Cultural and Linguistic Competence and Eliminating Disparities in Systems of Care

The achievement of cultural and linguistic competence and the elimination of disparities in systems of care require changes at every systems level including policy making, administration, workforce recruitment and training, service delivery, families and communities.  Cultural and linguistic competence defined is:

For the Individual
The state of being capable of functioning effectively in the context of cultural differences.

For the Organization
A set of congruent practice skills, attitudes, policies and structures, which come together in a system, agency, or among professions and enable that system, agency of those professionals to work effectively in the context of cultural differences.

(Cross, T., Bazron,B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care Vol. 1, National Technical Assistance Center for Children's Mental; Health, Georgetown University Child Development Center, Washington DC. & NWICWA, (1993))

The National Technical Assistance Center Approach

The National Technical Assistance Center for Children's Mental Health is committed to promoting the building of comprehensive service delivery systems that are culturally and linguistically competent by:

• Building the knowledge base of administrators, providers and families so that they have a solid understanding of the concepts and framework of cultural and linguistic competence; and
• Preparing advocates and leaders to understand and engage in the change processes necessary to facilitate cultural and linguistic competence within systems of care.

A significant focus of the Center's efforts is to effect change in organizational policies and service delivery practice in systems of care.  The National Technical Assistance Center takes two approaches to meeting these objectives.  First, the National Technical Assistance Center infuses content related to cultural and linguistic competence and addressing disparities into all of its activities and products.  Second, the National Technical Assistance Center conducts training events and offers on-site technical assistance on developing culturally and linguistically competent service delivery systems.

Technical Assistance Tools

To support the infusion of cultural and linguistic competence into all Center activities, technical assistance staff utilize two planning and facilitation tools.  One tool, the Cultural and Linguistic Competence and Family and Youth Partnerships Planning Guide, assists in planning events and activities so that considerations and content related to cultural and linguistic competence and disparities are part of the planning process.  A second tool, Planning for Cultural and Linguistic Competence in Systems of Care developed by the National Center for Cultural Competence, facilitates on-site technical assistance for communities developing culturally and linguistically competent service delivery systems.  Both tools can be used or adapted by other agencies, organizations, and communities working toward cultural and linguistic competence.

Promising Community Practice Briefs

The National TA Center and the National Center for Cultural Competence have published a series of Briefs that highlight promising and evidence-based community practices for cultural and linguistic competence and addressing disparities.  These Briefs are offered as guides to inform the work of communities around the country.

• Innovative Self-Assessment and Strategic Planning:  Addressing Health Disparities in Contra Costa County
• Latino Network:  a Natural Fit in a Community-Driven Model.  Westchester County Community Network. 
• Cultural Exchange Creates Community Understanding.  Federation of Families of West Palm Beach County, Inc.

Training

The National Technical Assistance Center offers training for states and communities on cultural and linguistic competence and addressing disparities.  Frequently discussed topics include: A framework for understanding cultural and linguistic competence and disparities; organizational self-assessment for cultural and linguistic competence; planning for addressing cultural and linguistic competence in systems of care; ethnic specific service delivery; mental health and culture; and organizing change.  Further information on these topics can also be accessed on the National Center for Cultural Competence website.

The National Technical Assistance Center also offers leadership training on the skills required to build culturally and linguistically competent family-centered systems of care for children with mental health needs and their families in racially, ethnically, and culturally diverse communities.  Building such a system of care requires leaders to have a unique blend of awareness, knowledge and skills to effectively weave the concepts and principles of cultural and linguistic competence with that of leadership to transform and create an inclusive, respectful and trusting environment for children and families.  The National Technical Assistance Center offers skill-building training in this area to states, communities and individuals.  Go to Leadership and Prepared Workforce, Individualized Skill Building Trainings for more information. 

Resources of the National Center for Cultural Competence

The National Technical Assistance Center carries out its work on cultural and linguistic competence and addressing disparities through a unique alliance with the National Center for Cultural Competence (NCCC) at Georgetown University, a recognized leader in the field.  The  National Center for Cultural Competence offers a broad range of informational and technical assistance resources on its website, including: organizational self-assessment tools; planning tools; enhanced curriculae; a searchable consultant data-base; and request forms for technical assistance.  There is a Spanish language portal on the website.