Cultural Competency - Mental Health America of Wisconsin
CULTURAL COMPETENCY
There are many reasons to involve cultural competency in the development and maintenance of suicide postvention programs. The United States population is growing, as is the cultural and linguistic diversity within the population. It is important that we understand the racial/ethnic, cultural, geographic, linguistic, and economic diversity within the populations we serve. The National Center for Cultural Competence has identified six salient reasons as rationale to incorporate cultural competencies into organizational policy:
●To respond to current and projected demographic changes in the United States.
●To eliminate long-standing disparities in the health status of people of diverse racial, ethnic and cultural backgrounds.
●To improve the quality of services and health outcomes.
●To meet legislative, regulatory and accreditation mandates.
●To gain a competitive edge in the market place.
●To decrease the likelihood of liability/malpractice claims.
When thinking of culture and cultural competency, it is important to be aware of different aspects of American culture. Among these aspects is a strong Protestant ethic that places a greater importance on an individual than on a group. Authority is vested in a hierarchical approach, with men usually in areas of power, although women are making great gains. America is a democratic society in which voting plays a major role in having one’s voice heard. Some people in the United States utilize “either/or” thinking, with “gray areas” difficult to conceive of. In the American workplace, it is important to not involve personal feelings with work. The end product usually justifies the means (unlike in the Native American culture), and success is measured economically. (Value Base of American Culture, presented at the SAMHSA State/Tribal/Adolescents at Risk Suicide Prevention Grantee Technical Assistance Meeting, December 2006).
Within Wisconsin are specific social and cultural norms and aspects of diversity special to this area of the Midwest. For example:
• Most of Wisconsin is rural, with 45% of the total land area being farmland and 46% of the total land being forest, with some larger cities like Milwaukee, Madison, and the Fox Valley Region (US Census Bureau). Wisconsin’s landscape is particularly important to consider when thinking about access to health care, as physical and mental health care is less available and accessible in the rural areas.
• Wisconsin’s population is becoming a more racially/ethnically diverse, but is still predominantly White (90%). Other racial/ethnic groups in Wisconsin include: African American (6%), Hispanic/Latino (4.5%), Asian (2%), and Tribal (0.9%) (US Census Bureau).
• The linguistic culture is expanding to include Spanish and Hmong.
• Though predominantly middle class, large economic variations exist in Wisconsin, which makes it difficult for all to obtain appropriate physical/mental health care along with prevention.
• The long winters in Wisconsin, with shorter days and a cold, snowy climate, have an effect one’s attitude and can impact those with possible mental health issues.
• The presence of a strong hunting community in Wisconsin increases access to guns (i.e. lethal means for suicide). This access poses a significant challenge in preventing firearm-related suicides in Wisconsin or restricting access to lethal means.
• Alcohol use is a strong social tie in Wisconsin, and Wisconsin is ranked number one in underage drinking in the US (SAMHSA). This raises a concern, because alcohol lowers the inhibition and increases impulsivity of someone who is suicidal.
Within Wisconsin it is important to be aware of these differences and make accommodations to any populations when developing, implementing, and evaluating suicide prevention, intervention, and postvention programs.
According to the National Center for Cultural Competence, “cultural competency requires that organizations:
* have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.
* have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve.
* incorporate the above in all aspects of policy making, administration, practice, and service delivery, and systematically involve consumers, key stakeholders, and communities.”
(See Appendix for Culturally Specific Fact Sheets)
These suggestions were compiled from a variety of sources including:
National Center for Cultural Competence
Substance Abuse and Mental Health Services Administration (SAMHSA)
US Census Bureau
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