title: The meanings of cultural competence in mental health: an exploratory focus group study with patients, clinicians, and administrators.
abstract: Cultural competence training is mandatory in the United States of America to alleviate minority health disparities though few studies have examined perceptions across stakeholders. We conducted separate focus groups with patients, clinicians, and administrators from the psychiatry department at one community hospital and compared responses to hospital policies. Stakeholders defined cultural competence through group-based or person-centered traits despite policies recommended person-centered approaches. Administrators and clinicians named clinician techniques for psycho-education whereas patients named these techniques for enlistment in treatment planning as equals. All groups named patient cultural views and institutional challenges as barriers to care, but only patients and administrators additionally named clinician biases as possible barriers. We discuss these discrepant perceptions and possible solutions to improve research, practice, and policy on cultural competence in mental health.
authors.affiliation: Columbia University, 1051 Riverside Drive, Unit 11, New York, NY 10032 USA ; New York State Psychiatric Institute, New York, NY USA.
authors.forename: Neil Krishan
authors.initials: NK
authors.lastname: Aggarwal
authors.affiliation: New York State Psychiatric Institute, New York, NY USA.
authors.forename: Kryst
authors.initials: K
authors.lastname: Cedeño
authors.affiliation: Department of Human Ecology, Rutgers, The State University of New Jersey, Newark, NJ USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Guarnaccia
authors.affiliation: Department of Social Medicine, Harvard University, Cambridge, MA USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kleinman
authors.affiliation: Columbia University Medical Center, New York, NY USA ; NYS Center of Excellence for Cultural Competence, and Hispanic Treatment Program, New York State Psychiatric Institute, New York, NY USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lewis-Fernández
keywords: Cross-cultural psychiatry; Cultural competence; Cultural psychiatry; Cultural sensitivity; Document analysis; Focus groups; Policy analysis; Transcultural psychiatry