Impact, Fall 1996 Page: 4
23 p. : ill.View a full description of this periodical.
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In today's world, cultural competency' is being
seen as an integral part of professional competency.
More attention has been placed on developing
multicultural human services and assessing the cultural
aspects of behavioral interventions, preventive
interventions and service delivery. But neither the
intended nor unintended consequences of the organi-
zation, financing and delivery of human services to
culturally diverse populations have been adequately
considered. As the helping professions advance
through the 1990s, discourse on these issues will be
imperative.
The dramatic increase and changes in culturally
diverse populations in the United States will bring
about new and exciting challenges to the human
service infrastructure, including research, training
programs and services provided by private and public
human service agencies. Some responses will be
necessitated by larger and more diverse patient
caseloads. But the challenge to service providers is not
limited to assessing the impact of their preconceptions
on culturally diverse populations or to identifying
strategies to change the human service infrastructure
so it can respond appropriately to growing needs.
While this is crucial, it is not sufficient.
Traditionally, changes have not been made by the
parties with the greatest influence in the human
services infrastructure: the parties responsible for
accrediting providers of inpatient and outpatient care,
educational institutions and specialized training for the
helping professions, and services for families and
children; for licensing and certifying human services
professionals; and for sanctioning and supporting
diagnostic and assessment tools, such as the Diagnostic
Statistical Manual-IV (DSM-IV), used extensively by the
helping professions. Although contracted to protect
society, these self-governing bodies have done little to
develop and enforce accreditation criteria that incor-
porate the needs and characteristics of different
cultures. As experience indicates, this omission has had
a mostly negative impact on culturally diverse popula-
tions. Still, the much needed evaluation of policies hasnot been done. In the meantime, budget constraints
have significantly affected populations that have
neither representation nor a data base, much less
advocacy, to counter the system's neglect. The chal-
lenge to these authorizing bodies to negotiate a social
contract for protecting culturally diverse populations
is long overdue. If met, such a challenge could effect
greater change than all the conferences and work-
shops on culturally diverse populations.
Among the initial steps in improving services for
culturally diverse populations should be retraining
helping professionals through continuing education,
revising the system for delivering services to culturally
diverse populations, adding multicultural content to
certification and licensing examinations, and including
multicultural criteria in the accreditation process.
These tasks must be incorporated in the authorities'
processes.
What can a department of mental health and
mental retardation do to recreate culturally competent
professionals? How can the marketplace require
authorities to adopt criteria that are responsive to the
needs of employers? How can employers demand
culturally competent professionals who effectively
meet the needs of individuals and provide quality
services? Some recent national developments, espe-
cially the inclusion of cultural considerations in the
DSM-IV, provide hope that change is possible.2 Much
more remains to be done. But it is important that
inefficient services not be tolerated and that serious
steps be taken to create model programs based on a
new set of assumptions. Then human services will truly
improve the lives of persons in need.
Contributed by Juan Ramos, Ph.D., Associate Director
for Prevention, National Institute on Mental Health.
See "Research," page 20, ot this i6sue ot Impact tor a
detailed definition ot cultural competency and an overview
ot TXMHMR ejjorto to develop it.
2 See "Resourcea," page 21, oj thi6 issue oj Impact tor
references to literature on DSM-IV and revised guidelines.Ionyiw
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Texas. Department of Mental Health and Mental Retardation. Impact, Fall 1996, periodical, Autumn 1996; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1588631/m1/4/?q=Lamar+University: accessed June 7, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.