A Netnographic Critique of Cultural Appropriation versus Cultural Competence in Digital Mental Health Ethnic Communities
DOI:
https://doi.org/10.62255/ijen.v2i1.250Abstract
Background: Digital mental health campaigns increasingly incorporate local cultural symbols to improve engagement among ethnically diverse populations. However, whether these adaptations represent genuine cultural responsiveness or merely superficial branding remains unclear, particularly within Indonesia's multicultural context. This study explored how ethnic and indigenous communities interpret, contest, and reclaim the cultural authenticity of institutional digital mental health advocacy.
Methods: A qualitative netnographic study was conducted through 24 weeks of non-participant observation across Indonesian- and Malay-language digital ecosystems, including institutional social media platforms, community-led discussion forums, and professional nursing and psychiatric networks. Public discussion threads were purposively sampled and analysed using reflexive thematic analysis to identify recurring patterns of community interpretation.
Results: Four interrelated themes emerged: (1) tokenistic aesthetic inclusion, (2) decontextualisation of sacred healing practices, (3) community reclamation through counter-narrative production, and (4) a discursive transition from cultural competence toward cultural justice. Participants overwhelmingly perceived institutional campaigns as relying on symbolic cultural representation rather than meaningful collaboration, criticising the use of indigenous knowledge and cultural symbols without shared decision-making or reciprocal community benefit.
Conclusion: Superficial visual and linguistic localisation alone does not meet communities' expectations of culturally safe digital mental health advocacy. The findings suggest that psychiatric nursing and digital health communication should move beyond conventional cultural competence frameworks toward culturally just approaches that prioritise community co-design, shared governance, equitable benefit-sharing, and recognition of indigenous epistemic authority in the development of digital mental health campaigns.
Keywords:
Health Communication, Psychiatric Nursing, Community-Based Participatory Research, Social Media, Mental Health, Cultural CompetencyReferences
Abbass-Dick, J. et al. (2018) “Designing an eHealth Breastfeeding Resource With Indigenous Families Using a Participatory Design.,” Journal of transcultural nursing?: official journal of the Transcultural Nursing Society, 29(5), pp. 480–488. Available at: https://doi.org/10.1177/1043659617731818.
Agudelo-Hernandez, F., Plata-Casas, L.I. and Gonzalez-Abril, K. (2025) “‘The Territory Has Its Ways of Warning Us’: Cultural Practices and Belief Systems of Two Indigenous Peoples in Colombia and Their Role in Public Mental Health.,” Culture, medicine and psychiatry, 49(4), pp. 1205–1225. Available at: https://doi.org/10.1007/s11013-025-09936-1.
Barker, B., Goodman, A. and DeBeck, K. (2017) “Reclaiming Indigenous identities: Culture as strength against suicide among Indigenous youth in Canada.,” Canadian journal of public health = Revue canadienne de sante publique, 108(2), pp. e208–e210. Available at: https://doi.org/10.17269/cjph.108.5754.
Van Bewer, V. (2023) “Trauma and survivance: The impacts of the COVID-19 pandemic on Indigenous nursing students.,” Nursing inquiry, 30(1), p. e12514. Available at: https://doi.org/10.1111/nin.12514.
Braybrook, C. et al. (2026) “Cultural Competency and Implicit Bias: Decreasing Barriers to Native American and First Nation Mental Health Care.,” The Nursing clinics of North America, 61(1), pp. 167–177. Available at: https://doi.org/10.1016/j.cnur.2025.09.006.
Chigangaidze, K.A.N. (2025) “Stigma, Silence, and the Nurse’s Voice: Reshaping Dementia Care in Zimbabwe.,” SAGE open nursing, 11, p. 23779608251407384. Available at: https://doi.org/10.1177/23779608251407384.
Donovan, R.J. et al. (2024) “Impact on stakeholders of a cultural adaptation of a social and emotional well-being intervention in an Aboriginal community.,” Health promotion journal of Australia?: official journal of Australian Association of Health Promotion Professionals, 35(1), pp. 134–143. Available at: https://doi.org/10.1002/hpja.723.
Foyet, M. and Child, B. (2024) “COVID-19, social media, algorithms and the rise of indigenous movements in Southern Africa: perspectives from activists, audiences and policymakers.,” Frontiers in sociology, 9, p. 1433998. Available at: https://doi.org/10.3389/fsoc.2024.1433998.
