The Centrality of Culture in Primary Care Providers’ Approach to Behavioral Health Treatment: A Phenomenological Study

Primary care offers an ideal setting to address the effects of systemic racism that contribute to behavioral health disparities for patients who identify as Black, Indigenous, and People of Color (BIPOC). However, addressing barriers to equitable care requires understanding how culture may influence primary care physicians’ (PCPs’) approach to behavioral health. Using a phenomenological method with semi-structured interviews of six PCPs, we explored culture’s role in screening, diagnosing, and treating behavioral health conditions in BIPOC patients. Transcript coding and analysis revealed seven themes surrounding culture that influence PCPs’ approach to behavioral health. Findings showed that culture is multi-faceted; race is one of many in a network of factors that PCPs consider when collaborating with patients to make treatment decisions. Achieving equitable health for all persons will require understanding covert and overt factors at each level of the system that, if not accounted for, exacerbate the marginalization of BIPOC patients.