Cultural competence and quality of care: Issues for mental health service delivery in managed care.

Abstract

Models of mental health service deliiery in managed care have evolved without considering the needs of ethnic minorities in any systematic manner. Consequently, these new systems may pose additional banie n t o access and treatment. In this article, the impact of the health care crisis on mental health service deiivery to ethnic minorities in terms of access, cost, and quality of care issues in managed care systems is explored. A quality-of-cam iramewodc is used for addressing the notion of cultural competence as a critical dlmsnslon of quality of care for ethnic minority populations. Research in minority mental health and quality of care is integrated in order to explore how various structures, processes, and outcomes in managod care systems (e.g., cost containment structures for controlling the supply and demand of mental hoalth sewicos, utilization management and gatekeeping processes) may impact mental health sonice delivery to ethnic minorities. Cultural competence is conceptualized as a critical componont of quality care for ethnic minority populations.

Disparities in Mental Health Service Utilization among Low-Income African American Adolescents: Closing the Gap by Enhancing Practitioner’s Competence

“…Cultural competence is one of many attributes of quality care (Abe- Kim & Takeuchi, 1996;Cross et al, 1989;Flaskerud, 1986) and included in accountability monitoring for behavioral health and managed care organizations (NCQA, 1995;Stork, Scholle, Greeno, Copeland, & Kelleher, 2001). The literature is replete with studies, which demonstrate the central role of family, peers, school, neighborhood, and community in the psycho-social development of children.…”

Research Article: Antidepressant use among Asians in the United States

“…(4) The limited research available on Asian Americans shows that despite these risk factors, Asian Americans report lower rates of mental health–related service use compared to the general population. (5-8) Explanations for this low mental health services use focus on several barriers to care: 1) cultural incompatibility of mental health services to needs (e.g., language, lack of patient-provider ethnic concordance); (7, 9-11) 2) cultural barriers, such as stigma, differing causal beliefs; (11-13) 3) limited access to care, (e.g., low rates insurance coverage); (14, 15) and 4) lack of awareness of mental health problems or understanding of healthcare services. (10, 16)…”

Culturally competent school assessment: Performance measures of personality

“…This desired outcome has not occurred because of inadequate linkages of cultural competency to access, cost, and especially to quality of care in the public sector (Abe-Kim & Takeuchi, 1996). Moreover, culturally competent assessment has been recognized as requiring more than mere reduction of technical bias and development of nonbiased tests (Skiba, Knesting, & Bush, 2002).…”