Kirmayer, L.J. and Jarvis, G.E. (2019) “Culturally Responsive Services as a Path to Equity in Mental Healthcare.,” HealthcarePapers, 18(2), pp. 11–23. Available at: https://doi.org/10.12927/hcpap.2019.25925.
Liu, M. et al. (2025) “Culturally Responsive Community Mental Health: Successes and Lessons from a Community Mental Health Organization.,” Journal of health communication, pp. 1–10. Available at: https://doi.org/10.1080/10810730.2025.2592153.
Lovely, J.J. et al. (2026) “Evidence in practice: implementing KAT in indigenous health services.,” Frontiers in psychiatry, 17, p. 1722573. Available at: https://doi.org/10.3389/fpsyt.2026.1722573.
Matsuoka, S. (2023) “Development of a Culturally Sensitive Recovery-Oriented Nursing Care Model in Community Psychiatric Nursing.,” Journal of psychosocial nursing and mental health services, 61(8), pp. 25–33. Available at: https://doi.org/10.3928/02793695-20221202-01.
Memchout, S. (2026) “Decolonizing Mental Health in Algeria: Integrating Local Beliefs, Culture, and Islamic Principles for Culturally Responsive Care.,” Culture, medicine and psychiatry, 50(2). Available at: https://doi.org/10.1007/s11013-025-09960-1.
Mota, N.B. et al. (2022) “A Brazilian bottom-up strategy to address mental health in a diverse population over a large territorial area - an inspiration for the use of digital mental health.,” Psychiatry research, 311, p. 114477. Available at: https://doi.org/10.1016/j.psychres.2022.114477.
Ogunwale, A., Fadipe, B. and Bifarin, O. (2023) “Indigenous mental healthcare and human rights abuses in Nigeria: The role of cultural syntonicity and stigmatization.,” Frontiers in public health, 11, p. 1122396. Available at: https://doi.org/10.3389/fpubh.2023.1122396.
Ong, J.J., Bilardi, J.E. and Tucker, J.D. (2017) “Wisdom of the Crowds: Crowd-Based Development of a Logo for a Conference Using a Crowdsourcing Contest.,” Sexually transmitted diseases, 44(10), pp. 630–636. Available at: https://doi.org/10.1097/OLQ.0000000000000658.
Power, T. et al. (2024) “Indigenous students’ experiences of being taught indigenous health.,” Nurse education today, 143, p. 106364. Available at: https://doi.org/10.1016/j.nedt.2024.106364.
Reeves, A. et al. (2026) “Nii Kandis (Knowing Myself): Finding a Sacred Home at Anishnawbe Health Toronto Through Spirit-Based Healing.,” International journal of environmental research and public health, 23(3). Available at: https://doi.org/10.3390/ijerph23030405.
Rice, A.N. and Harris, S.C. (2021) “Issues of cultural competence in mental health care.,” Journal of the American Pharmacists Association?: JAPhA, 61(1), pp. e65–e68. Available at: https://doi.org/10.1016/j.japh.2020.10.015.
Schill, K. et al. (2019) “Everything Is Related and It All Leads Up to My Mental Well-Being: A Qualitative Study of the Determinants of Mental Wellness Amongst Urban Indigenous Elders.,” British journal of social work, 49(4), pp. 860–879. Available at: https://doi.org/10.1093/bjsw/bcz046.
Stepanova, E. et al. (2026) “Consensus on Culturally Competent Mental Health Services Recommendations: A Modified Delphi Consensus Study With Ethnic Minorities, Carers, Public Advisors and Health Professionals.,” Health expectations?: an international journal of public participation in health care and health policy, 29(1), p. e70567. Available at: https://doi.org/10.1111/hex.70567.
Thorburn, R. and Ansloos, J. (2026) “Community Is Medicine: Understanding Indigenous Youth-Led Peer Support in Mental Health and Suicide Prevention.,” Journal of prevention and health promotion, 7(2), pp. 290–321. Available at: https://doi.org/10.1177/26320770251359603.
Watts, J. et al. (2023) “Nursing the Nuu-chah-nulth Way: Communities Driving Nursing Policy Priorities.,” Nursing leadership (Toronto, Ont.), 35(4), pp. 55–67. Available at: https://doi.org/10.12927/cjnl.2023.27073.
Woods-Giscombe, C.L. et al. (2022) “Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses’ commitment to advance diversity and equity in mental health care.,” Archives of psychiatric nursing, 41, pp. 354–358. Available at: https://doi.org/10.1016/j.apnu.2022.08.006.
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