Consumer-Driven Standards and Guidelines in Managed Mental Health for Populations of African Descent

Preamble

The accurate diagnosis, prevention, or efficacious treatment of mental illness in any population requires in-depth and unbiased knowledge of the individual’s culture in conjunction with knowledge about the illness presented. Clinical intervention methods, models, or skills that are not based in cultural competency fail to reflect what is known about the relationship between culture, mental illness, help seeking, recovery, and social policy. Culturally incompetent clinical services are unacceptable, unethical, and prima facie evidence of mal-practice and educational deficit. To ensure cultural competency, professional schools in universities and colleges must include content on culture and specific competencies and skills in their pre-service curriculum and continuing education programs. Professional associations and licensing organizations must include culturally competent standards and guidelines in their expectations for accreditation, membership, and credentialing.

Historically, mental health policies, systems, plans, and providers lacked an understanding or appreciation of the role of culture or race in mental health, mental illness, and clinical care. The development of managed care has illustrated the extent to which effective services is contingent on cultural competency. Meeting the needs of consumers of African descent, who have a mental illness, requires managed care plans to include cultural competency in the design, delivery, and evaluation of services and outcomes. Without cultural competency, access to mental health care for consumers of African descent will be limited; costs will outweigh profits; quality will be lacking; and poor outcomes will stimulate demand for additional services.

The unparalleled rise in the cost of health and mental health care in the American economy provides an opportunity for health care plans, policy makers, and providers to recognize cultural competency as a means of insuring access, quality, cost efficiency, and relevant outcomes. The standards and guidelines that are included in this report are designed to assist health care plans, policy makers, and providers in their efforts to design, finance, and deliver effective services to consumers of African descent who have mental illness.

In an effort to develop guidelines that are useful for clinical work with consumers of African descent, it is worth noting that this is a heterogenous population, whose individual qualities, characteristics and choices should not be eliminated in the quest to develop generic standards for managed care. Consumers must maintain their rights to determine when to seek care, from whom, in what combination or setting, and the extent to which their families, community, or church is involved in their care.