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

Standard and Guidelines for Plan of Treatment

 

Standard

The Treatment Plan for consumers and families of African descent must be relevant to their culture and life experiences. It must be developed by a culturally competent provider in conjunction with the consumer and family, where appropriate. In the absence of a culturally competent provider, review of the proposed plan of treatment and supervision by a culturally competent clinical consultant is necessary.

 

Implementation Guidelines

  1. The Treatment Plan for consumers of African descent must include consumer and family involvement, when appropriate, in its development and agreement.
  2. Group homes utilized as least restrictive placements must be monitored for compliance with state and local standards, regulations, and laws, as well as protocols for services. Where such protocols do not exist, they must be developed to insure that group homes do not become holding facilities.
  3. If authorized by the consumer, the plan of treatment must include contact with and utilization of African American community organizations.
  4. Psychotherapeutic modalities must be conducted within the context of the value system of consumers of African descent and their families (e.g. egalitarian, participatory, family focused, spirituality), and must address issues specific to consumers of African descent (racism, discrimination, violence, gender role conflicts, and life transitions).
  5. Treatment planning must be based on knowledge and skills derived from culturally competent interventions and models of care. These include concepts of recovery and rehabilitation that also consider cultural norms, values (spirituality, community, family), and critical life experiences (i.e. racism & discrimination). (See the appendix for a listing of model intervention programs utilized with consumers of African descent).
  6. Care planning and other critical treatment decisions for consumers of African descent must be performed or supervised directly by a culturally competent mental health professional. Managed care plans must include culturally competent independent practitioners within their networks.
  7. The Treatment Plan for consumers of African descent must incorporate consumer-driven goals and objectives that are functionally defined and oriented towards measurable recovery and rehabilitative outcomes.
  8. The Treatment Plan for consumers of African descent must address culturally defined and socio-economic needs.
  9. Treatment plans for consumers of African descent must incorporate individual, familial, and community strengths. Additionally, cultural strengths, spiritual/religious persons, natural support systems, community organizations, and self-help organizations, and interagency resources are appropriate to include in the plan of care.
  10. Treatment plans for consumers of African descent must reflect awareness of the mental health needs of the entire family, especially when children are the consumers. Coordination among multiple providers, with a single point of clinical accountability must occur and be documented.
  11. Treatment plans for consumers of African descent must address coordination of mental health and physical health, substance abuse, as well as other needed clinical services such as housing, transportation, employment, and education.
  12. The Treatment Plan for consumers of African descent must be developed so that interventions consider least restrictive placements, continuum of care, discharge, and cultural sensitivity in the treatment modalities and medication usage.
  13. Level of care decisions must be based on established protocols that are culturally sensitive/competent. These protocols must be reviewed periodically by the consumer and family, as appropriate. Placement considerations must include consumer and family preferences. Placement with the family is preferable unless otherwise clinically contraindicated.
  14. Develop creative options and procedures for consumers of African descent who, for whatever reason, have traditionally been labeled as non-compliant to treatment.
  15. In developing creative options, the consumer’s right to choice must be preserved. However, the provider has the ultimate responsibility for documenting both the recommendations and rationale for the treatment plan as well as informing the consumer and family of potential risks if recommendations are not followed.
  16. Treatment plans for consumers of African descent must include broad based culturally competent educational programs that explain the problem or conditions being treated, treatment methods, concepts of recovery, rehabilitation, prevention, and self-help approaches in communication styles understandable to the consumer.
  17. Treatment plans for consumers of African descent must be developed by a culturally competent staff. In the absence of a culturally competent staff, cultural competency training must be provided to staff and external consultation with a culturally competent mental health professional must be obtained.
  18. The decision to go forward with treatment with a consumer of African descent must be based on a mutually agreed upon written agreement or contract between the consumer and provider.
  19. In cases of consumers who present with acute mental illnesses requiring psychopharmacological interventions, the provider must discuss the medications and describe their effects with the consumer and family as soon as the consumer is able. A signed statement by the consumer (and counter-signed by the provider) that this guideline has been followed must be inserted in the case record.
  20. The plan of treatment must reflect specialized approaches to maintain continuity of care, prevent symptom relapse, and reduce re-hospitalization.
  21. Culturally specific literature in the communication style, language, and appropriate to the literacy level of the consumer on the prevalence of psychiatric disorders, treatment options, and psychopharmacological interventions must be distributed to consumers of African descent and their families.
  22. Informed consent must be obtained prior to the dispensing of medication. The informed consent document must be specific regarding the nature of the medication and its potential and demonstrated benefits and side effects. The physician prescribing the medication must be responsible for ensuring that medication information is explained in a culturally specific and clear manner. The consumer must acknowledge by signature that they understand the medication prescribed and its potential benefits and side effects. The signed forms must be dated and included in the consumer’s chart. The prescribing physician must be knowledgeable regarding the culturally specific effects of psychotropic medication in consumers of African descent.