HHS: Integrated Care for Racial & Ethnic Minorities

Integrated Care for Racial & Ethnic Minorities: A Look Into HHS’ Office of Minority Health

By Teresa Chapa, PhD, MPA, senior policy advisor, mental health, U.S. Department of Health & Human Services, Office of Minority Health

SAMHSA-HRSA Center for Integrated Health Solutions  May 1, 2012

 

 

When navigating our fragmented and complex healthcare system, racial and ethnic minorities and persons with limited English proficiency often seek behavioral health assistance through their primary care providers.

The Office of Minority Health (OMH) first examined the role of integrated care in 2004 to find solutions for improving access, engagement and utilization of mental health services by minority populations by writing a position brief that included the research and guidance of national experts in the fields of health, mental health, substance use and addiction, integrated health care, and cultural and linguistic competency. Since then, the field has gained significant momentum.

OMH developed its initiatives and programs in integrated care with the goal of improving the health and behavioral health status of racial and ethnic minority and limited English proficiency populations by highlighting and promoting models that provide efficient and seamless coordination of access, quality and delivery of care. Our goals and objectives are centered on promoting health equity while building on innovation and leadership, working collaboratively across the U.S. Department of Health and Human Services and with other federal and non-federal partners, leveraging dollars and bridging gaps. Along with our partners, OMH hopes these new models of integrated care can be implemented to improve the overall quality of care for our underserved communities.

Strategies aimed at eliminating behavioral health disparities include:

• Increase knowledge and implementation of integrated primary and behavioral healthcare models that serve racial and ethnic minority communities and those with limited English proficiency.
• Promote best, promising and evidence-based practices that are culturally and linguistically appropriate.
• Support efforts to build a multidisciplinary, diverse, knowledgeable, bilingual and culturally competent workforce and leadership for integrated care.
• Improve health and behavioral healthcare by addressing the role of social determinants of health.
• Improve information dissemination strategies through learning collaboratives.

Examples of OMH’s integrated care and workforce development projects include:

• Integrated Care for Asian American, Native Hawaiian & Pacific Islander Communities: A Blueprint for Action Summit (August 2011) and A Blueprint for Action. Consensus Statements and Recommendations (2012).
• Eliminating Behavioral Health Disparities through the Integration of Behavioral Health and Primary Care Services for Racial and Ethnic Minority populations: Establishing Models for Improving Clinical Outcomes. Hogg Foundation for Mental Health. Consensus meeting: Nov. 2011. Consensus paper: Jan. 2012. Final rollout: February 7, 2012. Review of the literature due May 2012.
• Mobilizing Social Work as a Resource for Eliminating Behavioral Health Disparities: a Disparities Curriculum Infusion Project, National Association of Deans and Directors of Schools of Social Work. Literature Review. Due April 2012.
• Dialogue and Strategies for Effective Holistic Health for African Americans-Blacks: Addressing the Integration of Mental Health, Substance Abuse and Primary Care (2010) and Pathways to Integrated Health Care, Strategies for African American Communities and Organizations: consensus statements and recommendations (2011).
• Movilizándonos por Nuestro Futuro: Strategic Development of a Mental Health Workforce for Latinos Consensus meeting (2009), and consensus statements and recommendations (2010); the Alliance for Latino Behavioral Health Workforce Development (2010), a leadership driven steering committee dedicated to implementing recommendations and actions steps of Movilizándonos and workforce overall.

For more information on OHM’s efforts related to integrated care for racial and ethnic minority populations, contact Teresa Chapa, PhD, MPA, senior policy advisor, mental health, U.S. Department of Health and Human Services, Office of Minority Health, at 240-453-6904 or teresa.chapa@hhs.gov.

Contact CIHS for technical assistance around health disparities and visit www.integration.samhsa.gov for resources on the integrated health workforce and cultural competency. For extensive information on diversity, visit the National Network to Eliminate Disparities in Behavioral Health (NNED).

 

Quick Tips to Strengthen the Provider-Client Relationship through Cultural Understanding

 

Clinicians working in integrated care settings have the best of intentions. They strive for better client engagement, better patient-provider relationships and better health and behavioral health outcomes. However, lack of cultural understanding and sensitivity are vital to engaging and caring for members of cultural, ethnic and racial groups in the care they need to achieve recovery and improved health. Below are several tips that a healthcare professional can implement today to help build stronger, more culturally competent relationships with clients of all minority populations.

• Recognize that culture is a defining characteristic for some clients, and in such, their cultural identity may be at the root of their presenting health problem.
• Alternatively, do not assume that culture is a defining characteristic of all clients. If your client views himself or herself outside the context of any cultural identity, you should too.
• Do not assure any client that you “understand.” Rather than try to prove how much you know about a client’s culture, demonstrate your willingness to learn from the client.
• Treat each client as an individual, not as a member of a group. People seek and need treatment, not cultures. Accept the level of importance culture takes up in a client’s life and don’t assume that all the characteristics you have learned are dominant in his or her culture.
• Do not assume you have an advantage with clients of the same culture as you. Your own feelings about your culture may be as much of a hindrance as a help. The feeling that you “have it right” may lead you to unknowingly force your preferences on your clients.
• Remember that human beings are more alike than different. Do not overlook obvious interpretations of behavioral health and health symptoms by only interpreting a client’s actions in context of their culture.
• Accept that we all relate to others within the context of our own set of values, knowledge and experiences. In that vein, assume that you have biases and beliefs that may hinder optimal provider-client relationships. Draw upon your own expertise at the same time you honor and acknowledge each client’s expertise. As an integrated healthcare provider, you are the expert on strategies of health behavior change and treatment and services. Each of your clients is the expert on his or her own culture and the place it holds in his or her life and healthcare.

Contact CIHS for technical assistance on culturally competent care in integrated care settings.

CIHS provides training and technical assistance to the Substance Abuse and Mental Health Services Administration’s Primary and Behavioral Health Care Integration (PBHCI) grantees. Each issue of eSolutions profiles a grantee’s work.