Who is this guidance for?
This guidance is intended for professionals working in the social and healthcare sectors.
Why was this guidance created?
The purpose of this guidance is to support professionals in encounters with clients from diverse backgrounds in a holistic way that promotes mental health. This includes the prevention of mental health disorders, the treatment of existing conditions, and the strengthening of overall mental wellbeing. The guidance also helps ensure that services are delivered equally to everyone.
Several Finnish laws require that services be provided equally:
- The Health Care Act and the Social Welfare Act require that services be offered equally, and that clients’ needs are assessed comprehensively.
- The Constitution of Finland and the Non-Discrimination Act oblige authorities to promote equality and prohibit discrimination based on language, religion, origin or culture.
- The Sámi Language Act safeguards the right of Sámi people to use their own language in dealings with authorities and services within the Sámi homeland.
- The Act on the Reception of Persons Applying for International Protection ensures essential subsistence and care for asylum seekers and victims of human trafficking.
- The Health Care Act also requires that urgent care be provided to everyone residing in Finland, regardless of residence permit status (including undocumented persons).
All persons living in a Finnish municipality, as well as all children and pregnant individuals, have the right to the same social and health services. Asylum seekers and undocumented people have more limited rights: asylum seekers are entitled to urgent and necessary care, and undocumented persons to urgent care. The need for care is assessed by a healthcare professional.
Cultural diversity in Finland
Each of us belongs to various cultures that position us within majority or minority groups. Finland’s population has always been culturally diverse. There are several ethnic, cultural, linguistic and religious minorities, such as the Indigenous Sámi people, Finland Swedish communities, the Roma, Ingrian Finns, Karelians, Jews and Tatars, as well as groups who have moved to Finland more recently and their descendants.
For some population groups, mental health challenges may be more pronounced or involve specific characteristics or needs. Mental wellbeing can be affected by life circumstances, such as migration or being a refugee, as well as wider societal factors, including racism or legislation. In addition, minority stress, stigma related to mental health conditions, limited trust in services, or low awareness of available support may act as barriers to accessing services.
How to promote mental wellbeing in client work
As with any client, the most important principle when working with clients who belong to minority groups is to meet the person as an individual rather than as a representative of a group. In your encounters, pay particular attention to the following:
Many minority groups have experienced discrimination or a lack of trust within services. This makes trust-building especially important.
- Approach the client without assumptions about their culture or background, and ask what matters to them. A person’s background may influence their expectations and values.
- Inform the client clearly and in good time about any changes and follow through on agreed actions. This is particularly important for clients who may have had negative experiences with authorities in the past.
- Gently correct misunderstandings. Honesty strengthens trust and provides a reparative experience.
Perceptions of mental health vary between population groups. It is important for professionals to provide information about mental wellbeing and the factors that influence it. This is often referred to as psychoeducation.
Explain phenomena related to both mental health conditions and mental wellbeing in a clear and concrete way. Ask the client about their preferences and what kind of support they hope for.
- Remind them that it is normal for both the mind and body to react to difficult experiences, and that anyone could respond similarly in the same situation. Emphasise that symptoms can be treated.
- Acknowledge that not all difficult situations can be solved. Show understanding for example by saying “I’m sorry” or “What has been done to you is wrong.”
Racist discrimination increases mental health burdens, heightens the risk of marginalisation, and undermines trust. Anti racism means taking active and conscious steps to counter all forms of racism. In social and healthcare services, an anti racist approach helps ensure that every client feels they are in the right place, safe, and valued as themselves.
- All of us have pre existing assumptions about other people. Aim to recognise these within yourself and be open to ways of thinking or acting that differ from your own, without judgement.
- Ensure that your approach is not merely neutral but actively anti racist and intentionally directed at addressing discriminatory structures.
- Identify and address racism in all its forms. Racism may appear as direct discrimination, subtle attitudes, or invisible structural barriers.
Many minority groups have experienced a higher-than-average accumulation of insecurity and traumatic events. A culturally sensitive and trauma informed approach helps create an environment where the client feels understood, respected, and safe.
