Exploring the Intersection between Cultural Competency and Managed Behavioral Health Care Policy: Implications for State and County Mental Health Agencies

134 Pages·1997·3.6 MB·English

Exploring the Intersection between
Cultural Competency and Managed
Behavioral Health Care Policy
Implications for State and County MentalHealth Agencies
December, 1997
National Technical Assistance Centerfor State Mental Health Planning
66 Canal Center Plaza, Suite 302, Alexandria, VA 22314 Telephone: [phone]
NationalTechnical Fax: [phone] Web site: http://www.nasmhpd.org/ntac E-mail: [email protected]
AssistanceCenter
forStateMentalHealthPlanning
National Technical Assistance Center for State Mental Health Planning
Supportedunder CooperativeAgreementNo. 1 U97SMS1944 between the CenterforMentalHealth
Services (CMHS), SubstanceAbuseandMentalHealth ServicesAdministration (SAMHSA) andthe
National Association ofStateMentalHealth Program Directors (NASMHPD).
Exploring the Intersection between
Cultural Competency and Managed
Behavioral Health Care Policy
Implications for State and County MentalHealth Agencies
December, 1997
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o Preparedby:
o
o King Davis, Ph.D.
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o Professor ofPublic Mental Health Policy
Virginia Commonwealth University
Richmond, Virginia
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oro Preparedfor:
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ro 00 c O National Technical Assistance Center
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ro CD CD for State Mental Health Planning (NTAC)
CD Bruce D. Emery, M.S.W., Director
In Collaboration with:
Action Council for Mental Health and Human Services
Center for Mental Health Services
Coastal Carolina Hospital
National Association ofState Mental Health Program Directors
National Institute ofMental Health
Ohio Department ofMental Health
Palmer Memorial Chapel
PMHC
d/b/a Health Force
South Carolina Department ofMental Health Cultural Action Program

Table of Contents
List ofAppendices
/
Preface and Acknowledgments
ii
Preamble and Vision Statement Hi
Introduction and Overview
1
Conceptualizing and Defining Cultural Competency 4
Key Differences in Utilization ofMental Health Services by Race and Ethnicity 6
Characteristics ofa Culturally Competent System ofCare 9
Status ofCultural Competency in State and Local Mental Health Systems 10
Issues ofCultural Competency in the Federal and Private Sectors 12
Responding to the Technical Assistance Needs ofStates 15
Recommendations for Establishing a National Policy and Vision for
Culturally Competent Mental Health Systems 18
Conclusion 21
Appendices
Exploring the Intersection between Cultural CompetencyandManagedBehavioral Health Care Policy

List of Appendices
Appendix A: IAPSRS: Organizational Bulletin:
Principles ofMulticultural Rehabilitation Services
Appendix B: IAPSRS: Standards and Indicators ofMulticultural Psychiatric
Rehabilitation Services
TA
Appendix C: Judge Baker Children's Center - Brief:
Culturally Competent Evaluation ofOutcomes in Systems of
Care for Children's Mental Health
Appendix D: Bibliography: Cultural Competence and Mental Health
Appendix E: Cultural Competence-Related Web Sites
Exploring the Intersection between Cultural CompetencyandManagedBehavioralHealth Care Policy

Preface and Acknowledgments
This report is based on discussions that occurred during a two-day National Mental Health
Policy Institute on Cultural Competency which tookplace on February 22-24, 1997 in Myrtle
Beach, SC. Conference co-sponsors included the South Carolina Department of Mental
Health's Cultural Affairs Program, the Ohio Department ofMental Health and the National
Association of State Mental Health Program Directors (NASMHPD).
The Institute was conceptualized by Dolores Macey, Ph.D., and staffofthe Cultural Affairs
Program within the South Carolina Department ofMental Health. Wilma Townsend, ofthe
Ohio Department ofMental Health helped craft the idea for a national focus on this topic.
Dr. King Davis of Virginia Commonwealth University facilitated the Institute. These
individuals sought to increase our collective understanding of the importance of cultural
competency to the mission of public mental health systems and the relationship between
cultural competency and managed care policy.
Conferences, institutes and workshops represent a valuable tool for the rapid transmission
ofnew knowledge, skills, and methods for solving a wide range ofproblems. Within the past
several years, education and training events that seek to understand the potential benefits of
ensuring cultural competency within managed care programs in both public and private
sectors have increased. For its part, this Institute afforded participants representing both
public and private mental health systems a unique opportunity to reflect and collaborate on
the status ofcultural competency and its intersection with managed care policy. Participants
collaborated in reaching agreement on an operational definition ofcultural competency and
on the vision and steps required to ensure its increased acceptance and application at both
state and local levels. It is also clear that a range of technical assistance supports will be
needed to encourage and support public mental health leaders in efforts to establish cultural
competency within their systems. These technical assistance needs are identified in this
report.
The Institute received financial support from the Center for Mental Health Services through
the efforts of Paul Wohlford, Ph.D., and Harriet McCombs, Ph.D., and the National
Technical Assistance Center for State Mental Health Planning, an affiliate program of
NASMHPD.
In addition, Ronald Manderscheid, Ph.D., of the Center for Mental Health
Services; Ivan Walks, M.D.. ofOptions Mental Health; and Mareasa Isaacs Shockley, Ph.D.,
contributed to the Institute through their presentations of new ideas, concepts and
approaches.
Produced under a contract between King Davis, Ph.D. and the National Technical Assistance
Center for State Mental Health Planning (NTAC), this report is designed to provide practical
assistance in considering the issues, challenges and benefits of strengthening the cultural
Exploringthe Intersection between Cultural CompetencyandManagedBehavioralHealth Care Policy