CIHS strives to promote culturally and linguistically competent service delivery systems to address growing diversity, persistent disparities, and health and behavioral health equity through design, implementation, and evaluation.
Check out the CIHS eSolutions article: Integrated Care for Minority Populations and read more about our fragmented and complex healthcare system, racial and ethnic minorities and persons with limited English proficiency who often seek behavioral health assistance through their primary care providers.
- General Resources
- African American & African Resources
- Asian American, Asian, & Pacific Islander Resources
- Native American & Alaskan Native Resources
- Hispanic & Latino American Resources
- Lesbian, Gay, Bisexual, and Transgender (LGBT) Resources
The National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Careare intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations.
A New Look at Racial/Ethnic Differences in Mental Health Service Use among Adults uses combined 2008 to 2012 data from the National Survey on Drug Use and Health (NSDUH) to present nationally representative estimates of mental health service utilization among adults aged 18 or older within different racial/ethnic groups in the United States. The percentages are annual averages.
While many health care organizations are motivated to identify and reduce racial and ethnic disparities in the health and health care of their patients, most lack the tools and resources to do so effectively. This paper, Reducing Health and Health Care Disparities: Implementation Lessons and Best Practices for Health Care Organizations, shares the lessons learned of nine health care organizations that implemented innovative programming to address disparities in their patient populations.
Toward Culturally Centered Integrative Care for Addressing Mental Health Disparities Among Ethnic Minorities proposes a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, which includes provider and patient factors, to the system level, which includes practice culture and system functionality issues.
The Maryland Department of Health and Mental Hygiene (DHMH)/Office of Minority Health and Health Disparities toolkits on Culturally and Linguistically Appropriate Services (CLAS) Standards features a CLAS planning worksheet, facilitation guides, and the supporting resources needed to implement the CLAS standards in organizations.
Free Cultural Competence Assessments
- Health Resources and Services Administration’s Organizational Cultural Competence Assessment Profile
- Georgetown University National Center for Cultural Competence's Cultural Competency Health Practitioner Assessment
- SUNY/Downstate Medical Center’s Conducting a Cultural Competence Self-assessment
Making CLAS Happen: Six Areas for Action offers innovative and practical approaches for agencies to incorporate the federal CLAS principles and practices into all aspects of organizational activities. Each chapter includes hands-on tools, resources lists, and case studies from public health and social service providers.
The Mental Health Interpreter Training (MHiT) is a joint project between the National Latino Behavioral Health Association and the National Asian American Pacific Islander Mental Health Association. MHiT supports mental health providers working within communities where concentrated numbers of monolingual Spanish speaking or Limited English Proficient clients often do not receive adequate care due to a lack of bilingual/bicultural staff.
DiversityRx supports providers to improve the accessibility and quality of health care for minority, immigrant and indigenous communities through delivery of services that are responsive to cultural and linguistic differences presented by diverse populations. Get resources and view training opportunities on organizational cultural competence, culturally competent care and language access.
SAMHSA's Racial/Ethnic Differences in Mental Health Service Use among Adults shares findings on how often adults in different racial and ethnic groups sought mental health services in the past year. Findings include estimates of overall service use, medication use, outpatient and inpatient service use, as well as reasons for not using services.The percentages are annual averages.
HHS' Think Cultural Health website offers a wealth of resources for building cultural competency. Their continuing education programs are designed to help individuals at all levels and in all disciplines promote health and health equity. Courses include:
- A Physician's Practical Guide to Culturally Competent Care, an e-learning program accredited for physicians, physician assistants and nurse practitioners
- Culturally Competent Nursing Care: A Cornerstone of Caring, an e-learning program accredited for nurses and social workers
- A Patient-Centered Guide for Implementing Language Access Services, an e-resource to help health care organizations meet the communication needs of patients with limited English proficiency
Treatment Improvement Protocol 59: Improving Cultural Competence assists professional care providers and administrators in understanding the role of culture in the delivery of substance abuse and mental health services. It also discusses racial, ethnic, and cultural considerations and the core elements of cultural competence.
