National Alliance on Mental Illness
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Cultural Competence in Mental Health Care
In 1999, the Surgeon General released Mental Health: A Report of the Surgeon General. This report acknowledged that not all Americans, especially minorities, receive equal mental health treatment, a finding that prompted the Surgeon General to release a supplemental report on disparities in mental health care for people of color. The supplement, which was published in 2001, sends one clear message: culture counts.
Culture—a person’s beliefs, norms, values, and language—plays a key role in how people perceive and experience mental illness, whether or not they seek help, what type of help they seek, what coping styles and supports they have, what treatments might work, and more. To effectively serve America’s diverse populations, mental health systems need to understand and respect cultural differences.
Cultural competence is the ability to work effectively and sensitively within various cultural contexts. The U.S. Department of Health and Human Services (DHHS) defines it as "a set of values, behaviors, attitudes, and practices within a system that enables people to work effectively across cultures" and says the term "refers to the ability to honor and respect the beliefs, language, interpersonal styles, and behaviors of individuals and families receiving services, as well as staff who are providing such services."
For consumers of color, access to mental health services and the quality of the services they receive are negatively affected by the lack of cultural competence in service delivery. Many research studies have shown that because of the lack of cultural competence, people of color may not seek services in the formal system, cannot access treatment, drop out of care, are misdiagnosed, or seek care only when their illness is at an advanced stage.
The final report issued in 2003 by the President’s New Freedom Commission on Mental Health (NFC) stated that "culturally competent services are essential to improve the mental health system" and recommended improving access to quality care that is culturally competent in Goal 3.
Statistics and Facts:
"The mental health system has not kept pace with the diverse needs of racial and ethnic minorities, often underserving or inappropriately serving them. Specifically, the system has neglected to incorporate respect or understanding of the histories, traditions, beliefs, languages, and value systems of culturally diverse groups."
—Final Report of the President’s New Freedom Commission for Mental Health, 2003
"Because State and local governments have primary oversight of public mental health spending, they have a clear and important role in assuring equal access to high-quality mental health services for racial and ethnic minoritie
—Surgeon General’s Report on Culture, Race, and Ethnicity, 2001
NAMI Fact Sheet: Cultural Competence, A Key for Success
Cultural Competence Now Law in New Jersey, American Medical News (AMNews) 4/25/05.
Cultural and Linguistic Competence Coordinators Network for State, Territorial, and Tribal Mental Health Services Collaboratively organized by the NAMI Multicultural Action Center, National Technical Assistance Center for Children’s Mental Health and National Center for Cultural Competence at Georgetown University Center for Child and Human Development