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

Guiding Principles

 

1. Principle of Advocacy & Participation:

Mental illness does not preclude the participation of consumers of African descent and their families from (1) designing managed care services that fit their culture, (2) participating in the development of policies to guide managed care systems, and (3) providing feedback on the quality of services they receive. Consumers of African descent and their families are enhanced by the opportunity to advocate in behalf of their needs. Where advocacy opportunities are either denied or viewed as negative by managed care systems, the health status of consumers of African descent and their families is at risk.

 

2. Principle of Collaboration & Empowerment:

Consumers of African descent and their families have the capacity to collaborate with managed care systems and providers in determining the course of treatment. The greater the extent of this collaboration the better the chances are that recovery and long term functioning will occur and be sustained. The risk of psychological dependency and lower functioning increases with a decrease in collaboration by consumers and families. Empowering consumers and families enhances their self-esteem and ability to manage their own health.

 

3. Principle of Holism:

Consumers of African descent are more likely to respond to managed care systems, organizations, and providers who recognize the value of holistic approaches to health care and implement these in their clinical work, policies, and standards. Where holistic approaches are absent, there is greater risk that consumers of African descent will over-utilize mental health services resulting in increased costs.

 

4. Principle of Feedback:

Managed care systems, organizations, and providers can improve the quality of their services and enhance desired outcomes of their service delivery to consumers of African descent where there are legitimate opportunities for feedback and exchange. Where such opportunities for feedback are absent, there is a greater likelihood that the system of managed care services and policies will not be congruent with the needs of consumers of African descent and will not result in high levels of consumer satisfaction. Managed care systems that lack opportunities for this feedback limit their chances of making culturally specific corrections in their approaches to services while simultaneously increasing their risks.

 

5. Principle of Access:

In order for consumers of African descent to seek, utilize, and gain from mental health care in a managed health plan, services, facilities, and providers must be accessible. Where services and facilities are geographically, psychologically, and culturally accessible, the chances that consumers of African descent will respond positively to treatment for mental illness are increased. Inadequate access to services result in increased costs, limited benefit to the consumer, and a greater probability that services will not result in the outcomes desired.

 

6. Principle of Universal Coverage:

Populations of African descent have higher than average frequencies of unemployment and receipt of transfer payments, but lower disposable income. Where health care coverage, benefits, and access are based on employment or ability to pay, consumers of African descent are more likely to be medically under-served. The greater the extent to which health care is universally available without regard to income, the greater the likelihood that the health status of consumers of African descent will be enhanced.

 

7. Principle of Cultural Competency:

Recovery and rehabilitation are more likely to occur where managed care systems, services, and providers have and utilize knowledge and skills that are culturally competent and compatible with the backgrounds of consumers of African descent their families, and communities.

 

8. Principle of Integration:

Consumers of African descent have higher than expected frequencies of physical health problems. Integrating primary care medicine, mental health, and substance abuse services in a managed care plan increases the potential that consumers of African descent will receive comprehensive treatment services and recover more rapidly, with fewer disruptions due to a fragmented system of care.

 

9. Principle of Quality:

The more emphasis that is placed in managed care systems on ensuring continuous quality culturally competent service to consumers of African descent, the greater the likelihood that illness will be prevented; sickness treated appropriately and costs lowered. The less emphasis placed on providing quality services to consumers of African descent, the greater the chances that costs will increase.

 

10. Principle of Data Driven Systems:

The quality of decision making, service design, and clinical intervention for consumers of African descent in managed health care is increased where data on prevalence, incidence and service utilization is used to inform and guide decisions.

 

11. Principle of Outcomes:

Consumers of African descent and their families evaluate services on the basis of actual outcomes relative to the problems that stimulated help seeking in a managed care environment. The greater the extent to which managed care plans, organizations, and providers emphasize and measure these outcomes in comparison to the expectations of consumers of African descent, the higher the degree of consumer satisfaction.