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Cultural Competence Standards
in Managed Care Mental Health Services:
Four Underserved/Underrepresented
Racial/Ethnic Groups
III. Clinical Standards and Implementation Guidelines
Access and Service Authorization
Standard
Services shall be provided irrespective of immigration status, insurance coverage, and language. Access to services shall be individual- and family-oriented (including client-defined family) in the context of racial/ethnic cultural values. Access criteria for different levels of care shall include diagnosis, health/medical, behavior, and functioning. Criteria shall be evaluated in six areas: psychiatric, medical, spiritual, social functioning, behavior, and community support.
Implementation Guidelines
The Health Plan shall:
- Include specific procedures to ensure comparability of access and receipt of benefits across populations. Racial/ethnic Mental Health Specialists shall be involved in the development and ongoing implementation and evaluation of these procedures;
- Ensure that gatekeeping, service authorization, and critical service junctures for consumers from the four groups shall be performed by or under the supervision of a culturally competent mental health professional;
- Ensure that restrictive placements for consumers from the four groups shall be made only with prior cultural consultation. Restrictive placements include inpatient, residential, and involuntary treatment;
- Ensure that access is decentralized and facilitated through multiple outreach and case-finding approaches. These approaches shall include strategic co-location within racial/ethnic community organizations, social service agencies, community action agencies, health centers, churches, mosques, schools, and neighborhood locales which are accessible through public transportation and in-home, in-community, and mobile care. They shall be publicized by culturally and linguistically appropriate information which allows client choices;
- Ensure that agencies have the flexibility of providing services to consumers from the four groups who may not reside in the agency's geographic service area, when this is in the best interest of the clients;
- Provide that access to traditional healers and self-help services shall be covered by the benefits package;
- Ensure that the use of telephone numbers (e.g.,. 1-800) for access shall not be exclusive of other points of entry for 24 hour crisis service and shall be accompanied by education of consumers from the four groups in the use of such access procedures;
- Ensure that legal documentation for immigrant groups is not a requirement for service and does not serve as a barrier to service access (Legal status shall not be confused with sponsored and unsponsored status.);
- Ensure that confidentiality requirements, by incorporating the values of consumers, including family decisions about services when appropriate, do not serve as a barrier to care;
- Ensure equal availability of telephone and other communication means of access for consumers and families from the four groups. Staff who provide telephone access services shall be culturally and linguistically competent, and have access to racial/ethnic mental health professional staff for consultation;
- Ensure that programs serving consumers and families of the four groups provide culturally inviting environments (e.g., decor, ambiance) as measured by consumer satisfaction surveys;
- Provide to all consumers, families, and providers a culturally based and linguistically complete orientation and ongoing education about access to managed care; and
- Ensure that ability to pay is not a barrier to accessing services in a managed health care environment.
Recommended Performance Indicators
- Procedures for access in place with specific provisions for consumers from the four groups.
- Time from point of first contact through service provision for all levels of care are tracked by age, gender, ethnicity (i.e., particular subgroup and mixed origins), primary language, and level of functioning.
- Rate and timeliness of response to telephone calls by consumers from the four groups.
Recommended Outcomes
- Tracking of authorization decisions including denials, rationale, and disposition by ethnicity.
Benchmark: Comparability across ethnic groups served.
- Tracking of access and utilization rates for populations of the four groups across all levels of care in comparison to the covered population.
Benchmark: Proportional to covered population.
- Consumer and family satisfaction with access and authorization services.
Benchmark: 90% satisfaction.
Triage and Assessment
Standard
Assessment shall include a multi-dimensional focus including individual, family, and community strengths, functional, psychiatric, medical, and social status as well as family support.
Implementation Guidelines
The Health Plan shall:
- Address cultural and demographic factors in the assessment process relating to age, gender, sexual orientation, and relational roles in the assessment of consumers from the four groups (both consumers and families);
- Identify beliefs and practices; family organization and relational roles (traditional and non-traditional); effects of ethnically-related stressors such as poverty and discrimination; beliefs related to health/mental health; attribution of condition; spirituality; and history at help-seeking and treatment. History of immigration, assimilation, or acculturation also shall be part of the assessment;
- Ensure that clinical and functional assessment scales utilized by managed mental health care systems, organizations, or providers are culturally competent, reliable, and validated for use with racial/ethnic consumers and their families;
- Address systemic cultural and ethnic factors to ensure accurate assessment and service planning (e.g., linguistic differiences, differences in symptom expression, culture-bound syndromes);
- Ensure that racial/ethnic Mental Health Specialists are involved, either directly or via consultation, especially at the time of care determination and prior to more restrictive placements, particularly with involuntary placement and treatment;
- Consider, prior to initiating service, the consumer's preference for therapeutic linkages with the racial/ethnic community or family;
- Encourage the use of family members as culturally informed individuals, including children when appropriate; and
- Use linguistically and culturally appropriate admission/entrance forms and procedures.
