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

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Guiding Principles


1. Principle of Cultural Competence

Recover and rehabilitation are more likely to occur where managed care systems, services, and providers have and utilize knowledge and skills that are culturally competent and compatible with the backgrounds of Asian and Pacific Islander American (APIA) consumers, their families, and communities.

Cultural competence includes the attainment of knowledge, skills, and attitudes to enable administrators and practitioners within systems of care to provide effective care for diverse populations, i.e., to work within the person’s values and reality conditions. Cultural competence acknowledges and incorporates variance in normative acceptable behaviors, beliefs, and values in:

  • determining an individual’s mental wellness/illness;
  • incorporating those variables into assessment and treatment.

2. Principle of Consumer-Driven System of Care

A consumer-driven system of care promotes consumer and family as the most important participants in the service-providing process. Whenever possible and appropriate, the services adapt self-help concepts from the specific APIA culture, taking into account the significant role that mothers and fathers play in the life of the APIA consumer.


3. Principle of Community-Based System of Care

A community based system of care includes a full continuum of care. The focus is on: 

  • providing services in a natural community setting;
  • delivering services that include familiar and valued community resources from the specific APIA culture; �
  • providing treatment in the least restrictive environment possible.

4. Principle of Quality Care

The costs of a managed health care delivery system are best maintained through the delivery of effective, quality services, not by cutting or limiting services. Effective systems provide individualized services. They emphasize outcome-driven systems and positive results. They acknowledge the importance of added-value inclusion of ethnic/cultural groups as treatment partners. It recognizes APIA/group-specific variables which have significant implications for individualized assessment and treatment. Quality care is creating the best possible outcomes with the resources available.


5. Principle of Natural Support

Natural community support and culturally competent practices are viewed as an integral part of a system of care which contributes to desired outcomes in a managed care environment.

  • Spiritual and religious leaders, traditional healing practices, and the school system should be incorporated into service delivery to APIAs when relevant or possible.
  • Extended family is defined by function, and APIAs generally conceive of family much more broadly than mainstream individuals.


6. Principle of Prevention

Investment in early intervention and prevention efforts are critical to providing quality care, especially to APIA consumers. APIA consumers historically tend to delay help-seeking from mainstream mental health services because of problems in access and care that are related to cultural incompatibility. The greater emphasis that is placed on preventative efforts, the greater the chances that costs will decrease.