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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 New York State Office of Mental Health (NYSOMH) Nathan Kline Institute for Psychiatric Research in Orangeburg NY. The Institute is affiliated with New York University.
In November 2007, the Nathan Kline Institute (NKI) for Psychiatric Research received funding from the New York State Office of Mental Health to establish a Center of Excellence in Culturally Competent Mental Health. The NYS legislature had proposed the formation of Centers 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 Center is housed in the Statistics and Services Research Division of NKI.
Dynamic research collaboration is key for the Center. Community representatives, consumers and family members serve on an advisory panel and participate in Center projects. Linkages to advocacy groups, the NYS Multicultural Advisory group, the NYSPI Center of Excellence in Cultural Competence, and the NKI Center for the Study of Recovery in Social Contexts along with national groups involved in cultural competency are promoted.
Mission: To eliminate racial and ethnic disparities in the availability, accessibility and quality of behavioral health care services through the development of culturally competent services.
Specific Center Aims include:
- Through research, identify and develop culturally competent mental health practices and provide evidence of their effectiveness.
- Through research, identify disparities and the culturally competent strategies to reduce these disparities for cultural groups.
- Create valid and reliable measures of the cultural competency of practices and organizational structures.
- Serve as a resource to providers, planners and consumers for service information and data on cultural groups in NYS.
- Serve as a resource to NYS OMH to promote cultural competency in programs, policies and practices.
Center projects are organized according to cultural competency domains.
Access to information on cultural groups is necessary for understanding their mental health needs. Three sources of information are available on the website:
1. Detailed cultural group mental health literature reviews that identify the specific concerns and issues for different cultural groups living in the US.
2. Maps and data tables of cultural and religious groups in NYS, organized by county.
3. A directory of mental health and other services for cultural groups in NYS.
Research examines evidence-based practices for cultural groups from both top down and bottom up approaches. A toolkit has been developed to modify evidence-based practices for cultural groups. Bottom up programs for cultural groups that have been identified by key community informants as achieving success are studied for clues to why they work.
Bottom-up: Three site study of community defined and experientially based culturally competent practices has been completed. Study was made of a NYC Latino Inpatient unit, a Monroe County based prevention program for youths and families of color that teaches self empowerment and confidence building techniques, and a mental health clinic serving a sizeable proportion of Chinese and Korean elderly in NYC. Based on an observational study, the Center has authored a document, entitled "Cultural Elements in Community Defined Evidence-Based Mental Health Programs", which is available on the website. The document describes the ways in which these programs have incorporated cultural features for the cultural groups they serve.
Top-down: The "Toolkit for Modifying Evidence-Based Practices to Increase Cultural Competence" has been completed. The Toolkit provides a step-by-step methodology for mental health practitioners and agency administrators to identify and evaluate evidence-based practices (EBPs) for possible modification for cultural groups. The Toolkit recognizes the multi-disciplinary nature of mental health service delivery and can be used in a wide range of settings from individual clinician practices to large public organizations. Two case studies are provided: one on modifying the "Illness Management and Recovery EBP Toolkit" to create a mental health curriculum for native Hawaiians, the other on lessons learned from a well-studied universal family and school intervention for pre-K students, which aims to prevent conduct problems and promote school success among ethnically diverse children from underserved communities. Importantly, ways in which the community members, parents, and program leaders participated in program development, implementation and conduct are documented.
Other on-going service related projects include: validation of depression screens for Latino cultural groups in Bellevue Primary Care, development of a screening instrument for gambling and co-occurring psychiatric conditions in Chinese, research into psychosocial problems for obese youth, and support group development.
Developing training materials of relevance to enhance cultural competency is another Center aim. We strive to create materials that will train clinicians and mental healthcare workers in culturally competent care.
1. A "Clergy Curriculum" is under development. The curriculum will serve as a training tool for clergy who encounter mental health concerns in congregants from cultural groups.
2. A guide for creating spiritual support groups for cultural groups in in- and out-patient settings is also underway.
Research into disparities among cultural groups is important as it identifies service discrepancies. Some of our projects include:
1. Utilization rates of ECT treatment for severe depression in African Americans versus Whites.
2. Disparity rates in service utilization for persons using the public mental health system in NYS.
1. The Cultural Competency Assessment Scale is applicable to an agency delivering behavioral health care in an outpatient setting. Implementation of Cultural Competency by the agency is expected to promote CC in all its staff members and to create a milieu that acts to improve access and retention in treatment of persons from diverse cultural groups. The scale is available on our website.
2. The Cultural Competency Scale for Chinese Providers is applicable to an agency delivering behavioral health care to Chinese populations in an outpatient treatment environment. Issues of Cultural Competency are still expected to arise because the Chinese population being served may have distinct cultural subgroups with language and special health care needs. The scale is available on our website.
3. A Program Level Cultural Competency Scale is under development. The scale will be useful at the program level for assessing cultural competency.
This web-site is continually updated to include salient findings. NKI has a fifteen-year history of research activities in mental health cultural competency.
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.