Cultural Competence Standards in Managed Mental Health Care

Communication Styles and Cross-Cultural Linguistic and Communication Support

Cross-cultural communication support across all levels of care shall be provided at the option of consumers and families at no additional cost to them. Access to these services shall be available at the point of entry into the system and throughout the course of services.


Implementation Guidelines

  1. Bilingual mental health staff and interpreters shall be certified or otherwise have formally demonstrated their linguistic competence. Use of family members as interpreters, especially children, shall be strictly prohibited.
  2. Policy and procedures shall be present and implemented which demonstrate performance-based clinical, cultural, and linguistic competence of designated trained interpreters.
  3. Use of tertiary telephonic interpreters shall be discouraged because of inconsistent availability of interpreters and lack of mental health training. accuracy and reliability. Although not optimal, video telecommunication shall be considered acceptable from 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 consumers from the four groups and families shall be trained in formal interpretation techniques and supervised by culturally competent racial/ethnic Mental Health Specialists.
  5. Training shall be provided to all clinicians in the use of interpreters for consumers from the four groups and their families. This training shall emphasize linguistics and culture.
  6. All pertinent written and oral and symbolic consumer and family materials (including consent forms, statement of rights forms, posters, signs, and audio tape recordings) provided to consumers from the four groups and their families shall be interpreted from the appropriate cultural perspective, as measured by consumer satisfaction surveys. Questions and concerns shall be actively solicited.
  7. Restricted or residential settings shall have the capacity to communicate effectively with monolingual, non-English speakers and individuals with culturally different or unique communication styles.
  8. An annual updated directory must be maintained by the mental health organization of paid trained interpreters who are available within 24 hours for routine situations and within one hour for urgent situations.
  9. The Health Plan shall designate a single fixed point of administrative responsibility for cross-cultural communication support services.


Recommended Performance Indicators

  1. Sufficient numbers of professional staff competent in the communication styles of consumers from the four groups so as to minimize the use of interpreters.
  2. Yearly updated directory of trained interpreters available within 24 hours for routine situations and within one hour or less for urgent situations.
  3. Time between point of first contact and communication support services, across all levels of care, and to all consumers and their families.
  4. Existence of core curriculum and training program for interpreters and staff.


Recommended Outcomes

  1. Linguistically competent services are provided to racial/ethnic consumers.
    Benchmark: 100% of limited English-proficient individuals served.
  2. Satisfaction rates related to communication styles and linguistically competent services by racial/ethnic consumers.
    Benchmark: 90% satisfaction.
  3. Elimination of misdiagnosis and inadequate treatment plans resulting from failure to communicate effectively with consumers from the four groups.
    Benchmark: Comparable to standards of care for general population and improving over time.
  4. All levels of care meet the standards for the provision of linguistically competent services.
    Benchmark: Comparable across groups and increasing over time.