Background and Purpose
In response to the call for national action to reduce mental health disparities and seek solutions for historically underserved communities in California, the Department of Mental Health (DMH), in partnership with Mental Health Services Oversight and Accountability Commission (MHSOAC), and in coordination with California Mental Health Directors Association (CMHDA) and the California Mental Health Planning Council, have called for a key statewide policy initiative as a means to improve access, quality of care, and increase positive outcomes for racial, ethnic and cultural communities. In 2009, DMH launched this two-year statewide Prevention and Early Intervention effort utilizing $3 million dollars in Mental Health Services Act (MHSA) state administrative funding.
This initiative, entitled the California Reducing Disparities Project, is focused on five populations:
- African Americans
- Asian/Pacific Islanders
- Lesbian, Gay, Bi-sexual, Transgender, Questioning (LGBTQ)
- Native Americans
Strategic Planning Workgroups (SPW)
In October 2009, after a competitive bid process, DMH awarded contracts to each of the five population groups listed above. These groups are all required to develop population- specific Strategic Planning Workgroups. These Strategic Planning Workgroups will be comprised of community leaders, mental health providers, consumers and family members from each of the five target populations. The goal of these five Strategic Planning Workgroups (SPWs) will be to develop population-specific reports (strategic plans) that will form the basis of a statewide comprehensive strategic plan to identify new approaches toward the reducing of disparities. These population-based strategic plans will move beyond defining disparities and seek new approaches from those communities most impacted by disparities. The strategic plan will include community-defined evidence and culturally appropriate strategies to improve access, services, outcomes and quality of care for the five ethnic and cultural populations identified for this project.
The five SPWs will work to identify new service delivery approaches defined by multicultural communities for multicultural communities using community-defined evidence to improve outcomes and reduce disparities. Community-defined evidence is defined as “a set of practices that communities have used and determined to yield positive results as determined by community consensus over time and which may or may not have been measured empirically but have reached a level of acceptance by the community.” 1
The five SPW contractors will have two years to complete the population-specific strategic plans. The second phase will include implementing the strategic plans at the local level. The current implementation plan is to fund selected approaches across these five communities for four years with a strong evaluation component. After successful completion of this [more than] six year investment in community-defined evidence, California will be in a position to better serve these communities and to replicate the new strategies, approaches, and knowledge across the state and nation.
The five SPW contracts were awarded to the following entities to address disparities in the identified populations:
- African American: The African American Health Institute of San Bernardino County
- Asian/Pacific Islander: Pacific Clinics
- Latino: The Regents of the University of California, Davis
- LGBTQ: Equality California Institute
- Native American: The Native American Health Center
California Reducing Disparities Project Strategic Plan
DMH is also developing two additional contracts to support the California Reducing Disparities Project (CRDP). One of these contracts will fund a single contractor who will serve as the facilitator/writer of the California Reducing Disparities Strategic Plan to collaborate with the Strategic Planning Workgroups and compile all of the population-specific reports developed by the five SPWs into one comprehensive strategic plan.
This comprehensive CRDP Strategic Plan will be developed in partnership with the five Strategic Planning Workgroup (SPW) contractors in an effort to identify population-specific strategies and, as appropriate, similarities between and among the five identified populations. It will provide the public mental health system with community-identified strategies and interventions that will result in relevant and meaningful culturally and linguistically competent services and programs to meet the unique needs of the five racial, ethnic, and cultural populations identified for the CRDP. It is expected that once the CRDP Strategic Plan is completed, the practices and strategies identified will be funded over four years and evaluated to demonstrate the effectiveness of this community-defined evidence in reducing disparities.
California MHSA Multicultural Coalition
The final contract will fund a California MHSA Multicultural Coalition (CMMC) to address a variety of mental health issues and provide state level recommendations on all of the MHSA components and related activities. The CMMC’s primary goal will be to work toward the integration of cultural and linguistic competence into the public mental health system. The CMMC will provide a new platform for racial, ethnic, and cultural communities to come together to address historical system & community barriers, and work collaboratively to seek solutions to eliminate barriers and mental health disparities. By creating and funding this coalition, DMH is developing a new structure to bring forward diverse multicultural perspectives that have not been adequately represented in the mental health system or in previous efforts to obtain consumer and family member input. The CMMC will be pivotal in providing critical insights and assessments of systems, e.g., policies, procedures, and service plans, in moving toward a more culturally and linguistically competent system.
Individuals who have expertise in areas concerning multicultural communities, community members interested in improving the mental health system (including consumers and family members from diverse backgrounds), and service providers who work with racial ethnic and cultural groups will form the membership of the CMMC. DMH recognizes the need to include people with experience across various systems, e.g., social services, criminal justice, and education), and across the life span, to better serve individuals with mental health challenges who have not yet been identified in the mental health system. The coalition will include representatives from each of the five CRDP Strategic Planning Workgroups and will also represent a broader spectrum of unserved and underserved ethnic, cultural communities in California.
For updates and more information about the California Reducing Disparities Project, please visit the CA Department of Mental Health Office of Multicultural Services web site: http://www.cdph.ca.gov/programs/Pages/Old%20-%20CaliforniaReducingDisparitiesProject.aspx
- National Latina/o Psychological Association, Fall/Winter 2008, National Network to Eliminate Disparities in Behavioral Health, SAMHSA, and CMHS, Larke Nahme Huang, Ph.D ↩