Recommended Performance Indicators
- Presence of specialized assessment procedures for consumers from the four groups.
- Inclusion of cultural factors in the assessment of consumers from the four groups.
- Inclusion of family members, as appropriate, and significant community stakeholders in the assessment process for consumers from the four groups. Documentation of efforts to include family and significant others, or rationale when not done.
- Involvement of culturally competent racial/ethnic Mental Health Specialists in assessment and treatment planning process and at other critical treatment junctures.
- The recognition of differentiating culture from a person's psychopathology.
Recommended Outcomes
- Consumer, family, and stakeholder satisfaction with the assessment process.
Benchmark: 90% satisfaction.
- Consistency of service authorizations with utilization management practice for consumers from the four groups.
Benchmark: Comparable across the four groups, and in general, increasing over time.
- Reduction of frequency of treatment plan revisions resulting from inadequate diagnosis and assessment.
Benchmark: Comparable across the four groups and decreasing over time.
- Compliance with Guidelines for assessment.
Benchmark: 90% compliance.
Care Planning
Standard
Care plans for consumers from the four groups shall be compatible with the cultural framework and community environment of consumers and family members. When appropriate, care plans shall involve culturally indicated family leaders and decision makers.
Implementation Guidelines
The care plan shall:
- Ensure that care planning and other critical treatment decisions for consumers from the four groups are performed, or supervised directly, by racial/ethnic Mental Health Specialists;
- Incorporate consumer-driven goals and objectives that are functionally defined and oriented toward measurable recovery and rehabilitation outcomes;
- Address culturally-defined and socioeconomic needs relevant to the consumer's condition and stressors when appropriate;
- Incorporate family and cultural strengths, traditional healers, religious and spiritual resources, natural support systems, community organizations, racial/ethnic self-help organizations, and interagency resources, except when clinically and/or culturally contraindicated;
- Address and coordinate the mental health needs of the individual within the context of the entire family, including coordination among multiple providers with a single point of clinical accountability;
- Include consumer and family education about problems and conditions being addressed. Plans shall also include treatment modalities, particularly those addressing cultural beliefs and attitudes about health and mental health, as well as education about preventive approaches;
- Address coordination of mental and physical health, as well as other needed social and treatment services (e.g., housing, transportation, education, services for substance abuse and other addictive behavior), according to the health beliefs and practices of the consumer and family; and
- Develop specialized approaches to maintain continuity of care, prevent symptom relapse, and reduce recidivism to more restrictive and expensive services, including flexible purchase of wrap-around services.
Recommended Performance Indicators
- Consumer and family involvement and investment in the development of, and agreement with, the Care Plan.
- Culturally defined needs addressed in the care plans of consumers from the four groups.
- Leadership by racial/ethnic Mental Health Specialists in the care planning process for consumers from the four groups.
- Inclusion of traditional healers in the Care Plan for consumers or family from the four groups, except when contraindicated.
Recommended Outcomes
- Consumer and family satisfaction with Care Plan.
Benchmark: 90% satisfaction via an independent evaluator.
- Consumer and family involvement with Care Plan.
Benchmark: 100% documented involvement.
- Functional outcomes in domains of daily living (e.g., housing, restrictiveness of placement, access to primary health care, family role, vocational/educational/employment, community tenure, and community engagement).
Benchmark: Comparable to overall community and significant improvement in at least one domain of function for over 75% of consumers.
Plan of Treatment
Standard
The Treatment Plan for consumers from the four groups shall be relevant to their culture and life experiences. It shall be developed by or under the guidance of a culturally competent provider in conjunction with the consumer and family, where appropriate.
