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

Standard and Guidelines for Comprehensive Assessment

 

Standard

Assessment must include a multi-dimensional focus including functional, psychiatric, medical, and social status as well as family support. Additionally, an evaluation of cultural and socio-economic stressors and factors must be completed. The assessment must be of appropriate breadth and depth to establish the nature of problems, the consumer’s willingness and ability to work, and the provider’s ability to deliver culturally competent services. All assessment scales and measurement tools must be culturally sensitive, administered, and scored by culturally competent providers.

 

Implementation Guidelines

  1. Cultural factors in the assessment process relating to age, gender, sexual orientation, and relational roles must be addressed for both consumers and families of African descent.
  2. The assessment should identify beliefs and practices; family organization and relational roles (traditional & non-traditional); impact of ethnically related stressors such as poverty and discrimination; beliefs related to health/mental health; attribution of condition; spirituality; and previous attempts at help-seeking. History of immigration, assimilation, or acculturation should be considered as needed. Consumers must be asked why they are seeking services, what their expectations are of the agency, previous efforts to obtain and use help, and outcomes of previous treatment efforts. Consumers must be asked to identify the criteria they use to determine when their condition is improved.
  3. The assessment should be family oriented, incorporating key members of both nuclear and extended families (especially family decision makers) as needed. The consumer must be asked to identify what family resources, if any, are available to help resolve the presenting problems.
  4. Clinical and functional assessment scales used must be culturally sensitive for use with consumers of African descent.
  5. For systems without culturally competent providers, consultation with such a provider is necessary to review the assessment as the level of care determination is made and, especially, to review more restrictive placement decisions involving involuntary commitment, placement, or treatment.
  6. Confidentiality requirements must be adapted to incorporate the values of consumers of African descent particularly the inclusion of families in decisions about services, so as not to serve as a barrier to care.
  7. Consumers must be asked to identify what community resources can be used to help resolve the presenting problems.
  8. Assess information or diagnosis of mental health status in the appropriate social context with regard to world view, socio-economic status, educational level, and family characteristics.
  9. Consider the consumer’s preference for therapeutic linkages to the African American Community or family prior to initiating service.