- Cultural sensitivity: respectful interaction allows both the professional and the client to express their cultural background and feel accepted and heard. Avoid stereotypical assumptions about culture, religion, background or behaviour, while remaining genuinely interested and respectful.
- Trauma informed practice: recognise the impact of trauma and ensure that every interaction strengthens the client’s sense of safety. Listen with empathy, avoid actions that could re traumatise, and reinforce the client’s sense of control.
- When a shared language is not available, non verbal communication becomes increasingly important. Pay attention to eye contact, posture, gestures, facial expressions, tone and rhythm of voice, as these strongly influence the client’s sense of safety.
For professionals, it can be challenging to recognise and assess mental health symptoms in people from different backgrounds, as culture influences how problems are expressed and presented.
- Aim to understand the client’s own experiences of their symptoms or difficulties. Showing interest in the client’s interpretation helps identify challenges more accurately and strengthens their sense of being heard.
- Evaluate the suitability of screening tools and assessments on a case by case basis and use a multi method, flexible approach. For example, a client’s educational background or literacy skills may influence which method is most appropriate. Do not avoid assessment simply because the client’s background differs from the majority.
- Explain your findings clearly and allow sufficient time. Adjust your communication, for example by using plain language, and ensure that you both understand one another.
- For many clients, public services and the service system may be unfamiliar, meaning they may need more guidance and support to navigate services and avoid gaps in service provision. Expectations about what services typically include can also vary, highlighting the importance of flexibility in the forms of support offered.
- Support needs are often more comprehensive and require a multi professional approach. Ask the client about their views and preferences regarding the goals and methods of care or support. As a professional, remain open minded and flexible.
- Ensure that the client understands what will happen next and knows what to expect. Explain your actions and the reasons for referrals clearly and transparently.
- Make sure the client actually reaches the next service. For example, you can book an appointment together or help complete necessary forms. Be prepared to offer flexible, hands on support.
Taking cultural diversity into account in services
Ensuring equality and accessibility in service structures is essential so that no one is excluded, and services genuinely meet the needs of different people.
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Make use of multi professional cooperation
Clients’ situations and backgrounds vary greatly, making multi professional collaboration particularly important. Working together allows professionals to more fully identify individual needs and refer clients to the most appropriate services.
- Seek advice from other professionals with a low threshold, for example within your own organisation, region or field.
- Ensure that essential information about the client’s situation is passed on to the next professional involved.
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Ensure accessibility of services and the use of interpreting services
In social and healthcare services, information must be communicated in an accessible way, and interpreting must be provided whenever the client and professional do not share a common language.
- Ensure that information about services and rights is easy to find. Translate written guidance and materials into plain language and, where possible, into minority languages. Use visual support materials and ensure diversity is represented in illustrations.
- Whenever services, processes or practices are being developed, check that cultural diversity has been considered. Also ask clients how well services meet their needs, otherwise services may unintentionally cater mainly to the majority population.
- Familiarise yourself with working through interpreters and with your organisation’s interpretation practices. Always book a professional interpreter when there is no shared language with the client and avoid using family members as interpreters.
- Where possible, make use of cultural interpreters, who can provide cultural context in addition to linguistic support and help prevent misunderstandings or clarify nuances.
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Take care of your own wellbeing
Clients may have extremely distressing life experiences, such as torture or cumulative losses caused by war. These experiences can increase the risk of compassion fatigue or secondary trauma for professionals.
- Look after your own wellbeing by taking care of yourself.
- Monitor and recognise warning signs such as sleep difficulties, irritability, numbness, cynicism or intense anxiety. Seek support when needed.
- Make use of supervision and peer support whenever possible.
Remember as a professional
You do not need to know every culture or understand all of their specific characteristics. What matters most is maintaining an open mind toward ways of thinking and acting that differ from your own, and showing appreciation for these differences. In every interaction, there is an opportunity to support mental wellbeing.