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Supporting Culturally Competent Care and Mental Health

Mina Schoenheit
Mina Schoenheit, M.A., is a cultural consultant who specializes in cross-cultural counseling and therapy and cultural competence. Mina has spent a great deal of her consulting and counseling careers advocating for the needs of communities underserved by the mental health system. For many years, she had been a supporter of NAMIWalks in Portland, a community fund-raiser designed to support the work of the Portland chapter of the National Alliance for the Mentally Ill (NAMI).

Mina is raising funds through this page, in an effort to support NAMI’s education classes, support groups and community outreach programs that serve individuals and families dealing with mental illnesses. The NAMIWalks event in Portland is scheduled for Sunday, May 17, and starts at East Bank esplanade. In the interview below, Mina shares her passion for supporting individuals dealing with mental health issues, as well as their families.   
 
What is NAMIWalks, and why is it important?
NAMI Northwest Walk is on Sunday, May 17 celebrating its 13-year anniversary!  It helps raise awareness and funds to help keep NAMI programs and services free of charge to those who need them. Help us fight discrimination and make a statement that mental health matters. 

NAMI is important because of the many things they do: They educate, advocate, listen and lead.  NAMI Walks and their many efforts successfully combat stigma, encourage understanding how important mental health is.    

What is "culturally-responsive" care and; how is it different from cultural competence?
“Culturally responsive” is the manner in which culturally competent services are delivered.  It requires organizational commitment and leadership, as well as an acknowledgement that it is a continuous process essential to diverse individuals’ specific range of needs. It cannot be viewed as a simple completion of a compliance/accreditation process with a fixed end point.  Culturally responsive mental health care approach turns principles into action.  For example, mental health organizations/programs should be mandated use of cultural content for hospital or clinic accreditation, demonstrate competence in cultural case formulation for professional certification of psychiatrists and other mental health clinicians and require inclusion of cultural content in pre-clinical and clinical components of curriculum for trainees in all health related disciplines to enhance quality of the care and outcome.                 . 

The definition has been widely adapted and modified during the past 10-15 years.  Cultural competence in mental health care is the ability of systems – and professionals within systems – to incorporate a person’s cultural background and beliefs into their case conceptualizations to guide their treatment.

As a practitioner, what are some of the issues you've observed?
It’s exciting to look back and see how far we have come and look forward to working on the challenges ahead.  However, there are potential sources of cultural conflict such as different worldviews of the consumer, provider, setting/system that can have an impact the course and outcome of treatment.  Some of the other issues I have observed are overall need for competency skills interviewing for clinical case formulation from a cultural perspective. Some of the cultural feature I would advocate for when interviewing for cultural assessment is to avoid “What’s wrong with you?  (Disease model) and instead ask “Tell me your story… what happened to you?”  (Narrative model), avoid cultural stereotyping and put emphasis on intra-cultural variability, avoid over-emphasizing culture to the neglect of personal attributes, for example: personality traits, or intolerance of frustration; language facilitation, including language uses, preferences and degree of fluency in first and second languages. 

How would supporting NAMI contribute to the work?
You can support the work by providing access to mental health care for persons with serious mental illness and their families. Supporting NAMI contributes to the advocacy and public policy issues NAMI is providing a strong voice for that affect adults and children living with mental illness and their loved ones.  
 
Interview by Maileen Hamto 

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