Implementation Guidelines
The Treatment Plan shall:
- Include consumer and family involvement, when appropriate, in its development and agreement;
- Monitor group homes (utilized as least restrictive placements) for compliance with state and local standards, regulations, and laws, as well as protocols for services. Best practices shall be encouraged in the process. Where such protocols do not exist, they shall be developed to ensure that group homes do not become holding facilities;
- If authorized by the consumer, include contact with and utilization of racial/ethnic community organizations;
- Conduct psychotherapeutic modalities within the context of the value system of consumers from the four groups and their families (e.g., egalitarian, participatory, family-focused, spirituality), and address issues specific to their life experiences (e.g., racism, discrimination, violence, gender role conflicts, and life transitions);
- Be based on knowledge and skills derived from culturally competent interventions and models of care. These shall include concepts of recovery and rehabilitation that also consider cultural norms, values (e.g., spirituality, community, family), and critical life experiences (e.g., racism and discrimination);
- Ensure that care planning and other critical treatment decisions for consumers from the four groups shall be performed or supervised directly by a culturally competent mental health professional. Managed care plans shall include culturally competent independent mental health practitioners within their networks;
- Incorporate consumer-driven goals and objectives that are functionally defined and oriented towards measurable recovery and rehabilitative outcomes;
- Address culturally defined and socio-economic needs;
- Reflect awareness of the mental health needs of the entire family, especially when children are the consumers. Coordination among multiple providers, with a single point of clinical accountability, shall occur and be documented;
- Address coordination of mental health and physical health, substance abuse, as well as other needed clinical services such as housing, transportation, employment, and education;
- Ensure that interventions provide for least restrictive placements, continuum of care, discharge, and cultural competence in treatment modalities and medication usage;
- Provide that level of care decisions are based on established protocols that are culturally relative to the consumer. These protocols shall be reviewed periodically with the consumer, and involved family as appropriate, by providers. Placement considerations shall include consumer and family preferences. Placement within or supported by the family shall be the preferred arrangement unless otherwise clinically contraindicated;
- Develop creative or innovative options and interventions for consumers from the four groups who, for whatever reason, have been labeled historically as non-compliant to treatment;
- Include broad based culturally competent educational programs that explain the problems or conditions being treated, treatment methods, concepts of recovery, rehabilitation, prevention, and self-help approaches in communication styles understandable to the consumer;
- Be developed by a culturally competent staff. In the absence of a culturally competent staff, external consultation with a culturally competent mental health professional shall be obtained;
- Ensure that decisions to go forward with treatment are based on a mutually agreed upon written understanding or contract between the consumer and provider;
- Ensure that, in cases where consumers have acute mental illnesses requiring psychopharmacological interventions, the provider discuss medications and their effects with the consumer and family as soon as the consumer is able. A statement signed by the consumer and counter-signed by the provider that this guideline has been followed shall be inserted in the case record;
- Reflect specialized approaches to maintain continuity of care, prevent symptom relapse, and reduce re-hospitalization;
- Provide for distribution of culturally specific literature, in the communication style, language, and appropriate to the literacy level of the consumer, on the prevalence of psychiatric disorders, treatment options, and psychopharmacological interventions; and
- Ensure that informed consent is obtained prior to dispensing medication. The informed consent document shall be specific regarding the nature of the medication and its potential and demonstrated benefits and side effects. The physician prescribing the medication shall be responsible for ensuring that medication information is explained in a culturally specific and clear manner. The consumer shall acknowledge, by signature, that he/she understands the medication prescribed and its potential benefits and side effects. The signed forms shall be dated and included in the consumer's chart. The prescribing physician shall be knowledgeable regarding the physiologically-specific effects of psychotropic medication on consumers from the four groups.
Recommended Performance Indicators
- The Treatment Plan reflects both consumer and family involvement in its development and agreement. The degree of family involvement depends on the wishes of the consumer.
- The organization has a written policy and a demonstrated practice linking families to advocacy and education groups.
- The organization has a written policy which expressly targets least restrictive environments for residential placement in or near the community.
- There is evidence in the Treatment Plan that proposed psychotherapeutic modalities address specific cultural issues and are conducted with specific cultural values.
- There is evidence in the Treatment Plan of the use of racial/ethnic community services and resources.
- The Treatment Plan was developed with a culturally competent clinician (defined in chapter on Human Resource Development) or consultation from such a clinician.
- The Treatment Plan is oriented towards measurable recovery and rehabilitation outcomes.
Recommended Outcomes
- Documented level of involvement of racial/ethnic consumers, and family when appropriate, in the development of, and agreement, with the Treatment Plan. The level of involvement is at least comparable with non-racial/ethnic groups.
- Evidence of a policy linking families to advocacy and education groups.
- Documentation of the level of referrals of families to advocacy and education groups.
