Cultural Competence: A Literature Review and Conceptual Model for Mental Health Services

Hernandez, Mario; Nesman, Teresa M.; Mowery, Debra; Acevedo-Polakovich, Ignacio D.; Callejas, Linda M.

doi:10.1176/ps.2009.60.8.1046

Cited by 126 publications

(63 citation statements)

References 32 publications

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“…Culturally competent agencies incorporate culturally sensitive evidence-based treatments and culturally specific interventions whenever possible. Culturally competent systems of care (the final level) reflect meaningfully the issues within the communities they purport to serve (Hernandez, Nesman, Mowery, Accevedo-Polakovich, & Callejas, 2009). This includes effective and essential language-appropriate outreach and coordination with emergency service agencies (i.e., police and fire, schools, homeless shelters, women's centers, and hospitals).…”

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confidence: 99%

“…Sue, Arrendondo & McDavis, 1992). Recent conceptualizations, however, view cultural competence within the context of the community behavioral health delivery system itself (Gamst et al, 2011;Hernandez et al, 2009). Therefore, cultural competence is seen as the "the degree of compatibility between the cultural and linguistic characteristics of a community and the manner in which the combined policies, structures, and processes underlying local mental health services seek to make these services available, accessible, and utilized" (Hernandez et al, 2009(Hernandez et al, , p. 1047.…”

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confidence: 99%

“…Recent conceptualizations, however, view cultural competence within the context of the community behavioral health delivery system itself (Gamst et al, 2011;Hernandez et al, 2009). Therefore, cultural competence is seen as the "the degree of compatibility between the cultural and linguistic characteristics of a community and the manner in which the combined policies, structures, and processes underlying local mental health services seek to make these services available, accessible, and utilized" (Hernandez et al, 2009(Hernandez et al, , p. 1047. Cultural competence, then, is realized through a proper assessment of each client's behavioral health needs and cultural values, as well as the delivery of culturally responsive interventions and services that are situated within the cultural milieu of their particular community.…”

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confidence: 99%

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A Review and Critique of Multicultural Competence Measures

Gamst

Liang

2013

Handbook of Multicultural Mental Health

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A Review and Critique of Multicultural Competence Measures

Gamst

Liang

2013

Handbook of Multicultural Mental Health

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“…Levels of education, burnout, and MCC and clinicians’ race appear less important than general experiences and relationships with people from other racial and ethnic groups. Perhaps factors embedded in community dynamics or organizational functioning also play a role, along with experiences and relationships, in shaping clinicians’ ability to work effectively with black and white patients (10,45). …”

Section: Discussionmentioning

confidence: 99%

“…Two clinician factors are frequently posited to either produce or ameliorate outcome differences for black patients: clinicians’ level of multicultural counseling competency (MCC) and their race (3,8-10). In a content analysis covering 20 years of MCC research, Worthington and colleagues (11) found some evidence that such competence improves clinicians’ skills with patients from nonwhite racial-ethnic and cultural minority groups.…”

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Clinician Factors Related to Outcome Differences Between Black and White Patients at CMHCs

Larrison¹

2011

Psychiatric Services

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Objectives Data are limited on how clinicians contribute to outcome differences between black patients and white patients. Because the clinician-patient relationship is the foundation of mental health services, understanding clinicians’ role in outcome differences may help identify evidence-based interventions that decrease disparities and capitalize on positive differences. Symptoms and functioning in a sample of black and white adults receiving outpatient services were examined to determine the effects of their primary clinician on those patterns. Methods The study included 551 patients (25% black) with serious mental illness and 62 mental health professionals (21% black) identified as the patients’ primary clinician. Treatment outcomes were measured at baseline and two follow-ups (two and four months) with the Behavior and Symptom Identification Scale, a measure of symptoms and functioning. Data were analyzed with hierarchical linear modeling. Clinicians’ levels of multi-cultural competence, burnout, and education were analyzed. Results Clinicians moderated the relationship between patient race and outcome differences. There was significant variability among clinicians: approximately 20% had black patients whose outcomes were worse than those of their white patients, and 40% had black patients with better outcomes than their white patients. The only clinician factor predicting these differences was clinician's general experiences and relationships with people from racial-ethnic and cultural groups other than their own. Conclusions The occurrence of outcome differences varied across clinicians, with some clinicians magnifying outcome differences between black and white patients and others minimizing them. Factors other than clinicians’ race, multicultural competence, education, and burnout may contribute to outcome differences between black and white patients.

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Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada

et al. 2022

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IMPORTANCEThere remains limited understanding of population-level patterns of mental disorder prevalence for first-and second-generation immigrant and refugee children and youth and how such patterns may vary across mental disorders. OBJECTIVE To examine the diagnostic prevalence of conduct, attention-deficit/hyperactivity disorder (ADHD), and mood/anxiety disorders in immigrant, refugee, and nonimmigrant children and youth in British Columbia, Canada. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-level cohort study examined linked health administrative records of children and youth in British Columbia (birth to age 19 years) spanning 2 decades (1996-2016). Physician billings, hospitalizations, and drug dispensations were linked to immigration records to estimate time-in-British Columbia-adjusted prevalence of mental disorder diagnosis among children and youth from immigrant or refugee backgrounds compared with those from nonimmigrant backgrounds. Analyses were conducted from August 2020 to November 2021. MAIN OUTCOMES AND MEASURESThe diagnostic prevalence of conduct, ADHD, and mood/ anxiety disorders were the main outcomes. Results were stratified by migration category (immigrant, refugee, nonimmigrant), generation status (first-and second-generation), age, and sex. RESULTSA total of 470 464 children and youth in British Columbia were included in the study (227 217 [48.3%] female). Nonimmigrant children and youth represented 65.5% of the total study population (307 902 individuals). Among those who migrated, 142 011 (87.8%) were first-or secondgeneration immigrants, and 19 686 (12.2%) were first-or second-generation refugees. Diagnostic prevalence of mental disorders varied by migration category, generation status, age, and sex.Children and youth from immigrant and refugee backgrounds (both first-and second-generation), compared with nonimmigrant youth, generally had a lower prevalence of conduct disorder (eg, age

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Cultural Competence: A Literature Review and Conceptual Model for Mental Health Services

Cited by 126 publications

References 32 publications

A Review and Critique of Multicultural Competence Measures

A Review and Critique of Multicultural Competence Measures

Clinician Factors Related to Outcome Differences Between Black and White Patients at CMHCs

Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada

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