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Cultural Competency in Disaster Mental Health Recovery. Cecilia Rivera-Casale Ph.D., Senior Project Officer 301-443-4735 CCasale@samhsa.gov Cathy Cave B.S., Cultural Competence Coordinator NYSOMH, 518-408-2026 ccave@omh.state.ny.us. We don’t see things as they are, we see them as we are.

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cultural competency in disaster mental health recovery

Cultural Competency in Disaster Mental Health Recovery

Cecilia Rivera-Casale Ph.D., Senior Project Officer

301-443-4735 CCasale@samhsa.gov

Cathy Cave B.S., Cultural Competence Coordinator

NYSOMH, 518-408-2026 ccave@omh.state.ny.us

slide3

CROSS-CUTTING PRINCIPLES

SAMHSA Matrix Priorities

Cultural Competency & Eliminating Barriers

Community and Faith-based Approaches

Financing Strategies and Cost Effectiveness

Rural and Other Specific Settings

Data and Evidence-Based Outcomes

Collaboration with Public and Private Partners

Recovery/reducing Stigma and Barriers to Services

Trauma and Violence

Workforce Development

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

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)

Cultural Competence Addresses:
cultural competence definition
Clinical Standards

Skills

Tailored Service Approaches

Techniques (Outreach)

Marketing Programs (Public Education)

Cultural Competence Definition

Knowledge, Information and Data from and aboutIndividuals and Groups

Integrated and Transformed

INTO

That match the individual’s culture and increase both the quality and appropriateness of health care and health outcomes. (King Davis, 1997)

cultural competence definition6
Cultural Competence Definition
  • Expressed Differently Depending Upon One’s Culture
  • Meaning of “Sacred Place”, “Shrine”, “Burial Ground”
  • Personal and Family Rituals
  • Ritual Helps to Face Loss and Accept Reality
challenges to recovery stigma mistrust and discrimination
Bias and oppression are part of people’s 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.

Challenges to Recovery: Stigma, Mistrust and Discrimination
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.

Elements of Recovery for Individuals and Families
typical phases of disaster

Honeymoon(Community Cohesion)

ReconstructionA New Beginning

“Heroic”

Pre-disaster

Disillusionment

Warning

Threat

(Coming to Terms) Working Through Grief

Impact

Trigger Events and Anniversary Reactions

Inventory

Typical Phases of Disaster

1 to 3 Days -------------------TIME-------------------------------------------1 to 3 Years

Zunin/Meyers

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

Cultural Considerations
grief and grieving
Expressed Differently Depending Upon One’s Culture

Meaning of “Sacred Place”, “Shrine”, “Burial Ground”

Personal and Family Rituals

Ritual Helps to Face Loss and Accept Reality

Grief and Grieving
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.

Guiding Principles for Cultural Competence in Disaster Recovery
guiding principles for cultural competence in disaster recovery14
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.

Guiding Principles for Cultural Competence in Disaster Recovery
guiding principles for cultural competence in disaster recovery15
Ensure that services and information are culturally and linguistically competent.

Assess and evaluate the program’s level of cultural competence.

Guiding Principles for Cultural Competence in Disaster Recovery
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

Provide Ongoing Cultural Competence Training
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

Culture Brokers
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

Ensure Cultural and Linguistic Competence in Service Delivery
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

Assessment