumers; and develop ways to respect-fully engage with these consumers on their recovery journey (Health Quality & Safety Commission New Zealand, 2021). Practice that is culturally safe seeks to overcome the unequal power relations that are evident in health settings and perpetuate inequalities (Rheault et al., 2021; Richardson, 2021).While the principles of cultural safety are being advocated in health settings across the globe (Tremblay et al., 2020), close consideration of the reality of unequal power relations in health settings raises questions. For example, how able or equipped are culturally diverse mental health consumers who experience substantial disadvantage and disempowerment, to speak out and express their needs or preferences in health settings (Doyle & Doyle, 2021)?This column considers the notions of cultural safety and cultural competence in health settings, and advocates for deeper consideration of the concepts involved, particularly power inequity. The discussion focuses on the steps that can be taken by mental health nurses when supporting indigenous peoples and communities who continue to experience lower levels of mental health on all indices, worldwide (McKenna, 2020).