Overview
Nathan
Kline Institute Designated a Center of Excellence
in Culturally Competent Mental Health
The
NKI Center of Excellence in Culturally Competent Mental Health
is housed in the Statistical and Services Research Division of the
Nathan Kline Institute for Psychiatric Research in Orangeburg NY.
The Institute is affiliated with New York University.
Inequities
in the engagement into, retention in and outcomes of mental health
services for cultural minority groups have been widely documented.
Less is known concerning the means and best practices that would demonstrate
effective ways to alleviate these inequities. Promoting cultural competency
in mental health care delivery is highly endorsed as a way to enhance
the delivery of services to cultural groups. But the concept still
requires greater specificity and articulation of ways to promote and
implement culturally competent practices.
The
recently enacted Amendment
to the 2007 NYS Mental Hygiene Law establishes two Centers of
Excellence in Culturally Competent Mental Health. The legislative
charge is to “identify, assess the outcome and disseminate best
practices of demonstrated behaviors, attitudes, policies and structures”
that work effectively cross-culturally across varied modalities of
care. The New York State Office of Mental Health (OMH) designated
the OMH Nathan Kline Institute for Psychiatric Research (NKI) in Orangeburg
NY as one such Center and the OMH Psychiatric Institute in New York
City as another.
The
NKI Center will focus on establishing evidence based practices for
Latino, African-American and Asian-American populations, and the numerous
groups within each of these large headings for different age groups
and modalities of care. Community representatives, consumers and family
members will serve on an advisory panel and have input into the Center’s
projects. Center collaborators include the NYS Office of Mental Health
Central Office, NYS Multicultural Advisory Committee, the Psychiatric
Institute Center of Excellence in Cultural Competence, NKI Center
for the Study of Recovery in Social Contexts along with the NKI/NYU
clinical affiliates.
Activities
with respect to evidence-based care will be both top down and bottom
up. The top down work will result in a template for adapting evidence-based
practices to specific cultural groups. In addition a well-studied
research-developed pre-K school-based program that aims to reduce
anti-social behaviors in poor inner city African-American and Afro-Carribean
children through parent and teacher training will serve as a model
for developing (from scratch) other culturally sensitive programs
for children. This will include documenting ways in which the community
members, parents and its leaders, were participants in program development
and facilitation of the implementation and conduct of the program.
In
the bottom up work, promising programs for cultural groups that have
been identified by key community informants will be studied in order
to elevate them to evidence-based levels. Sites to be studied are
a NYC Latino Inpatient unit, a Rochester based prevention program
that teaches self empowerment and confidence building techniques to
adolescents from all cultural and ethnic groups who are experiencing
challenges in their daily lives, and a mental health clinic servicing
a sizeable proportion of Chinese and Korean elderly in NYC. The work
of the Center will be to make specific the ways in which these programs
have incorporated features that take into account the cultural groups
they serve. The Center will also continue ongoing NKI activities in
the development of tools and procedures that enable care delivery
environments to effectively and compassionately engage and treat persons
from cultural groups.
Another
first year Center aim is to assist in the conduct of disparity research
through collaborations and technical support. The Center will augment
ongoing studies to include an examination of possible disparities.
One such study being conducted by a research group affiliated with
both NKI and NYU Medical School is establishing the prevalence of
metabolic syndrome in high school children in NYC, an overwhelming
proportion of whom are Latino. The Center enhancement will include
the addition of a mental health screen for depression in order to
investigate a possible relationship between obesity and depression
in cultural groups. A second will investigate whether the Medicare
Modernization ACT Part D that requires dual eligibles to receive their
medications through Medicare supported prescription drug plans rather
than through Medicaid results in differential treatment gaps among
ethnic groups.
This
web-site will be developed to include salient findings from literature
reviews on the background factors of cultural groups in NYS (including
maps to show the distribution of the cultural groups across the State),
and cultural factors that providers and planners would benefit from
knowing as they introduce mental health treatments for these groups.
It will also identify mental health programs throughout New York State
that have developed special programs for cultural groups that will
include descriptions of the services offered and contact information
as provided by these programs.
NKI
has a fifteen-year history of research activities in mental health
cultural competency. Working with multi-cultural groups of consumers,
advocates, families and professionals, indicators of cultural competency
were developed for all levels of care, along with a Cultural Competency
Assessment Scale to measure competencies on the organizational level.
The scale is currently being tested for reliability and validity.
Carole
Siegel Ph.D., head of the Statistics and Services Research Division
at NKI, is director of the Center of Excellence. Gary Haugland, MA,
Research Scientist at NKI, and Lenora Reid-Rose, MBA, Director of
Cultural Competency at CCSI, and Chairperson of the NYS Multicultural
Advisory Committee are Co-Directors. Jennifer C. Hernandez, MPA, is
the Center’s Administrative Director.