- Evidence of a policy which expressly targets least restrictive environments for residential placement in or near the community. Evidence that the policy has been approved by culturally competent consultants.
- Documentation that illustrates how critical life issues such as racism, discrimination, violence, gender role conflicts, and life transitions are addressed. Documentation that illustrates how values such as spirituality, community, and family are addressed.
- Evidence that a culturally competent clinician was involved in the development of the Treatment Plan, e.g. signature.
- Evidence that outcomes are re-evaluated by a culturally competent clinician when goals have been achieved.
Treatment Services
Standard
The Health Plan shall assure that the full array of generally available treatment modalities are tailored such that they are culturally acceptable and effective with populations of the four groups (e.g., psycho-education, psychosocial rehabilitation, family therapy, specialized group therapy, behavioral approaches, use of traditional healers, and outreach).
Implementation Guidelines
The Health Plan shall:
- Ensure that consumers and families are informed about treatment choices available under the Health Plan, as well as about medications and other treatments not available in the Health Plan. The final decision to be treated rests with the consumer;
- Provide that treatment is consumer-driven and performed or guided by culturally competent Mental Health Specialists;
- Ensure that assignment of clinicians is based on a match between clinician skills, including cultural competency, and the consumer's clinical, cultural, and linguistic needs;
- Provide for the optimal utilization of the racial/ethnic clinical workforce by affording these clinicians a variety of clinical experiences including service to consumers other than consumers from similar backgrounds;
- Ensure that the workforce meets the needs of these consumers and their families while maintaining comparability in overall workload with other clinical providers. This shall take into consideration requests for interpretation and use of other specialized skills, so that they are not in addition to regular duties;
- Contract with, and utilize, local racial/ethnic community-based organizations and independent practitioners in its network and include them in the provider's network or panel. Such providers shall demonstrate cultural competence;
- Ensure that psychotherapeutic modalities address psychological issues specific to consumers, e.g., current and historical trauma, acculturation, inter-generational and gender role distinctions, and life transitions;
- Ensure that psychological evaluations are conducted by qualified practitioners trained in ethnic-specific biological, physiological, cultural, socioeconomic, and psychological variables. Psychological evaluations also shall be provided based on the use of culturally and linguistically competent literature and other specialized approaches. Specific knowledge concerning the norms, biases, and limitations of each instrument used shall be demonstrated; and
- Provide that the principle of least restrictive levels of care shall govern treatment and placement decisions, with family placement preferable unless otherwise indicated. Level of care decisions shall be governed by protocols to ensure timely and accurate decision-making and shall be designed and carried out by, or in consultation with, qualified culturally competent Mental Health Specialists.
Recommended Performance Indicators
- Protocols for level of care decisions for consumers from the four underserved/ underrepresented groups.
- Distinction and equivalence of services for consumers from the four underserved/ underrepresented groups.
- Specialized protocols for prevention of symptom relapse and reduction of recidivism for consumers from the four groups.
- Culturally and linguistically competent literature on prevalent psychiatric disorders, medical treatment options, and pharmacological interventions distributed to all consumers from the four groups and their families.
- Consumers receive services by traditional healers, when appropriate and accepted.
Recommended Outcomes
- Consumer and family satisfaction with treatment services.
Benchmark: 90% satisfaction.
- Inclusion of culturally specific activities and domains of daily living (e.g., housing, access to primary health care and maintenance, family role, behavioral/developmental, vocational/ educational/employment, and community tenure) in treatment services.
Benchmark: Comparable to overall population served and significant improvement in at least one domain of function for more than 75% of consumers.
- Rates of symptom relapse and recidivism into restrictive level of care or other restrictive placements.
Benchmark: Comparable to overall population served and significant reductions over time.
- Rates of medication side effects, adverse incidents, and utilization of latest pharmacological interventions.
Benchmark: Comparable to overall population served and reduction of medication side effects and adverse incidents.
- Rates of adverse occurrences during treatment (e.g., suicide, homicide, self-injury, accidents, physical and sexual abuse) within comparable age groups.
Benchmark: Comparable to overall population served and decreasing over time.
- Demonstrated incorporation of value of cultural identity, including ethnicity (subgroup membership and mixed origin) and other relevant factors in treatment services.
Discharge Planning
Standard
Discharge planning for consumers and families from the four underserved/underrepresented racial/ethnic groups shall include involvement of the consumer and family in the development and implementation of the plan and evaluation of outcomes. Discharge planning shall be done within a culturally competent framework and in a communication style congruent with the consumer's values. The plan shall allow for transfer to less restrictive levels of care in addition to termination of treatment based on accomplishment of mutually agreed upon goals in the treatment plan.
