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J Community Psychol. 2013 Apr;41(3):378-393. doi: 10.1002/jcop.21544.

CULTURALLY COMPETENT SERVICES WITHIN A STATEWIDE BEHAVIORAL HEALTHCARE TRANSFORMATION: A MIXED-METHOD ASSESSMENT.

Journal of community psychology

Rafael M Semansky, Jessica Goodkind, David H Sommerfeld, Cathleen E Willging

Affiliations

  1. Health Care Consultant.
  2. University of New Mexico.
  3. University of California.
  4. Pacific Institute for Research and Evaluation.

PMID: 25937679 PMCID: PMC4415618 DOI: 10.1002/jcop.21544

Abstract

In 2005, New Mexico created a single health plan to administer all publicly-funded behavioral health services. Our mixed-method study combined surveys, document review, and ethnography to examine this reform's influence on culturally competent services (CCS). Participants were executives, providers, and support staff of behavioral healthcare agencies. Key variables included language access services and organizational supports, i.e., training, self-assessments of CCS, and maintenance of client-level data. Survey and document review suggested minimal effects on statewide capacity for CCS during the first three years of the reform. Ethnographic research helped explain these findings: (1) state government, the managed behavioral health plan and agencies failed to champion CCS; and (2) increased administrative requirements minimized time and financial resources for CCS. There was also insufficient appreciation among providers for CCS. Although agencies made progress in addressing language assistance services, availability and quality remained limited.

Keywords: Cultural appropriateness; health policy; mental health; mixed-method; rural

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