PBH Cultural Competence Process

In 2002, PBH (Piedmont Behavioral Healthcare), as part of its local business plan, determined that Cultural Competence was an important aspect of successfully reforming the local mental health system. To accomplish this goal, it became necessary to methodically proceed through a process, which would result in the identification of the cultural competency of our system, and to develop an overall cultural competence plan for the system.

In fall 2004, the Cultural Competence Committee was formed. This committee consisted of PBH employees representing the various departments within the agency, chaired by the Director of Community Relations. The committee reviewed several nationally recognized articles and reports on the importance and relevancy of cultural and linguistic competence. This included a review of the National Cultural Competence Standards, Achieving the Promise: Transforming Mental Health Care in America, Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General, and various material from Georgetown University, National Center for Cultural Competency. The committee also has engaged in pertinent discussions of race/ethnicity, myths, culture, beliefs, norms and the racial and ethnic composition of PBH’s five-county catchment area and of North Carolina. The Cultural Competence Committee began meeting regularly in January 2005. The role of the Cultural Competence Committee was:

  • To conduct a national literature review on cultural competence
  • To assist in the development of the Cultural Competence Plan

In winter 2004, culturally diverse representatives from the community and various agencies, including consumers, family members, stakeholders, and network providers were selected to comprise a Cultural Competence Study Group. This 25-member committee joined in the process of developing recommendations for a Cultural Competence Plan for PBH. The roles of the Cultural Competence Study Group were:

  • To participate in discussions, identify disparities and make recommendations based on those identified disparities;
  • To select a survey instrument that would be used to survey PBH service providers and determine the cultural competence baseline of the system; and
  • To review the results of the cultural competence survey of PBH providers.

The Cultural Competence Study Group began meeting monthly in January 2005. The committee heard several presentations on the importance of cultural competence and how a system can support recovery-oriented cultural competency.

In February 2005, the study committee was presented with several surveys for review and selection. After a thorough discussion, the “Organizational Self-Assessment Survey for Cultural Competence” survey was selected.

The Study Group then began its work of identifying disparities in mental health care for culturally diverse populations. The disparities fell within seven areas, which were:

  • Access to Services
  • Communication and Community Engagement
  • Treatment
  • Research, Evaluation and Monitoring
  • Human Resources
  • Stigma
  • Training

As a result of the identification of disparities, the Cultural Competency Study Group was able to develop specific recommendations for each of the disparity areas, which considered the perspectives of, community representatives, consumers, family members, stakeholders, providers and others concerned about the disparities that exist in the mental health system.

PBH contracted with WLT Consulting, LLC, to conduct an assessment of baseline data on cultural competence within its system. PBH mailed surveys to 109 provider agencies, which were to be completed by the agency chief executive officer, supervisors and line staff. A total of 151 surveys were returned, representing 60 PBH providers, which is a response rate of 55%. Based on the findings of this survey, another set of recommendations was developed for the purpose of assisting in developing its Cultural Competence Plan. There were eight areas that the recommendations fell among:

  • Provider training and education
  • Develop more community contacts
  • Culturally competent person-centered planning
  • Improving relations with the Hispanic/Latino communities
  • Increased diversity in the workplace
  • The identification of culturally appropriate diagnostic tools and best practice treatments
  • Teaching staff how to utilize the culturally appropriate diagnostic tools and best practice treatments
  • Teaching staff how to utilize community resources to make treatment more effective and to make recovery possible

The road to finding answers to difficult questions is not always easy but well worth the journey. PBH has utilized the experiential learning from the work of the Cultural Competence Study Group, the Cross-Functional Cultural Competency Committee and provider survey responses for the development of a Cultural Competence Plan. This plan will earnestly help PBH work toward the dynamic process of cultural competence.