The Center for Disease Control and Prevention Health Literacy webpage provides information and tools to improve health literacy and public health. These resources are for all organizations that interact and communicate with people about health.
The Target Area Intervention Tool, designed by Community Commons helps providers define areas of concern in their community geographically; overlays poverty rate and educational attainment, two key drivers of poor health outcomes, to identify where health disparities may exist in a community; input an address, zip code, city name or, if you are using a location enabled device, simply zoom to your location.
For the 11th year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report and the National Healthcare Disparities Report. These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care.
The National Institute on Minority Health and Health Disparities (NIMHD) released The Health Disparities Pulse, a quarterly newsletter for the health disparities community that covers a wide array of topics, issues, and information pertaining to minority health and health disparities research and activities.
A Window Of Opportunity: Philanthropy’s Role in Eliminating Health Disparities through Integrated Health Care provides an overview of the role of philanthropy in eliminating disparities through integrated care.Through four key strategies—grantmaking, educating, convening, and advocating—foundations can address health disparities and achieve greater access to health care, improved quality of service delivery, and better health outcomes.This report was made possible through support by the Hogg Foundation for Mental Health and the U.S. Department of Health and Human Services, Office of Minority Health.
The literature report, Eliminating Disparities through the Integration of Behavioral Health and Primary Care Services for Racial and Ethnic Minority Populations, Including Individuals with Limited English Proficiency serves to inform a national consensus meeting to develop recommendations on the most promising approaches for engaging racial and ethnic minority populations and persons with LEP in integrated health care to improve health outcomes and reduce health and mental health disparities.
The HHS Office of Minority Health's National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice offers comprehensive information on each CLAS Standard. The Blueprint is an implementation guide for advancing and sustaining culturally and linguistically appropriate services within health and health care organizations.
Social Determinants of Subthreshold Psychotic Symptoms Among Racial & Ethnic Minorities is a report from the Center of Excellence for Cultural Competence at the New York State Psychiatric Institute (NYSPI-CECC). This report underscores the increased risk for clinical and subthreshold psychotic symptoms and disorders among racial and ethnic minorities and describes the development of an integrated model of risk for subthreshold psychotic experiences and symptoms that take into account culturally relevant factors.
The Agency for Healthcare Research and Quality’s National Healthcare Disparities Report: 2011released in March 2012 shows that access to healthcare do not improve for most racial and ethnic groups between 2002 and 2008, the years leading up to enactment of the Affordable Care Act.
People with psychiatric diseases have a severely increased risk for physical morbidity and premature death from physical diseases. The Cultural diversity in physical diseases among patients with mental illnesses is a study that investigates the occurrence of cardiovascular diseases (CVD), diabetes (DM) and obesity in schizophrenia and depression in three different geographical areas – Asia (Japan), Africa (Nigeria) and Western Europe (Switzerland, Germany and Denmark) – and to search for possible transcultural differences in these correlations, which would also reflect the differences between low-income areas in Africa (Nigeria) and high-income areas in Europe and Japan.
The National Network to Eliminate Disparities in Behavioral Health (NNED) addresses disparities in behavioral healthcare. Formed with support from SAMHSA in partnership with the National Alliance of Multi-ethnic Behavioral Health Associations, NNED supports information sharing, training, and technical assistance among organizations and communities dedicated to the behavioral health and wellbeing of diverse communities.
Workforce Capacity for Reducing Rural Disparities in Public Mental Health Services for Adults with Severe Mental Illness, a study published in the Journal of Rural Mental Health (Jan. 13, 2012) examined workforce capacity in publicly-funded mental health agencies in rural mental health service areas (MHSAs). Overall, workforce capacity in rural MHSAs varied greatly, with some areas’ workforce capacity similar to of metropolitan areas,’ while others have little to no capacity. The study asserts that better leverage of rural MHSA’s core workforce would lead to more comprehensive, higher quality services, noting that the current core workforce lacks high levels of training in specialty care or adequate access to support from urban areas. It also calls for future efforts to establish sustainable mechanisms for ongoing training, education, and support for the core workforce in rural areas and for de facto rural systems of care in general.
