Cultural competence training is mandatory in the United States of America to alleviate minority health disparities though few studies have examined perceptions across stakeholders. We conducted separate focus groups with patients, clinicians, and administrators from the psychiatry department at one community hospital and compared responses to hospital policies. Stakeholders defined cultural competence through group-based or person-centered traits despite policies recommended person-centered approaches. Administrators and clinicians named clinician techniques for psycho-education whereas patients named these techniques for enlistment in treatment planning as equals. All groups named patient cultural views and institutional challenges as barriers to care, but only patients and administrators additionally named clinician biases as possible barriers. We discuss these discrepant perceptions and possible solutions to improve research, practice, and policy on cultural competence in mental health.

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Objective: This study reports the extent to which states have adopted the National Culturally and Linguistically Appropriate Services (CLAS) Standards. Methods: Officials from public mental health agencies in the fifty states, Washington, DC, and Puerto Rico were contacted to obtain current policies between January and June 2016. Each policy was coded through thematic analysis to determine correspondence with any of the fourteen National CLAS Standards which are divided into three domains. Results: Officials from 47 states and territories (90%) responded. Eight states (17%) reported adopting all National CLAS standards. Ten (23%) had no policies, five (12%) had policies under one domain, three (7%) had policies under two domains, and 25 (58%) had policies under all three domains. Conclusion: Most states still do not have policies that meet all CLAS standards, raising questions on how they should be adopted.

This study explores the applicability of the American Group Psychotherapy Association’s (AGPA) Practice Guidelines for Group Psychotherapy to analyse the construction of group processes in three focus groups with patients, clinicians, and administrators on cultural competence. Each focus group was recorded, transcribed, and analysed through codes developed from the AGPA’s Guidelines. Findings were compared and contrasted to discover thematic convergences and divergences. Our results show that certain processes such as catharsis, imparting information, and universality emerged commonly across all three focus groups, but with different frequencies. Group processes influenced how participants interacted and influenced each other in their responses, suggesting the value of analysing group processes in multicultural focus groups.