Title: Cultural Competence in Disaster Mental Health: Review of concept paper written for the Office of Min
1Cultural Competence in Disaster Mental
HealthReview of concept paper written for the
Office of Minority Health
- CDR R. Andrew Hunt Public Health Advisor, SAMHSA
- Deputy Team Leader, PHS Mental Health Team 1
2Presenter Background and Experience
- US Public Health Service Commissioned Corps
disaster response experience - 3 Disaster Mental Health deployments
- W. Virginia Floods - 2003
- Red Lake Indian Tribe school shooting - 2005
- Hurricane Katrina, Gulf Port, Mississippi 2005
- Currently PHS Mental Health Team 1 Deputy Team
Leader - Experience in cultural competence training
- Mentored and trained by Terry L. Cross since 1990
- Provided many local, regional, and national
training sessions - Additional relevant experience
- Mental health provider with Indian Health Service
in tribal communities from 1991-2000 with many
small disasters and community crisis
3Concept Paper for OMH
- July 2007 - papers were commissioned on Cultural
Competence for Emergency Responders including one
on Disaster Mental Health by CDR Hunt - November 2007 Consensus building meeting
convened by OMH and contractors to begin
developing concept papers into online curriculum - Curriculum to be launched in 2009 online at
- www.thinkculturalhealth.org
- Interactive video training will include actors as
PHS Officers, and civilian MH providers in
various disaster MH scenarios
4Intended Audience for the Training
- Primary audience includes disaster mental health
providers and program/agency level personnel - Examples of specific groups in this audience
include - US Public Health Service Commissioned Corps
Mental Health Team members - American Red Cross mental health staff and
volunteers - State or local government mental health
responders - Other relief organizations that have a mental
health component to disaster response - Individual volunteer mental health responders
5Overview of Concept Paper
- There is a need for cultural competency training
for disaster mental health responders - Main concepts included in paper
- Definition of cultural competence and exploring
concept of culture - The relationship between basic human needs and
culture - Discussion of influences of culture in
help-seeking and service provision - Distinction between cultural awareness and
competence and developing competency statements
for workers - Review of common disaster mental health models
- How CLAS Standards may be applied in disaster
mental health - Cultural encounters in disaster mental health
6Need for Cultural Competency Training in Disaster
Mental Health
- The term cultural competence is used frequently
but the concept and its application are not well
understood - Ethnic minorities and other cultural groups
experience more health disparities and less
access to mental health services in general, even
under normal circumstances - Disaster response efforts tend to be a one size
fits all approach, which may not account for
cultural differences and leave cultural groups
underserved - Disaster mental health workers should be aware of
cultural differences and be prepared to adapt
their interventions or services to fit the
context of different cultures
7Main Concepts included in Paper
- Definition of cultural competence and exploring
concept of culture in the context of disasters - Relationship between human needs and culture
- Discussion of influences of culture in
help-seeking and service provision - Distinction between cultural awareness and
competence and developing competency statements - Review of common disaster mental health models
8Cultural Competence Model
- Five elements of the cultural competence model
- (as defined by Cross et al, 1989)
- Awareness and acceptance of difference
- Awareness of own cultural values
- Understanding and managing for the dynamics of
difference - Development of cultural knowledge
- Ability to adapt practice to fit the cultural
context of the client/family
9Cultural Competence Strategies and
Recommendations in Disaster Mental Health
- Practical suggestions from the field
- Review of SAMHSA document
- Developing Cultural Competence in Disaster Mental
Health Programs Guiding Principles and
Recommendations (2003) - Relating CLAS Standards to SAMHSA document
- Implications for training of disaster mental
health workers
10Cultural Experiences Encountered by Disaster
Mental Health Responders
- Communication differences
- Language, style, protocols, personal space
- Differences in help-seeking preferences
- Individual focus vs. family/group interaction
- Role of helper and who can ask for help
- Centralized vs. outreach services
- Community history with outside helpers
- Distrust, fear, tolerance, acceptance
- Differences in what brings comfort
11Promoting visibility of the PHS
The US Public Health Service Flag flies amidst
others during the Katrina response
12US Public Health Service Mental Health Responders
Hurricane Katrina 2005
PHS Mental Health Team in Gulf Port,
Mississippi (1 week post-Katrina) assembled
under the direction of FEMA
13Meeting Basic Needs during disaster Donated food
provided post-Hurricane Katrina
German Military Rations Is this comfort food
for anyone in Mississippi?
14US Public Health Service Mental Health Responders
Red Lake Indian Tribe School Shooting May 2005
Team adjusted at request of the Tribe to not wear
the PHS uniform while providing direct service
for cultural reasons
Team arrived to the site in uniform according to
standard PHS deployment protocol
15Key References/Resources
- Cross, T., Bazron, B., Dennis, K. Isaacs, M.
(1989). Towards a culturally competent system
of care A Monograph on Effective Services for
Minority Children Who Are Severely Emotionally
Disturbed Volume I Washington, DC Georgetown
University Child Development Center. - U.S. Department of Health and Human Services.
(2003). Developing Cultural Competence in
Disaster Mental Health Programs Guiding
Principals and Recommendations. DHHS Pub. No SMA
3828. Rockville, MD Center for Mental Health
Services, Substance Abuse and Mental Health
Services Administration. - National Center for Cultural Competence at
Georgetown http//www11.georgetown.edu/research/g
ucchd/nccc/ - Office of Minority Health Think Cultural Health
training website www.thinkculturalhealth.org