Ethnocultural and linguistic bias in mental health evaluation of Hispanics.

Abstract

At the root of effective mental health care is valid psychodtagnosts, premtsed upon accurate psychometrtc technology and sound chntcal judgment The majority of clintctans, however, are monolingual and White, whtch does today (and wdl mcreasmgly) pose a problem for mental health servtce dellvery--partwularly for Htspanic pattents This arttcle examines sources of ethnw and lmgutsttc btas m evaluation of Htspamc clients It ts argued that even tf unblased assessment techmques can be developed, vahd psychodiagnosts of Hlspantc patients wdl remam dlusory to the extent that cllmctans are msensittve to the lingutsttc and cultural nuances of thetr chentele. Recommendatwns for tmprovmg chntcal practtce are offered

Bilingualism and neuropsychiatric disorders

“…As with bilingual aphasia, it is recommended that, before conducting any assessment, the clinician should ascertain the client's specific language history and preferences, and evaluate the client's sociocultural background and level of acculturation (Altarriba & Santiago-Rivera, 1994;Cofresi & Gorman, 2004;Malgady, Rogler, & Costantino, 1987;Rozensky & Gomez, 1983).…”

Race, Managed Care, And The Quality Of Substance Abuse Treatment

“…Aside from the risk of misdiagnosis, non-English speaking Hispanics will be less likely to understand the physician's instructions, less likely to receive psychotropic medications (Sclar, Robin, Staer, & Galin, 1999;Malgady et al, 1987), and perhaps most importantly, less likely to benefit from support groups or talk therapy. Communication problems can adversely affect many aspects of mental health and substance abuse counseling, where the ability to communicate is necessary to diagnose, plan, and benefit from treatment.…”

Preliminary Evaluation of the Validity and Reliability of the Spanish Version of the Therapeutic Alliance with Clinician (TAC) Questionnaire

“…Hendricson et al (1989) cautioned researchers about the risk of comparing ethnic groups using secondlanguage translations of questionnaires that lack correspondence to original language versions. Likewise, Malgady et al (1987) emphasized the importance of conducting an accurate assessment on Hispanics' mental health since a proper diagnosis will provide the basis for correct treatment and follow-up. For instance, Berkanovic (1980) reported poor responses on health surveys that did not follow recommended methodological procedures such as backtranslation.…”