Cultural Competence Standards in Managed Mental Health Care

Preface

This document, Cultural Competence Standards in Managed Care Mental Health Services for Four Underserved/Underrepresented Racial/Ethnic Groups, was the result of the separate and joint work of four national racial/ethnic panels. These panels were formed to develop ethnic-specific cultural competence standards in mental health services for African American, Asian and Pacific Islander American, Latino/Hispanic, and Native American/American Indian/Native Alaskan/Native Hawaiian populations, and a set of core standards applicable across all four populations.

Cultural competence standards for Latino populations developed by a national panel of Latino mental health professionals, families, and consumers in 1996, were used as a model by the other three panels. The work of the Latino panel was sponsored by the Western Interstate Commission for Higher Education (WICHE) Mental Health Program and funded by the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration (SAMHSA).

In October 1996, WICHE established two new panels, one for Native American/Alaska Native populations, and the other for Asian and Pacific Islander American populations. A panel to develop standards for African Americans was established separately under the auspices of the CMHS Managed Care and Workforce Training Initiative coordinated by the University of Pennsylvania School of Medicine. Each panel conducted literature reviews and developed reports summarizing the literature about mental health research and services pertaining to their particular racial/ethnic group. During this process, the four national panels began sharing materials and ideas. WICHE convened members of the four panels in Washington, D.C. in June 1997 to develop a consensus on core cultural competence standards applicable to all four groups.

Core standards, Cultural Competence Standards in Managed Care Mental Health Services for Four Underserved/Underrepresented Racial/Ethnic Groups were developed by members of the four national racial/ethnic panels with the recognition that in order to provide individualized mental health services consumers shall be viewed within the context of their cultural group and their experiences from being part of that group. (Panel chairs, members, project officers, and WICHE staff are listed after this preface.)

The Americans with Disabilities Act of 1990 and Title VI of the Civil Rights Act of 1964, as amended, both mandate accessibility to programs and the facilities at which services are dispensed. It is therefore critical for public and private agencies to be staffed with culturally competent and appropriately qualified bicultural and bilingual personnel. To help meet this requirement, co-chairs and selected members of the four racial/ethnic panels (hereafter Four National Panels) recommend that cultural competence training be provided to all direct care staff and those with management responsibilities.

In this document, individuals from "four underserved/underrepresented racial/ethnic groups," and populations of "four underserved/underrepresented racial/ethnic groups," designate people from the following four racial/ethnic groups: African American; Asian/Pacific Islander; Latino/Hispanic; and Native American/American Indian/Native Alaskan/Native Hawaiian. More detailed information about the sub-groups making up each of the four racial/ethnic groups is given in the Introduction. These groups have been identified as underserved. Furthermore, they are underrepresented in the administrative, service provider, research, and education mental health workforce.

Several groups are known by more than one commonly used term, e.g., African American and Black are used interchangeably, as are Native American and American Indian, and Latino and Hispanic. Whereas each group includes various subgroups, only two include subgroups in their formal designation: Native American, Alaskan Native, and Native Hawaiian; and Asian and Pacific Islander. To avoid wordiness, the shorter term "the four groups" is used when referring to these four racial/ethnic groups.

Although individuals within each of these groups share the same broad race/ethnicity, any particular person's cultural identity may involve the following factors, among others: race, ethnicity, language, country of origin, acculturation, gender, age, class, religious/spiritual beliefs, sexual orientation, and physical disabilities.

A second document developed by the co-chairs and selected members of the Four National Panels is an Implementation Plan for implementing the above-mentioned Standards. The Implementation Plan complements the Standards, addressing specific initiatives that would facilitate successful implementation of the Standards, such as personnel hiring and management, marketing plans for building community partnerships, funding strategies, and quality monitoring and improvement. Members of the Four National Panels believe that a critical element in implementing these Standards is having culturally competent racial/ethnic staff and consultants with expertise in cultural competency. Co-chairs and members of the Four National Panels are available to provide services to anyone interested in their expertise in planning or implementing any aspect of the Standards.

The development of Cultural Competence Standards in Managed Care Mental Health Services for Four Underserved/Underrepresented Racial/Ethnic Groups was sponsored by theWICHE Mental Health Program and funded by the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration. This project is part of the CMHS sponsored Managed Care and Workforce Training Initiative coordinated by the Center for Mental Health Policy and Services Research at the University of Pennsylvania School of Medicine.

For further information about the Standards, contact A. Marie Sanchez, WICHE Mental Health Program, P. O. Box 9752, Boulder, CO 80301-9752, 303-541-0250.