Cultural Competence Standards in Managed Care Mental Health Services for Asian and Pacific Islander Americans

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Communication Styles and Cross-cultural Communication Support



Cross-cultural communication support shall be provided at the option of APIA consumers and families at no additionally cost to them. Access to these services shall be available at the point of entry into the system and throughout the system.


Implementation Guidelines

  1. Use of family members as interpreters, especially children, shall be strictly prohibited in the care of APIA consumers. The exceptions to this prohibition include emergency situations and in the case where languages are spoken by very few people.
  2. Policy and procedures shall be present and implemented which demonstrate clinical, cultural, and linguistic competence of APIA designated trained interpreters.
  3. Use of tertiary telephonic interpreters shall be discouraged because of inconsistent availability of interpreters and lack of mental health training. Although not optional, video telecommunication shall be acceptable for improving accuracy and reliability. In areas with limited linguistic support resources, qualified telephonic interpreters with training in mental health shall be considered acceptable but only in emergency situations.
  4. Interpreters and translators working with APIA consumers and families shall be trained in formal interpretation techniques and supervised by APIA culturally competent Mental Health Specialists.
  5. Training shall be provided to all clinicians in the use of interpreters for APIA consumers and their families. This training shall emphasize linguistics and culture.
  6. All pertinent written, oral, and symbolic materials (including, consent forms, statements of rights forms, posters, signs, audio tape recordings), provided to APIA consumers and their families shall be interpreted from the appropriate cultural perspective, as measured by consumer satisfaction surveys. Questions and concerns shall be actively solicited.


Recommended Performance Indicators

  1. Sufficient numbers of mental health staff competent in the communication styles of APIA consumers so as to minimize the use of interpreters.
  2. Yearly updated directory of trained APIA interpreters available within 24 hours for routine situations and within one hour or less for urgent situations.
  3. All levels of care meet the standards for the provision of linguistically competent services to APIA consumers and their families.
  4. Existence of core curriculum and training program for interpreters, staff, and Mental Health Specialists who are involved in the service of APIA consumers and their families.


Recommended Outcomes

  1. Linguistically competent services are provided to APIA consumers.
    Benchmark: 100% of limited English-proficient individuals served
  2. APIA satisfaction rates related to communication styles and linguistically competent services.
    Benchmark: 90% satisfaction
  3. Misdiagnosis and inadequate treatment plans resulting from failure to communicate effectively with APIA consumers.
    Benchmark: Comparable to standards of care and decreasing over time
  4. Time between point of first contact and communication support service provision, across all levels of care and to all APIA consumers and their families
    Benchmark: Comparable across groups and decreasing over time