Cultural and Linguistic Competencies: Mental Health

MENTAL HEALTH
The mental health field has taken the lead in making valuable contributions to the cultural and linguistic competency literature on the development of standards for culturally competent practices. The most frequently cited work is a two-volume monograph by Cross, et al. that outlines a philosophical framework for developing and implementing a mental health service delivery system that provides culturally competent care. The resources below highlight the current literature on evaluation needs in the area of mental health and step-by-step guides to the provision of care.

Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Services Research [serial online]. 2007;7(15):1-10. Available at: http://www.biomedcentral.com/content/pdf/1472-6963-7-15.pdf. Accessed May 18, 2007.

This article is a systematic review of evaluated models of culturally competent practice and service delivery in mental health. Very few studies were found to include an evaluation component and none included evaluation of client satisfaction. The authors recommend that future studies evaluate the effectiveness of cultural competency training and culturally competent service delivery.
The Colorado Trust. Keys to cultural competency: a literature review for evaluators of recent immigrant and refugee service programs in Colorado. Denver, CO: The Colorado Trust; 2002. Available at: thecoloradotrust.org/. Accessed May 20, 2007.

This report provides an overview of immigrant and refugee groups from Bosnia-Herzegovina, Central America, Kurdistan, Laos, Mexico, Somalia, Sudan, the former Soviet Union and Vietnam. For each group, the report briefly describes the following: history, entry status, social networks, intergenerational and gender conflict, social identification, at-risk youth, education, employment and stress experiences (e.g., war trauma). The report also discusses challenges for evaluators and provides recommendations for how best to work with immigrant and refugee populations when conducting evaluations.
Hogg Foundation for Mental Health. Cultural competency: a practical guide for mental health service providers. Saldaña D, ed. Texas: Hogg Foundation for Mental Health; 2001. Available at: http://www.hogg.utexas.edu/PDF/Saldana.pdf. Accessed May 18, 2007.

This guide offers a wide variety of concrete strategies to improve the cultural competency of mental health service provision. Examples of strategies include: building rapport, conducting culturally sensitive assessments, evaluating culturally-related syndromes, addressing interpreter challenges and ensuring confidentiality.
Working Group on Cultural Competence in Managed Mental Health Care. Cultural competence standards in managed mental health care for four underserved/underrepresented racial/ethnic groups. Rockville, MD: Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration, Department of Health and Human Services; 1998. Available at: http://www.wiche.edu/MentalHealth/Cultural_Comp/ccstoc.htm. Accessed December 27, 2005.

This document was developed as a result of the separate and joint work of four national panels to develop cultural competency standards in mental health services for four racial or ethnic groups (i.e., African Americans, Latinos, Native Americans, and Alaskan Natives and Asian and Pacific Islander Americans). Each panel reviewed the literature on mental health research and services pertaining to their particular racial or ethnic group and developed a set of 16 guiding principles for providing mental health care to that population. The panels also developed standards for eight aspects of health care systems and nine aspects of clinical care. Standards developed for providers included: 1) knowledge and understanding of patient populations’ backgrounds, clinical issues for different ethnic groups and sub-groups, how to provide appropriate treatment, and agency and provider roles and 2) the knowledge and skills to communicate effectively across cultures, provide quality assessments, formulate and implement quality care and treatment plans, provide quality treatment and demonstrate respectful attitudes.
? Cross TL, Bazron BJ, Dennis KW, Isaacs MR. Towards a culturally competent system of care: a monograph on effective services for minority children who are severely emotionally disturbed. Washington, DC: National Institute of Mental Health, Child and Adolescent Service System Program Technical Assistance Center, Georgetown University Child Development Center; 1989. Available at: http://www.eric.ed.gov. Accessed August 14, 2007.

This frequently cited two-volume monograph outlines a philosophical framework for developing and implementing a service delivery system that provides culturally competent care. The authors outline the cultural competency continuum; identify principles; and offer practical ideas for improving service delivery at policy, administrative and clinical levels to children of color who are severely emotionally disturbed.

Viccora E. Creating culturally competent mental health systems for Latinos: perspectives from an expert panel. National Technical Assistance Center for Mental Health Training; 2001. Available at: http://www.consumerstar.org. Accessed December 20, 2005.

This report is one in a series created to provide basic information and guidelines to mental health agencies regarding the needs of racial and ethnic minorities. The report describes the mental health needs of Latinos, their relevant cultural characteristics and traditions, their perceptions of mental illness and their preferences for services and supports. The report also describes successful mental health agencies that have tailored their services to meet the needs of Latino consumers.

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