Policy Programs and Services

Cultural Competence

Erin Buell

Concordia University

Policy Programs and Services

514

Jean Elliott

May 24, 2014

CULTURAL COMPETENCE1

Cultural Competence

Cultural competence in the practice setting for health care, social work, and mental health care is a necessary component for closing the disparities in care that often occur. For the professional to accomplish such competency, it is essential that there exists recognition of the need, and that the identification of both the existing diverse populations, and the potential gaps in service is documented. Studies suggest that cultural minorities receive lesser care than that of non-minority Caucasians in the United States,and even though the Surgeon General has identified that disparities exist, progress lacks in addressing the issue (Kohn-Wood & Hooper, 2014).

As we move forward in the twenty first century, we can witness that the influx of ethnic plurality in our country is significant. We are also acknowledging that in addition to ethnicity, cultural difference includes gender, religion, sexual orientation, and income levels. Furthermore, cultural difference can also present as political affiliation, physical and mental health status, intellect, and many other elements of an eclectic population.

The human service professional has a responsibility to work toward policies and practices that that can bring equitable, quality care to an individual or group no matter what the cultural identifiers may be. As well, the human service professional must be mindful and diligent in respecting that the goals of care that the client has may not be congruent with what the caregiver assumes would be quality care. Therefore, policies that are created must be at once specific to allowing care to be accessible, adequate and appropriate, yet flexible and sensitive to accommodate an array of potential influential cultural norms.

The human service professional is responsible for studying current research, local and regional legislation and policy, and current trends in population and diversity, and to build a network of reliable and diverse resources and referral processes. As well, a practice of advocacy for individual and group rights for culturally sensitive approaches to care is essential. Without cultural competence in the human service field, and with the expanding diversities that can be recognized, the gaps in care will increase. Without a continuum of care that is equitable across cultural lines, expanding portions of the population risk not receiving mental, physical, and social services that are vital will escalate, and societal costs will climb. The human service professional has a valuable role in care coordination. Understanding cultural nuances of a given client can lead to productive resource navigation and goal setting with that client.

Consider Walt, a60 year old man who is paranoid and probably schizophrenic, although undiagnosed. He has worked off and on throughout his adult life, but it is increasingly difficult for him to stay in any work environment for very long. He currently is homeless, un-kempt, and hungry. He has not seen a doctor and cannot handle the process of applying for food stamps or any other public assistance. His homelessness is creating a lot of anxiety, and he has been picked up and sent to jail on several occasions for disturbing the peace. This escalates his instability, and a vicious cycle seems to be occurring.A judge ordered a psychiatric evaluation, and on the morning of the appointment his anxiety reached acute levels and he hit his head against the wall of his jail cell. He was then sent to a psychiatric inpatient facility. In reality, Walt is eligible for food stamps, and either Supplemental Security Income or Social Security Disability.He has mental health issues that have not been treated. Cultural competence would include workers who understand mental illness and anxiety. A worker would have to develop a trusting relationship with Walt that let him feel safe to move at his own pace in a task centered model in which Walt could feel in control. Such a model is described in case study 4.1 in Introduction to Human Services; Through the Eyes of Practice Settings(Martin, 2014, p. 76). In such a model, the human service worker allows the client to set a pace that is comfortable and on the client’s terms. The case worker will establish a trusting relationship in which the client is assured control of the process of goal setting and follow through. This allows the client the power to feel in control of his or her own choices. The professional can help the client determine realistic goals that are well rounded and account for budget, preferences, safety, independence, and building blocks of self-esteem. The plan will include follow up support, and encouragement to access any appropriate referrals in social, emotional, community, physical, or mental health resources.

References

Kohn-Wood, L. P., & Hooper, L. M. (2014, April). Cultural competency, culturallytailored care, and the primary caresetting: possible solutions to reduceracial/ethnic disparities in mentalhealth care. Journal of Mental Health Counseling, 36, 173-178. Retrieved from

Martin, M. E. (2014). Introduction to human services; through the eyes of practice settings (3rd ed.). Upper Saddle River, NJ: Pearson Education.