Cultural Competence Standards in Managed Care Mental Health Services for Latino Populations

Triage and Assessment

 

Standard

Assessments should include evaluation of individual, family and community strengths, assets and resources. As indicated, consumers should receive a comprehensive assessment which includes a multi-dimensional focus, functional assessment, physical health review, psychiatric status, and social and family supports, in addition to evaluation of cultural and socioeconomic stressors and factors affecting their problems.

 

Implementation Guidelines

  1. Cultural factors relating to age, gender, sexual orientation, and relational roles should be addressed in the assessment of Latino consumers.
  2. The cultural component of the assessment should identify the beliefs and practices, family organization and relational roles, history of immigration and assimilation/acculturation, effects of ethnically related stressors such as poverty and discrimination, beliefs related to health/mental health, attribution of their condition (spiritual, supernatural), and previous attempts at help-seeking.
  3. The cultural component of the assessment should be family-oriented, incorporating key members of the nuclear and extended family (especially family decision makers), as well as significant community stakeholders. The assessment should also utilize specialized techniques such as ethnographic interviewing, use of family and community collateral informants, and incorporate traditional healers where indicated.
  4. Clinical and functional assessment scales should be culturally competent and validated for Latino populations.
  5. Systemic cultural and ethnic factors should be addressed to ensure accurate assessment and service planning (e.g., linguistic barriers, differences in symptom expression, culture-bound syndromes).
  6. Latino Mental Health Specialists should be involved in triage and assessment processes, especially at the time of care determination and prior to more restrictive placements, particularly with involuntary placement and treatment.


Recommended Performance Indicators

  1. Presence of specialized assessment procedures for Latino consumers.
  2. Inclusion of cultural factors in the assessment of Latino consumers.
  3. Inclusion of family members, as appropriate, and significant community stakeholders in the assessment process for Latino consumers.
  4. Inclusion of culturally competent functional assessment within the overall assessment process for Latino consumers.
  5. Involvement of Latino Mental Health Specialists in assessment and treatment planning process.
  6. The recognition of not missing pathology by culture.


Recommended Outcomes

  1. Consumer, family, and stakeholder satisfaction with the assessment process
    Benchmark: 90% satisfaction
  2. Consistency of service authorizations with utilization management practice for Latino consumers
    Benchmark: Comparable across ethnic groups and in general increasing over time
  3. Frequency of diagnostic revisions resulting from failure to respond to treatment
    Benchmark: Comparable across ethnic groups and decreasing over time