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

Linguistic Support

 

Standard

Linguistic support should be provided at the option of consumers and families at no cost to them. Interpreters should be paid for their services. Access to these services should be available at the point of entry into the system and throughout the system. Certified interpreters should be utilized only in the absence of competent bilingual and bicultural staff.

 

Implementation Guidelines

1. Urban/Suburban and Rural/Reservation:

Use of family members as interpreters, especially children, should be strictly prohibited. The exceptions to this prohibition include emergency situations and in the case where languages are spoken by very few people.

2. Urban/Suburban and Rural/Reservation:

Interpreters and translators working with Native American consumers and families should be trained in formal interpretation techniques and in consultation with Native American Mental Health Specialists.

3. Urban/Suburban and Rural/Reservation:

Training in the use of interpreters for Native American consumers and families should be provided to English monolingual clinicians and/or clinicians in which English is a second language. This training should emphasize linguistics and culture.

4. Urban/Suburban and Rural/Reservation:

All pertinent consumer and family materials and forms, especially informed consent and statements of rights, should be translated, and questions and concerns be actively solicited.

5. Urban/Suburban and Rural/Reservation:

Monolingual non-English- or limited English-proficient individuals should only be placed in restricted or residential settings which have capacity to communicate with them effectively. If not possible, the setting should make and document every attempt to acquire an appropriate interpreter.

 

Recommended Performance Indicators

  1. Regularly updated directory of certified interpreters available within 24 hours for routine and within one hour or less for urgent situations.
  2. All levels of care meet the standards for the provision of linguistically competent services.

 

Recommended Outcomes

  1. Where possible, linguistically competent services are provided to limited English-proficient Native American language-speaking consumers.
    Benchmark: 100% of limited English-proficient individuals served
  2. Satisfaction rates for Native American language-speaking and limited English-proficient consumers and families
    Benchmark: 90% satisfaction
  3. Frequency of diagnostic revisions resulting from failure to respond to treatment for Native American language-speaking and limited English-proficient consumers and families
    Benchmark: Comparable across linguistic status and decreasing over time
  4. Time from point of first contact to linguistically competent service provision for all levels of care to all consumers and families
    Benchmark: Comparable across linguistic status and decreasing over time