Implementation Guidelines
Discharge planning shall:
- Involve the consumer, family, or legal guardian who have participated in supporting the consumer's treatment course;
- Include case management and aggressive outreach to assure that contact is made with the consumer and family to minimize "administrative" termination which typically results from culturally inappropriate services;
- Ensure that steps are taken to address linkages to the next level of care. Documentation shall also demonstrate that a reasonable effort to define the next steps in treatment is made. The provider of case management services shall communicate, discuss, and facilitate linkage to the next level of care;
- Acknowledge and recognize the skills needed and the resources available to facilitate a successful recovery program;
- Include the identification of personal, familial, community, and other support systems to help them improve and maintain healthy lifestyles;
- Include an assessment of the biopsychosocial environment to ensure minimum disruption in their quality of life;
- Include identification of a case manager or primary provider to act as the single point of responsibility for coordinating care; and
- Include assurances that consumers who fail to return to treatment will receive active follow-up to assure their level of care needs are met.
Recommended Performance Indicators
- Consumer and family involvement in development of treatment plan.
- Documented provision of case management services designed to facilitate linkage to next level of care.
- Involvement of consumers and their identified support systems in improving and maintaining the consumer's health.
- Documented efforts to contact consumers who fail to return for treatment.
Recommended Outcomes
- Consumer and family satisfaction with discharge plans.
Benchmark: 90% satisfaction via an independent evaluator.
- Consumer involvement with discharge plan.
Benchmark: 100% documented involvement.
- Consumer remains connected to health care system in accordance with treatment plan.
Benchmark: 100% documented involvement.
- No more than 10% of consumers from the four groups in the plan who receive restrictive level of care services experience recidivism.
Benchmark: No more than 10% documented recidivism.
Case Management
Standard
Case management shall be central to the operation of the interdisciplinary treatment team and shall be based on the level of care needed by the primary consumer. Case managers for consumers from the four groups shall have special skills in advocacy, access of community-based services and systems, and interagency coordination. Case management shall also be consumer- and family-driven. Case managers shall be accountable for the cost and appropriateness of the services they coordinate. The Managed Care Plan shall maintain responsibility for the successful and appropriate implementation of the Case Management Plan and providing adequate administrative resources and endorsement.
Implementation Guidelines
The Case Management Plan shall:
- Ensure that case managers demonstrate their level of cultural competence as part of their privileging and credentialing standards within the Plan;
- Ensure that case managers are knowledgeable about the four groups and their subgroups, their resources, and natural supports;
- Ensure that case managers have access to flexible funds for the provision of wrap-around services;
- Provide that case management is continuous and proportional to the degree of the consumer's need, level of impairment, and person/family resilience. The case manager shall act as a single point of contact in the Plan and have support for coordinating service across all levels of the system of care;
- Ensure, through enforcement, that caseloads for case managers are consistent with industry standards, accounting for severity of consumer impairment/case mix and associated cultural stressors. It shall be recognized that case or care management for patients who have limited English proficiency and/or have a broadly defined "client-defined family" and/or social network (e.g., clan leader) relevant to their care, may required additional time for planning and coordination;
- Afford case managers practice privileges across the entire system of care, including settings such as inpatient facilities;
- Provide that each member of the consumer's Treatment Plan has responsibility for developing progress notes and reports as appropriate; and
- Ensure that the primary provider/case manager periodically reviews the consumer's progress in accordance with the Treatment Plan. Changes in the Treatment Plan's components shall be reviewed with the consumer before implementation.
Recommended Performance Indicators
- Cultural competence requirements commensurate with level of responsibility, including culturally competent supervision of case managers who serve consumers from the four groups.
- Cultural competence training for all case managers as part of a credentialing process.
- Community resources and natural supports included in all care plans.
- Use of flexible funding for consumers from the four groups, comparable to others.
- Sufficient numbers of case managers to support caseload and workload standards for consumers from the four groups.
- Consumer and case manager involvement in treatment decisions across all levels of care.
Recommended Outcomes
- Consumer and family satisfaction with services selection and coordination.
Benchmark: 90% satisfaction.
- Reduction in utilization of and lengths of stay in more restrictive levels of care.
Benchmark: Comparable to overall community and decreasing over time.
- Access to culturally competent mental health care across all levels of care within the system.
Benchmark: Comparable to overall community and increasing over time.
