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Contents

  Learning Objectives
1. Statement on Cultural Competence
    What Is Culture, and How Does It Affect Care?
    Why Cultural Competence?
    What Is Cultural Competence?
    How Is Cultural Competence Related To Evidence-Based Practices?
    How Can Cultural Competence Be Put Into Practice?
    Case Studies of Cultural Competence
      Vignette 1—Dual Diagnosis
      Vignette 2—Assertive Community Treatment
      Vignette 3—Supported Employment
      Vignette 4— Medication Management
      Vignette 5— Illness Management and Recovery Skills
      Vignette 6— Family Psychoeducation
    Some Thoughts on Four Cultural Concepts
      Minority versus Diverse Groups
      Race versus Ethnicity
    References
    Shift in Goal From Assimilation to Biculturalism
    Critical Aspects of Cultural Competence
    Selected Resources on Cultural Competence
2. The Cultural Competence Continuum
      Cultural Destructiveness
      Cultural Incapacity
      Cultural Blindness
      Cultural Pre-Competence
      Cultural Competence
      Cultural Proficiency
3. The Culturally Competent System of Care
      Valuing Diversity
      Cultural Self-Assessment
      Dynamics of Difference
      Institution of Cultural Knowledge
      Adaptation to Diversity
      A Value Base for Cultural Competence
4. Developing Cultural Competence
      Policymaking Level
      Administrative Level
      Practitioner Level
      Consumer Level
      Service Adaptations
      Intake and Client Identification
      Assessment and Treatment
      Communication and Interviewing
      Case Management
      Out-Of-Home Care
      Guiding Principles
5. Cultural Competence Standards in Managed Care Mental Health Services:
Four Underserved/Underrepresented Racial/Ethnic Groups
      Demographic and Health Profile
    People of African Descent
      Demographic and Health Profile
      Historic Patterns of Mental Health Service Use
      Managed Behavioral Health Care and Race: Implications
    Asian and Pacific Islander People
      Asian Pacific Islander American Mental Health Issues
      Asian Pacific Islander Mental Health Service Delivery Issues
    American Indian, Native Alaskan, and Native Hawaiian Populations
      Demographic and Health Profile
    Managed Care in the Delivery of Mental Health Services
    References
6. Mental Health Needs of Hispanics
    The Mental Health Needs of Hispanics in the United States
      Demographic Background
      Mental Health and Substance Use Problems
      Use of Mental Health Services
      Addressing the Service Gaps
      Conclusion
    References
7. Cultural Competence in Serving Children and Adolescents with Mental Health Problems
      Goals and Principles of Cultural Competence
      Developing Cultural Competence
8. Achieving Cultural Competence:
A Guidebook for Providers of Services to Older Americans and Their Families
    Purpose
    Introduction
    What is Culture?
    Factors that Influence Culture
    What is Cultural Competence?
    Barriers to Service Access
      Structural Barriers
      Cultural Barriers
    Research on Cultural Competence
    Why is Cultural Competence Important?
      Introduction
      Demographics
      Racial and Ethnic Disparities Education Level
      Living Arrangements
    Poverty
      Life Expectancy
      Death Rates by Condition
      Self-Rated Health Status
      Access to and Satisfaction with Health Care
    Principles of Cultural Competence
      Values and Attitudes
      Communication Styles
      Community/Consumer Participation
      Physical Environment
      Policies and Procedures
      Population-Based Service Delivery
      Training and Professional Development
    Creating Programs That Work
      The Three M’s
      Characteristics of Culturally Competent Service Delivery
    People Profiles
    Program Profiles
      Illustrative Examples
  Post Test