Mental Health’s Address to the Challenging Cultural Reality of Malta

  • Michael Galea Department of Mental Health, Faculty of Health Sciences, University of Malta, Malta
  • Frankline Zammit Galea University of Malta, Malta
Keywords: culture, cultural diversity, multiculturalism, mental health, holistic wellbeing


Appreciation of society as being the whole made up of so many different parts in terms of groups with various interests, skills and needs is what cultural diversity is about. Culture is defined as the distinctive customs, values, beliefs, knowledge, art and language of a society.

Multiculturalism has always been embedded with the Maltese reality. However, a steep increase in the country’s population since 2011 may be presenting new realities that can translate into hefty and challenging demands. This review therefore presents the following research-based evidence on how mental health can address this phenomenon, particularly in the case of Malta and similar small countries. In particular, the following aspects were highlighted, namely: cultural safety, holistic health services, multicultural awareness, sensitive lingual expression, community integrity and cultural partnership. Practical recommendations are presented.


Andrade, S. (2017). Cultural Influences on Mental Health. The Public Health Advocate. Retrieved from
APA Dictionary of Psychology. (2023). Retrieved from
APA. (2013). Diagnostic and statistical manual of mental disorders. 5th edn. Washington, DC: American Psychiatric Association. Retrieved from
Aubarell, G. (2022). Intercultural Trends and Social Change in the Euro-Mediterranean Region. Retrieved from
Azzopardi, K. (2019). Malta with the largest population increase in the EU. The Malta Today. Retrieved from
Bartolo, E. (2022). Learning to live together. The Times of Malta. Retrieved from
Bhugra, D., Warson, C., & Wijesuriya, R. (2021). Culture and mental illnesses. International Review of Psychiatry, 33, 1-2.
Boksa, P., Joober, R., & Kirmayer, L. J. (2015). Mental wellness in Canada's aboriginal communities: Striving toward reconciliation. J Psychiatry Neurosci. 40:363–5.
Debono, J. (2012). The Maltese: I’m not Racist, but … In Malta Today, 5 July 2012. Retrieved from
Doublesin, M. G. (2013). The Impact of Multicultural exposure on Maltese society in the late 20th and early 21st century and its challenge for counselors: A Narrative Ethnographic Approach. University of Malta. Unpublished dissertation. Retrieved from
Canadian Mental Health Association. (2022). Cross-cultural Mental Health. Retrieved from
FECCA. (2011). Mental Health and Australia's Culturally and Linguistically Diverse Communities: A Submission to the Senate Standing Committee on Community Affairs. Canberra.
Goodwin, J. L., Williams, A., & Herzog, P. S. (2020). Cross-cultural Values: A Meta-analysis of Major Quantitative Studies in the Last Decade (2010-2020). Religions, 11(8), 396.
Gopalkrishnan, N. (2018). Cultural Diversity and Mental Health: Considerations for Policy and Practice. Front Public Health, 6, 179.
Haley, M., & Combs, D. C. (2010). Creating a Culturally Sensitive Environment for Second Language Learners in Counselor Education Programs. American Counseling Association. Retrieved from
Hall, S. (2000). Conclusion: The multicultural question. In Un/settled multiculturalism, Edited by: Hesse, B. London: Zed Books.
Hechanova, R., & Waelde, L. (2017). The influence of culture on disaster mental health and psychosocial support interventions in Southeast Asia. Mental Health Religion Cult., 20, 31-44.
Held, D., & McGrew, A. (2007). Globalization/Anti-Globalization. Cambridge: Polity Press.
Helman, C. G. (2007). Culture, Health and Illness, 5 Edn. London: Hodder Arnold.
Isaacs, A. N., Pyett, P., Oakley-Browne, M. A., Gruis, H., & Waples-Crowe, P. (2010). Barriers and facilitators to the utilization of adult mental health services by Australia's Indigenous people: Seeking a way forward. Int J Mental Health Nurs, 19, 75-82.
Kirmayer, L. (2018). Cultural Psychiatry in historical perspective. In D. Bhugra and K. Bhui (eds), Textbook of Cultural psychiatry (pp 1-17). Cambridge University Press. [Google Scholar]
Kirmayer, L. J., Guzder, J., & Rousseau, D. (2014). Cultural consultation. Encountering the Other in Mental Health Care. Springer Link.
Marsella, A. J. (2011). Twelve critical issues for mental health professionals working with ethno-culturally diverse populations. Psychol Int., 22, 7-10.
Melluish, S. (2014). Globalization, culture and psychology. Int Rev Psychiatry. 26, 538-543.
Mental Health First Aid. (2022). Retrieved from
Minbaeva, D., Fitzsimmons, S., & Brewster, C. (2021). Beyond the double-edged sword of cultural diversity in teams: Progress, critique, and next steps. J. Int. Bus. Stud., 52(1), 45-55.
Sant, A. (2023). Problem with multiculturalism. Facebook post (20.01.2023).
The Malta Independent. (2022). Census. Retrieved from
Tribe R. (2005). The mental health needs of refugees and asylum seekers. Mental Health Rev., 10, 8-15.
Trump, D. (2002). Megalithic Architecture in Malta. 13. 128-140. Retrieved from
USDHHS. (2001). Mental Health: Culture, Race, and Ethnicity: A supplement to mental health: A report of the Surgeon General. Rockville: US Department of Health and Human Services, 2001.
Xuereb, K. (2009). European Cultural Policy and Migration: Why Should Cultural Policy in the EU address the Impact of Migration on Identity and Social Integration? International Migration, 49(2), 28-53.
Zammit, J. (2021). Maltese as a Foreign Language Educator’s Acquisition of Intercultural Capabilities. Research Square.