Wednesday, March 26, 2008

The Culture Question: What is the culture of the Commonwealth?

I have been getting feedback from many of you in the Network.   Thank you.  I have elected to not edit my draft responses on the blog, but to integrate your comments into the "final document", which I will try to post as a .pdf next week.  We will see how this goes.
These are hard questions.
(1) CSAs will serve relatively large areas with diverse populations. It may be difficult for one organization to have the cultural expertise to effectively serve such a broad range of needs. What strategies would you suggest to ensure that culturally competent care is available for all MassHealth children and families who need behavioral health services in a given Service Area?
This is an incredibly challenging issue, as we are facing an array of patients from a variety of backgrounds like we have never seen before.  A few ideas:
1)  Development of a statewide registry of resources (people) and services provided throughout the Commonwealth. This would allow interagency referral and facilitate the ability of people to address needs when there are no local resources.  
2)  Adequately funding the use of "off-site" interpreters for folks with language needs that cannot be met locally.  This requires providers to have the proper equipment (ie.  speakphones or videoconferencing capability in the exam rooms)
3)  Developing a "fast track" to recruit and credential therapists who were born and raised in other cultures.  They may help to provide some level of service.
4) Support agencies that recognize their limitations and seek outside support, rather than penalize them for not having the right services on-site.
(2) What suggestions do you have for strategies to reduce any health care disparities in the area of behavioral health?
First and foremost, we need to track the screening and referrals of folks with respect to race and ethnicity, so that we can actually get a handle on what the disparities are.  It is sometimes challenging to assign patients to a certain race and ethnicity, and one certainly difficult to deal with a problem until you have defined it.  We should also engage in a discussion (or perhaps focus groups) to identify barriers perceived by different sub-populations and respond to them.  Finally, we need to push the definition of patient focused care to incorporate the families health belief system into the treatment plan.  I defer to the group regarding other ideas.
(3) Are there models of culturally competent care you think MassHealth should consider?
Yes.  One is the  the "Latino Mental Health Project, which  partners the Massachusetts Department of Mental Health with community health centers and local health care providers to identify barriers preventing Latinos from seeking mental health care. With a grant from the American Psychiatric Foundation, CMAHEC created “Hablemos en Familia,” a series of workshops educating Latino community members to recognize, cope with and seek treatment. The federal Office of Minority Health recognized the program and selected CMAHEC from 500 entries to present at its national leadership summit.".  
Another is the HOPE Coalition (Healthy Options for Prevention and Education) is a youth-adult partnership coalition created to reduce youth violence, substance use and promote adolescent mental health in the City of Worcester. (Laurie Ross, Coordinator Phone: (508) 793-7642 , Email:  Both of these build on partnerships with community-based organizations to make it all work.

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