Cultural Competency in Disaster Mental Health Recovery

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Cultural Competency in Disaster Mental Health
Recovery

• Cecilia Rivera-Casale Ph.D., Senior Project
  Officer
• 301-443-4735 CCasale_at_samhsa.gov
• Cathy Cave B.S., Cultural Competence Coordinator
• NYSOMH, 518-408-2026 ccave_at_omh.state.ny.us

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Cultural Care

• We dont see things as they are,
• we see them as we are.

Anais Nin
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CROSS-CUTTING PRINCIPLES
SAMHSA Matrix Priorities
Financing Strategies and Cost Effectiveness
Community and Faith-based Approaches
Cultural Competency Eliminating Barriers
Rural and Other Specific Settings
Workforce Development
Trauma and Violence
Recovery/reducing Stigma and Barriers to Services
Collaboration with Public and Private Partners
Data and Evidence-Based Outcomes
PROGRAMS/ISSUES
Co-occurring Disorders
A Life in the Community for
Everyone Building Resilience and Facilitating
Recovery
Substance Abuse Treatment Capacity
Seclusion and Restraint
Prevention and Early Intervention
Children and Families
New Freedom Initiative
Terrorism/Bioterrorism
Homelessness
Aging
HIV/AIDS and Hepatitis C
Criminal Justice
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Cultural Competence Addresses

• Access to Supportive Services
• Cultural Adaptation of Outreach Approaches and
  Services
• Equity in Service Benefit
• More often, culture bears upon whether people
  even seek help in the first place, what types of
  help they seek, what coping styles and social
  supports they have, and how much stigma they
  attach to mental illness. (DHHS,2001)

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Cultural Competence Definition
Knowledge, Information and Data from and
aboutIndividuals and Groups
Integrated and Transformed
INTO

• Clinical Standards
• Skills
• Tailored Service Approaches
• Techniques (Outreach)
• Marketing Programs (Public Education)

That match the individuals culture and increase
both the quality and appropriateness of health
care and health outcomes. (King Davis, 1997)
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Cultural Competence Definition

• Expressed Differently Depending Upon Ones
  Culture
• Meaning of Sacred Place, Shrine, Burial
  Ground
• Personal and Family Rituals
• Ritual Helps to Face Loss and Accept Reality

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Challenges to Recovery Stigma, Mistrust and
Discrimination

• Bias and oppression are part of peoples history.
• Differences in expressions of distress, due to
  cultural variability in mourning, grief and
  ritual.
• Our view of the world is the world.
• Language and value differences.

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Elements of Recovery for Individuals and Families

• Outreach to individuals and families provides
  assistance and connection to available community
  supports.
• Recognize and utilize indigenous healing networks
  and practices.
• Emotional conditions are identified and
  counseling services are provided.

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Typical Phases of Disaster
1 to 3 Days -------------------TIME---------------
----------------------------1 to 3 Years
Zunin/Meyers
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Cultural Considerations

• Ethnicity
• Race
• Gender
• Age
• Socioeconomic Status
• Language and Dialects
• English Proficiency
• Country of Origin
• Prior Trauma Exposure
• Housing

• Spirituality/Religion
• Literacy Level
• Sexual Orientation
• Employment
• Geography (urban/rural)
• Physical Ability/Limitation
• Immigration Status
• Acculturation
• Criminal Justice
• Education Systems

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Role of Culture in Recovery

• Customs and traditions in trauma and loss
• Natural support networks
• Grief and grieving

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Grief and Grieving

• Expressed Differently Depending Upon Ones
  Culture
• Meaning of Sacred Place, Shrine, Burial
  Ground
• Personal and Family Rituals
• Ritual Helps to Face Loss and Accept Reality

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Guiding Principles for Cultural Competence in
Disaster Recovery

• Recognize the importance of culture and respect
  diversity.
• Maintain a current profile of the cultural
  composition of the community.
• Recruit disaster workers who are representative
  of the community or service area.
• Provide ongoing cultural competence training to
  disaster mental health staff.

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Guiding Principles for Cultural Competence in
Disaster Recovery

• Ensure that services are accessible, appropriate,
  and equitable.
• Recognize the role of help-seeking behaviors,
  customs and traditions, and natural support
  networks.
• Involve as culture brokers community leaders
  and organizations representing diverse cultural
  groups.

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Guiding Principles for Cultural Competence in
Disaster Recovery

• Ensure that services and information are
  culturally and linguistically competent.
• Assess and evaluate the programs level of
  cultural competence.

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Recruit Indigenous Staff

• Personal attributes
• Knowledge areas
• Skills

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Provide Ongoing Cultural Competence Training

• Cultural values and traditions
• Family values
• Linguistics and literacy
• Immigrant/refugee experiences and status
• Help-seeking behaviors
• Cross-cultural outreach techniques and strategies
• Avoidance of stereotypes and labels

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Culture Brokers

• Establish partnerships with community leaders and
  organizations representing diverse cultural
  groups in service design and delivery.
• Civic and social clubs
• Neighborhood groups
• Interfaith/mutual aid
• Volunteer
• Healthcare/social service
• Nonprofit advocacy organizations

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Ensure Cultural and Linguistic Competence in
Service Delivery

• Recognize Differences Within Communities
• Train Bilingual and Bicultural Staff
• Disseminate Educational Material
• Languages other than English
• Adapt Printed Materials

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Assessment

• Within the overall disaster recovery evaluation
  process, assess the level of cultural competence
• Focus group
• Survey
• Open Forum
• Key Stakeholder Interviews
• Involve Indigenous People as Evaluators