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Recommendations for Implementation
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a.
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Recruit members
of minority communities for clinical and administrative positions in which
there is regular client contact.
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The quest for cultural competency has been under way in
the public mental health field for some time, but the results to date are
mixed. With so many different cultural groups now living side by side in our
society, it would be difficult for mental health practitioners or agencies to
develop expertise in each one. It is reasonable, however, for agencies to
approach the challenge in a manner similar to the approach suggested by the
Surgeon General's office in compiling its supplemental report. That is, it
makes sense for each agency to identify practitioners with the cultural
understanding and, if applicable, the language skills to communicate effectively
with the cultures most highly represented in the community. The
underrepresentation of minorities among mental health providers,
administrators, policymakers, and consumer and family organizations only helps
to perpetuate the system's disparities. Agencies should be encouraged to
recruit members of minority communities to fill clinical and contact positions.
Example:
North Carolina Area Health Education Centers
Since 1985, the North Carolina Area Health
Education Center (AHEC) Program has received special state funding to bring its
educational services, training programs, and information services to the
community mental health facilities in the state. Recognizing that a significant
percentage of mental health clients in the public system are from minority
groups, yet that the majority of mental health professionals are not
minorities, AHECs promote the recruitment of racial and ethnic minority
students into mental health professions through special regional programs.
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b.
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Provide
training in cultural issues to all staff members in contact with clients.
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At the same time, each agency should make sure that every
staff member who comes in contact with clients has training that will allow him
or her to recognize cultural clues in a person's presentation and response to
offered services. Cultural competency training itself is evolving, but it is
clear that for the mental health system to meet its responsibilities to all in
the communities it serves, mental health professionals must develop an
understanding of the roles of age, gender, race, ethnicity, and culture in the
manifestation of mental illness and its research and treatment. A culturally
informed training curriculum is essential if the system is to advance in this
area.
Example:
Pacific Clinics, (CA)
Pacific Clinics, a provider of behavioral health
care services in Los Angeles, Orange, Riverside, and San Bernardino counties in
California, has made a priority of establishing services to meet the needs of
different cultural groups. Many of their 50 sites include staff from
Spanish-speaking cultures who can provide culturally sensitive services to
Latino clients. Pacific Clinics also has developed services that are sensitive
to the needs of the multiple Asian populations living in that part of California.
Services at the clinics include links to culture-specific family and consumer
groups, as well.
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c.
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Develop
targeted outreach programs to make services available to members of minority
communities.
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Members of cultural and linguistic minority groups not
only have a more difficult time than others accessing services, many simply
fail to consider seeking help when they need it. To many in minority
communities, the system is remote and frightening, especially when no one
working in it appears to share their language or experience. Deep-seated values
can also result in even greater stigma within some cultural groups than exist
in the general population.
It is therefore very important for local agencies and the
public mental health system in general to seek innovative ways to reach out to
cultural minorities in their service areas. Outreach can and should take into
account the cultural and linguistic barriers that may be standing between
people in need and the services that could help them. One effective way to do
this is to tailor outreach approaches to specific groups by using their
language and by forming partnerships with cultural institutions that
traditionally serve specific communities. In many parts of the country, for
instance, mental health agencies have sought to improve outreach to
African-American populations by forming collaborative relationships with
churches in their communities.
Example:
Mental Health Association of New York City (NY)
In 1998, the Mental Health Association of New
York City extended its LifeNet help line service to the city's Hispanic
community by creating Ayudese, a
Spanish-language 24 - hour referral and
education toll-free telephone service. In 2000, the help line service became
available to members of New York's largest Asian communities when a new number
was created to provide information and referrals in Mandarin and Cantonese. The
service is advertised on posters in different languages that are carried in the
city's subway cars. In a recent pilot project, police in eight of the city's
police precincts carried LifeNet referral cards in different languages to give
to people they perceived to be in need of services.
Example:
Haitian Mental Health Clinic, Cambridge (MA)
Operated through Cambridge Hospital, the Haitian
Mental Health Clinic provides culturally and linguistically appropriate
ambulatory mental health care for first-and second-generation immigrants of the
Haitian community of metropolitan Boston, including individual and family
treatment for adults and children, long-term and short-term therapy, crisis
intervention, psychological testing, and psychopharmacology within a managed
care framework, encouraging preventive and primary care.
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