Resolving Differences Between Behavioral Health and Primary Care Cultures, a presentation by Beth Wrobel and Bob Franko at the National Council's 2009 Conference, communicates the importance of collaboration between primary care and behavioral health providers and how to achieve partnership.
Enhancing the Delivery of Health Care:Eliminating Health Disparities through a Culturally & Linguistically Centered Integrated Health Care Approach identifies key components and considerations to reduce racial and ethnic disparities in integrated health care and specialty care settings. It is based on research conducted by the Hogg Foundation for Mental Health and proceedings from the national consensus meeting held in 2011, funded by the U.S. Department of Health and Human Services, Office of Minority Health.
African American Communities and Mental Health, a webpage designed by Mental Health America provides statistics and educational materials that focus on African American mental health.
Pathways to Integrated Care: Strategies for African American Communities and Organizations includes a set of consensus statements and recommendations for improving the health status of the country’s diverse African American population. The consensus statements and recommendations originated from an Office of Minority Health meeting of nearly 50 key leaders in health, medicine, mental health, substance use, religion, education, research, advocacy, public policy, and clinical practice.
The Health Care Law and You is a presentation tool developed by the U.S. Department of Health and Human Services to educate community members about the benefits of the Affordable Care Act. This resource has been translated by the Office of Public Engagement at the Centers for Medicare & Medicaid Services into the following languages: Chinese, Korean, Vietnamese, Tagalog, Hindi, Bengali, Hmong, Khmer, Laotian, Samoan and Tongan.
The Association of Asian Pacific Community Health Organizations (AAPCHO): In collaboration with the National Association of Community Health Centers (NACHC), released a new report brief titled, Health Centers' Role in Reducing Health Disparities Among AA&NHOPIs which describes the disparties among Asian American, Native Hawaiian, and other Pacific Islanders (AA&NHOPIs) and how health centers overcome them.
Integrated Care for Asian Americans, Native Hawaiians, and Pacific Islanders Communities: A Blueprint for Action, a product of the U.S. Office of Minority Health, is based on research conducted by the National Asian American Pacific Islander Mental Health Association and proceedings from a 2011 national consensus meeting of the same title. The document provides a blueprint for addressing the health and behavioral health needs of these populations through integrated care.
Availability of Asian language Substance Abuse Treatment Counselors Varies by Region, a SAMHSA Data Spotlight, indicates the number of substance abuse treatment services tailored to various Asian cultures is not distributed evenly in the United States
SAMHSA's American Indian and Alaska Native culture card is intended to enhance cultural competence when serving American Indian and Alaska Native communities. The card covers regional differences; cultural customs; spirituality; communications styles; the role of veterans and the elderly, and health disparities, such as suicide.
The American Indian/Alaska Native Cancer Information Resource Center and Learning Exchange ("Native CIRCLE"),provides, stimulates, develops, maintains, and disseminates culturally appropriate cancer, diabetes and health and wellness materials for American Indian/Alaskan Native educators, providers, and students. Movies and print materials sent to CIRCLE from around Indian country are reviewed by the medical director (Dr. Judith Salmon Kaur) for medical accuracy, modified if necessary, and made available for distribution to health care and community settings.
Research on mental health among American Indians/Alaskan Natives is limited due to the small size of this population. Although, existing research suggests that American Indian/Alaskan Native youths and adults suffer a disproportionate burden of mental health problems and disorders.
FamiliesUSA: New infographic. Latino Health Disparities Compared to Non-Hispanic Whites. This resource shows some of the more prevalent health disparities that afflict Latinos in the United States.
Diabetes and Depression in the Hispanic/Latino Community briefly describes the relationship between diabetes, depression and culture in the L:atino community---and the role of advocacy in addressing the problem.
