Presenter: Nancy Sung Shelton, M.A. (585) 730-1372

NancySungShelton.citizen@gmail.com

Children’s Mental Health Services Staff Development Training Forum

Saratoga Springs, NY

11/30/10

BUILDING AND LEADING A DIVERSE,

CULTURALLY COMPETENT WORKFORCE

WHAT IS CULTURE??? You have the opportunity to travel to another country, you exit the plane, what is it that you…

SEE

TASTE

SMELL

HEAR

FEEL

That makes you aware that you are in a foreign place?

K E Y T E R M S

CULTURE History, values, beliefs,

motivations, feelings, thoughts, perceptions, biases,

communication styles, association to racial/ethnic, religious or social

groups, and our definition of success and failure.

These elements make us who we are, they determine how we live

our lives and interpret our reality.

K E Y T E R M S

LINGUISTIC Refers to language;

persons of limited English proficiency , those who have low literacy skills or are not literate , and

individuals with disabilities.

(LEP)

(LRS)

K E Y T E R M S

COMPETENCE The knowledge, skills,

and abilities to successfully take on and complete a task

or activity.

K E Y T E R M S

MINORITY GROUP

Central features characterizing a minority group are:

• The members of a minority group suffer various disadvantages at the hand of another group;

• A minority group is identified by group characteristics that are socially visible;

• A minority is a self-conscious group with a strong sense of "oneness";

• People usually do not become members of a minority group voluntarily; they are born into it;

• By choice or necessity, members of a minority group tend to marry within the group.

A sub-group within the major racial/ethnic groups of African Heritage, Hispanic/Latino, Asian American, Native Hawaiian, Pacific Islander, or American Indian/Alaskan Native.

Groups can be identified by distinct languages (e.g., Mandarin- speaking Chinese among Asian Americans), or locales of origin (e.g., Dominicans among Latinos). A group from a recent immigrant or refugee population. A group identified as requiring special attention since features of its “culture” limit the ability of its members to appropriately access or participate in mainstream service delivery systems.

Examples include, but are not limited to, gay and lesbian communities, people with hearing impairments, rural and “mountain folk,” migratory workers, etc.

K E Y T E R M S

CULTURAL GROUPS

K E Y T E R M S

DISPARITES When individuals from one group, while attempting to obtain or while using services, receives in comparison to individuals from another group.

The groups include: gender, race or ethnicity, education or income, age, geographic area, language, customs, sexual orientation, and other cultural factors.

UNEQUAL/INEQUITABLE TREATMENT

K E Y T E R M S

CULTURAL COMPETENCE A set of congruent

that come together in a system, agency, or among professionals to work effectively in cross-cultural situations .

A culturally & linguistically competent (CLC) environment acknowledges and incorporates the importance of:

• Culture and Language

• Cultural Strengths Associated with People and Communities

• Assessment of Cross-Cultural Relations

• Expansion of CLC Knowledge

• Adaptation of Services to Meet CLC Unique Needs

• Includes the INTEGRATION and TRANSFORMATION of Knowledge into specific Standards, Policies, Practices and Attitudes.

BEHAVIORS, ATTITUDES, and POLICIES

WHAT YOUTH AND FAMILES WANT…

BUY-IN & COMMUNITY

PARTNERSHIP

A s s e s s m e n t P ro c e s s

CULTURAL COMPETENCE

COMMITTEE

Content Expert

Responsible for CC Activities

Member of Leadership Team

CC Definition - adopted and used to frame/drive future processes

CC Integration - addressing gaps, barriers & service capacity

Stakeholder training

Stakeholder and Internal dialogue discussing CC perspectives

Determines agency CC readiness

Identify CC Self-Assessment Tool

Agency self-identifies access & retention issues in diverse cultural groups

Lead by CC Champion

Review of CC assessment tool results

Professional Development

Agency CC Strategic Plan

Partners with QI/QA Department

Diverse Composition

W H A T Y O U R A G E N C Y N E E D S …

Consumers

Youth & Families

Staff

CC Action

Team

Community

Informal Supports

School

Partner Agencies

DSS

CPS

Juvenile Justice

Faith-Based

Peer Groups

A G E N C Y

C U LT U R A L C O M P E T E N C E C H A M P I O N

Reid-Rose, L.. “Cultural and Linguistic Competence Agency Narrative & Self Evaluation”

CLC AGENCY ASSESSMENT Baseline of information profiling cultural groups within the service population (youth and their families’ communities).

The extent to which the organization receives information about the cultural characteristics of the community.

All clinical and non-clinical activities and treatments offered, performed and assessed via culturally appropriate services to all cultural groups.

The management of all employees at all levels of an organization. Staff at all levels must have mandated annual CLC training.

Mechanisms that require that specific tasks and procedures be conducted and are in place that lead to CLC organizational behaviors.

For individual consumers, the goal of achieving desirable outcomes will be evidenced by clinical change, improved social functioning, recovery and self-empowerment.

NEEDS ASSESSMENT

INFORMATION EXCHANGE

SERVICES

HUMAN RESOURCES

POLICIES / PLANS

OUTCOMES

A D D R E S S I N G D I S P A R I T I E S …

What Causes Disparities

in Our

Systems, Agencies,

and Communities?

A D D R E S S I N G D I S P A R I T I E S … ACCESS to services:

WHO gets in?

WHERE do they get in?

HOW do they get in?

AGE of first contact?

CONTINUITY OF CARE while receiving services:

HOW LONG did they stay in care?

WHAT DO THEY GET while in care? (type of service)

WHERE DO THEY GO when they leave care?

WHAT are the types of services that each person receives?

QUALITY of the service received: QUALITY OF LIFE - Did services improve their social/familial lives,

employment, educational, housing…?

SELF-DEFINED SUCCESS - Are they now in recovery, experiencing

wellness, and/or maintaining stability?

RECIDIVISM RATES – After discharge, who comes back in to the system and

why?

OTHER SYSTEM INVOLVEMENT - With Criminal Justice, Juvenile Justice,

Emergency Department, etc.

Values Diversity

Cultural Self-Assessment

Manages the Dynamics of Difference

Development of Cultural Knowledge

Adaptation to Diversity

T H E P E R S O N A L J O U R N E Y …

5

ELEMENTS OF

CULTURAL COMPETENCE

WHAT’S IMPORTANT TO YOU???

ACTIVITY

T H A N K Y O U !

QUESTIONS, COMMENTS or MUSINGS….

If we could shrink the earth's population to a village of precisely 100 people, with all the existing human ratios remaining the same, it would look something like the following.

57 Asians 21 Europeans 14 from the Western Hemisphere (both north and south) 8 Africans

52 would be Female 48 would be Male

70 would be Non-White 30 would be White

70 would be Non-Christian 30 would be Christian

89 would be heterosexual 11 would be homosexual

6 people would possess 59% of the entire world's wealth (and all 6 would be from the United States.)

80 would live in substandard housing

70 would be unable to read

50 would suffer from malnutrition

1 would be near death 1 would be near birth

1 would have a college education 1 would own a computer

When one considers our world from such a compressed perspective, the need for both acceptance, understanding and education becomes glaringly apparent.