Cultural Competence Standards in Managed Care Mental Health Services For Native American Populations

Care Planning

 

Standard

Care plans for Native American consumers should be compatible with the conceptual framework and community environment of consumers and family members. Consumers and family members should be equal participants in care planning. Care plans should involve culturally indicated family leaders and decision makers.

 

Implementation Guidelines

1. Urban/Suburban and Rural/Reservation:

Care planning and other critical treatment decisions for Native American consumers should be performed in consultation with a Native American Mental Health Specialist.

2. Urban/Suburban and Rural/Reservation:

Care plans for Native American consumers should incorporate consumer goals and objectives that are functionally defined and oriented toward rehabilitative outcomes.

3. Urban/Suburban and Rural/Reservation:

Care plans for minority consumers should address culturally-defined and socioeconomic needs relevant to the consumer’s condition and stressors when appropriate.

4. Urban/Suburban and Rural/Reservation:

Care plans for minority consumers should incorporate family and cultural strengths, traditional healers, spiritual/religious leaders, natural support systems, community organizations, self-help organizations, and interagency resources when appropriate.

5. Urban/Suburban and Rural/Reservation:

When appropriate care plans for minority consumers should address and coordinate the mental health needs of the individual within the context of the entire family when appropriate, including coordination among multiple providers with a single point of clinical accountability.

6. Urban/Suburban and Rural/Reservation:

Care plans for Native American consumers should include consumer and family education about problems and conditions being addressed. Plans should also include treatment modalities, particularly those addressing cultural beliefs and attitudes about health and mental health, as well as education about preventive approaches.

7. Urban/Suburban and Rural/Reservation:

Care plans for Native American consumers should address coordination of mental and physical health, as well as other needed social and treatment services (e.g., housing, transportation, education, substance abuse services), according to the health beliefs and practices of the Native American consumer and family.

 

Recommended Performance Indicators

  1. Native American consumer and family involvement and investment in the development of, and agreement with, the Care Plan.
  2. Culturally defined needs addressed in the care of Native American consumers.
  3. Native American Mental Health Specialist involvement in the care planning process for Native American consumers.
  4. Inclusion of traditional healers in the Care Plan for Native American consumers when indicated for the consumer or family

 

Recommended Outcomes

  1. Consumer and family satisfaction with Care Plan
    Benchmark: 90% satisfaction
  2. Functional outcomes in domains of daily living (e.g., housing, restrictiveness of placement, access to primary health care, family role, vocational/education/employment, community tenure)
    Benchmark: Comparable to overall community and significant improvement in at least one domain of function over 75% of consumers