Cultural safety

Jessica Ball, School of Child and Youth Care, University of Victoria, Canada

Project background

Talk of cultural safety conjures the possibility that some people who seek help from service agencies have been disregarded, challenged, or harmed as a result of their encounters with health care providers and services on the basis of their social and cultural location. Unlike the linked concepts of cultural sensitivity or cultural competence, which may contribute to a service recipient's experiences, cultural safety is an outcome. Regardless of how culturally sensitive, attuned or informed we think we have been as a service professional or investigator, the concept of cultural safety asks: How safe did the service recipient experience an encounter in terms of being respected and assisted in having their cultural location, values, and preferences taken into account?

Many people who have been minoritized (e.g., Indigenous, small ethnolinguistic and religious groups) have experienced their cultural identity, beliefs, and lifestyles denigrated by service practitioners who are part of dominant cultural, linguistic, or religious groups. These practitioners might include doctors, nurses, teachers, social workers, or clergy.

A more subtle example of cultural 'un-safety' can occur when a person is asked to present oneself for a service (e.g., traveling to a hospital in a nearby town, meeting a school principal) or to participate in a program of care (e.g., entering a substance use treatment program, moving to a long-term care facility). For many people, this entails crossing cultural borders, to the foreign culture of a mainstream institution, or to a social group composed of people from cultures other than one's own. The sense of risk in cross-cultural encounters, especially when one is part of a culture that has long been the object of social injustice, can be mitigated by being accompanied by an advocate, navigator, or case worker. This support can provide cultural orientation and mediation both for the service recipient and for the service practitioner.

Indicators of cultural un-safety

  • Low utilization of available services
  • 'Denial' of suggestions that there is a problem
  • 'Non-compliance' with referrals or prescribed interventions
  • Reticence in interactions with practitioners
  • Anger
  • Low self-worth
  • Complaints about lack of 'cultural appropriateness' of tools and interventions transported from dominant culture to minority culture
Projects undertaken in the Early Childhood Development Intercultural Partnerships Program have led to guidelines to increase experiences of cultural safety.

Five principles to engender cultural safety

1. Protocols

Find out about cultural forms of engagement and respect these.

2. Personal knowledge

Become mindful of one's own cultural identity, socio-historical location in relation to service recipients, commitments to certain beliefs and ways of conceptualizing things like health, wellness, and optimal child development. Be prepared to share information about oneself if this will help to create equity and trust.

3. Partnerships

Promote collaborative practice in which those seeking help are also welcomed into a joint problem-solving approach as carriers of important information and know-how.

4. Process

Engage in mutual learning, frequent checking in to ensure that proposed action plans 'fit' with service recipient's values, preferences, and lifestyles.

5. Positive purpose

Ensure that there is a good probability that positive steps to achieve a service recipient's goals (or resolve problems) can be taken and that these are likely to be beneficial. Make it matter.


View all reports and resources related to this project.