Should You Talk to Someone About a Drug, Alcohol, or Mental Health Problem? is based on the Treatment Improvement Protocol (TIP) 42: Substance Abuse Treatment for Persons With Co-Occurring Disorders, lists questions consumers can ask themselves to help them decide whether to seek help for a substance abuse problem, a mental health issue, or both. It urges those who answered "yes" to any of the questions to seek help and lists resources for more information.
Enhancing Mental Health Service Delivery to Hispanics: An Online Toolkit for Eliminating Disparities. This resource consists of various print, video and audio resources designed to assist mental health agency administrators and their governing leadership, as well as direct service providers, to best attract, engage and serve Hispanics in a culturally and linguistically competent manner.
Movilizandonos por Nuestro Futuro: Strategic Development of a Mental Health Workforce for Latinos, a report prepared by HHS’ Office of Minority Health and the National Resource Center for Hispanic Mental Health, serves as a blueprint for improving the behavioral health conditions of Latinos through workforce development. According to the report, despite constituting more than 15% of the overall population, Latinos are visibly absent from the behavioral health profession.
The Bienvenido Program trains health and mental health professionals and taps into the strengths of community health centers to create a unique opportunity for cultural bridging through reliance on community networking and team building. The program has resulted in increased engagement of Latino immigrants within the broader community.
The Alliance for Latino Behavioral Health Workforce Development created the first-ever national Directory of Latina/o Behavioral Health Training Programs. This directory supports one of the recommendations contained in the United States Department of Health and Human Services, Office of Minority Health's seminal report titled Movilizandonos por Nuestro Futuro: Strategic Development of a Mental Health Workforce for Latinos, Consensus Statements and Recommendations.
SAMHSA and HRSA identified and reviewed curricula that help behavioral health and primary care practitioners assess, treat, and refer lesbian, gay, bisexual, and transgender (LGBT) clients in a culturally sensitive manner. Six federally-supported LGBT culturally sensitive training curricula are available for Continuing Medical Education/Continuing Education Unit (CME/CEU) credit. SAMHSA and HRSA will continue to disseminate this information on their LGBT websites: LGBT Training Curricula (SAMHSA) and LGBT Health (HRSA).
Optimizing Transgender Health: A Core Course for Healthcare Providers is an online training series on the health care needs of the transgender community for medical professionals. This series covers topics critical to the foundation of quality care for the transgender community, and will provide free continuing education credits for medical professionals.
The Fenway Institute webinar archive, Introduction to LGBT Health: Ending Invisibility, Overcoming Health Disparities provides an overview of LGBT health disparities, demographics, and terminology, as well as key strategies for bringing high quality care to LGBT people at health centers and other health care organizations. The archive also shares ideas around creating LGBT-inclusive environments of care and about the intersections of LGBT health, population health and patient centered medical homes.
Top Health Issues for LGBT Populations: Information & Resource Kit reviews current health issues among LGBT populations and includes an overview of terms related to gender identity and sexual expression.
Resources for Culturally Appropriate Integrated Services for LGBT Individuals
July 16, 2014
Presenters: Andrea Washington, LCSW-S, SUD and Integrated Care Coordinator, Montrose Center; Dr. Scout, Director, Network for LGBT Health Equity at CenterLink; Harvey Makadon, MD Clinical Professor of Medicine at Harvard Medical School and Director of the National LGBT Health Education Center at The Fenway Institute
- SAMHSA’s “A Practitioner's Resource
Guide: Helping Families to Support Their
- The Fenway Institute’s, “National LGBT
Health Education Center”
- Network for LGBT Health Equity at
- SAMHSA’s LGBT Training Curricula for Behavioral Health & Primary Care Practitioners
Improving Quality and Access to Integrated Care for Racially Diverse and Limited English Proficiency Communities
July 16, 2013
Presented by Katherine Sanchez, Henry Chung, and Teresa Chapa
Integrating Behavioral Health in Community and Migrant Health Centers: Motivation, Readiness, & Cultural Challenges
August 23, 2012
Presented by Tillman Farley and Jennie McLaurin
Recordings (synched audio and slides) remain in our archive for one year. For webinar recordings more than one year old, contact us at Integration@TheNationalCouncil.org.