Communication Styles and Cross-cultural Linguistic and
Communication Support
Standard
Cross-cultural communication support to participate in all services 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
The Health Plan shall:
- Ensure that bilingual mental health staff and interpreters are certified or otherwise have formally demonstrated their linguistic competence. Use of family members as interpreters, especially children, shall be strictly prohibited;
- Ensure that policy and procedures are present and implemented which demonstrate performance-based clinical, cultural, and linguistic competence of designated trained interpreters;
- Discourage the use of tertiary telephone interpreters because of inconsistent availability of interpreters and lack of mental health training accuracy and reliability. Although not optimal, video telecommunication shall be considered acceptable for improving accuracy and reliability. In areas with limited linguistic support resources, qualified telephone interpreters with training in mental health shall be considered acceptable, but only in emergency situations;
- Provide that interpreters and translators are trained in formal interpretation techniques and supervised by culturally competent racial/ethnic Mental Health Specialists;
- Provide to all clinicians training in the use of interpreters for consumers from the four groups and their families. This training shall emphasize linguistics and culture;
- Ensure that all pertinent written and oral and symbolic consumer and family materials (including consent forms, statement of rights forms, posters, signs, and audio tape recordings) are interpreted from the appropriate cultural perspective, as measured by consumer satisfaction surveys. Questions and concerns shall be actively solicited;
- Ensure that restricted or residential settings have the capacity to communicate effectively with monolingual, non-English speakers and individuals with culturally different or unique communication styles;
- Ensure that the mental health organization maintains an annual updated directory of paid trained interpreters who are available within 24 hours for routine situations and within one hour for urgent situations; and
- Designate a single fixed point of administrative responsibility for cross-cultural communication support services.
Recommended Performance Indicators
- To minimize the use of interpreters, sufficient numbers of professional staff competent in the communication styles of consumers from the four groups.
- Yearly updated directory of trained interpreters available within 24 hours for routine situations and within one hour or less for urgent situations.
- Time between point of first contact and communication support services, across all levels of care, and to all consumers and their families.
- Existence of core curriculum and training program for interpreters and staff.
Recommended Outcomes
- Linguistically competent services are provided to racial/ethnic consumers.
Benchmark: 100% of limited English-proficient individuals served.
- Satisfaction rates related to communication styles and linguistically competent services by racial/ethnic consumers.
Benchmark: 90% satisfaction.
- 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.
- All levels of care meet the standards for the provision of linguistically competent services.
Benchmark: Comparable across groups and increasing over time.
Self Help
Standard
Culturally competent self help groups shall be created to provide services to consumers from the four groups and their families. The self help groups shall function as part of a continuum of care. Self help groups for consumers from the four groups shall incorporate consumer-driven goals and objectives that are functionally defined and oriented towards rehabilitative and recovery outcomes. Equal consideration and support shall be given to family and primary consumer self help groups.
Implementation Guidelines
The Health Plan shall:
- Include resources to enable consumers from the four groups and their families to conduct self help groups;
- Ensure that consumers from the four groups and their families shall design, implement, and evaluate self help programs. Culturally competent mental health professionals shall serve in a consultative or educational role at the request of the consumer group;
- Provide that existing self help entities (programs, agencies, and organizations) that provide services to consumers from the four groups and their families are identified, acknowledged, and supported to ensure that they meet these standards;
- Ensure that self help planning for consumers from the four groups and their families includes consumer and family education about problems and conditions being treated, and preventive and treatment approaches; and
- Provide that consumer self help groups are given opportunities to help ensure that benefit packages, changes in benefits, alterations in services, location of service programs, and changes in providers are congruent with consumer needs.
Recommended Performance Indicators
- Resources are expended on self-help groups.
- In-kind support is expended on self-help groups including such items as meeting rooms, advertising, and/or conducting mailings.
- Consumers and family participate in self-help or support groups.
- The agency provides information about disorders and treatment approaches to consumers and family in a culturally competent manner.
- The Managed Care Mental Health Plan supports the involvement of consumer and family self-help groups in planning for services.
Recommended Outcomes
- The total amount of expenditures on consumer-run mental health services in one year, divided by expenditures on mental health services.
- The estimates expenditures on consumer-run mental health services in one year, divided by expenditures on mental health services.
- Documentation of the level and proportion of racial/ethnic consumers and family who participate in self-help groups or support groups. This should be comparable with the participation of non-racial/ethnic groups.
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SMA00-3457
1/2001
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