Develop culturally competent guidelines for providers
Recommendation
The Substance Abuse and Mental Health Services Administration (SAMHSA) should develop culturally competent guidelines for mental health and substance use service providers[1], particularly those serving predominantly underserved communities—particularly Black/African American; Hispanic/Latino; Asian American, Native Hawaiian, and Pacific Islander; American Indian and Alaska Native; lesbian, gay, bisexual, transgender, queer, and intersex(LGBTQI+) communities[2][3]—through inclusive and responsive community engagement.
Background/summary
Numerous factors cause disparate outcomes for individuals in underrepresented or marginalized communities, including inaccessible mental health and substance use disorder (MH/SUD) services, cultural stigma around mental health care, discrimination, and lack of diversity in the MH/SUD workforce and in clinical research.[4][5][6][7] MH/SUD providers who are not culturally competent contribute to underdiagnosis or misdiagnosis of MH/SUDs in individuals from diverse populations.[8] MH/SUD services that are culturally competent incorporate perspectives and decision-making from diverse groups[10][11] and provides care responsive to the beliefs, traditions, customs, practices, and needs of diverse individuals.[12][13]
While national standards for Culturally and Linguistically Appropriate Services (CLAS) in health and healthcare outline steps for health care organizations to reduce health disparities[14], additional culturally competent guidelines specific to mental health and substance use would be very valuable, especially given ongoing efforts to build an MH/SUD crisis response system centered around the 988 Suicide and Crisis Lifeline, which are essential to advancing efforts to decriminalize MH/SUDs. Such guidelines would advance efforts to increase culturally competent care such as requirements for Certified Community Behavioral Health Clinics (CCBHCs) to demonstrate cultural competence.[12] Unfortunately, 56 percent of White healthcare providers report having no cultural competency training to better serve their patients.[16] By developing culturally competent guidelines, SAMHSA could help improve access to culturally competent MH/SUD care for underrepresented and marginalized communities.
citations
1. Congressional Black Caucus, Emergency Taskforce on Black Youth Suicide and Mental Health. Ring the Alarm: The Crisis of Black Youth Suicide in America. Last Updated December 2019.
2. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). Behavioral Health Equity. Last Updated May 25, 2023.
3. National Alliance on Mental Illness (NAMI). Identity and Cultural Dimensions. Last Accessed July 23, 2023.
4. American Psychiatric Association. Mental Health Disparities: Diverse Populations. Last Accessed July 23, 2023.
5. Gopalkrishnan, Narayan. “Cultural Diversity and Mental Health: Considerations for Policy and Practice.” Front Public Health. Last Updated June 19, 2018.
6. Lin, Luona, Karen Stamm, and Peggy Christidis. “How diverse is the psychology workforce?” Monitor on Psychology, 49 (2), American Psychological Association. Last Updated February 2018.
7. “Psychology’s workforce is becoming more diverse.” American Psychological Association, Monitor on Psychology 51 (8). Last Updated November 2020.
8. American Psychiatric Association. Mental Health Disparities: Diverse Populations (Fact Sheet). Last Accessed July 23, 2023.
9. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Prevention Information Network. Cultural Competence in Health and Human Services. Last Updated September 10, 2021.
10. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Health Equity: Prioritizing Minority Mental Health. Last Updated June 27, 2023.
11. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). Improving Cultural Competence: Quick Guide for Clinicians. Last Updated 2016.
12. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). CCBHCs and Cultural Competence. Last Updated March 16, 2023.
13. Harms, William. “Looking at the Cultural Aspects of Mental Health.” School of Social Service Administration Magazine 24 (2), The University of Chicago. Last Updated Summer 2017.
14. U.S. Department of Health and Human Services, Office of Minority Health. National CLAS Standards. Last Accessed July 23, 2023.
15. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). 988 Suicide and Crisis Lifeline. Last Accessed July 23, 2023.
16. Simmons University. Racial Disparities in Mental Health Treatment. Last Accessed July 23, 2023.