Culturally Competent Mental Health Practice with Latino Immigrants: Shifting the Paradigm of Cultural Competence

Background & Purpose. While there is a large body of literature documenting the importance of culturally competent social work practice with diverse populations, there is considerable ambiguity regarding what culturally competent practice entails. A review of the literature further suggests that the term’s ambiguity stems from the fact that the literature is largely theoretical and lacks empirical grounding. Informed by these gaps in the research, the present study sought to explore what cultural competence looks like in practice, with the aim of developing an empirical model to guide social workers in the development and implementation of culturally competent services. To achieve this aim, this study explored service delivery at a branch of Saint Anthony Hospital’s Community Wellness Program (CWP), located in Chicago, Illinois, that provides mental health services to uninsured Latino immigrant adults. The study was guided by the following research questions:

 1) How do service providers and mental health service participants describe the CWP’s model of service delivery?

2) How do service providers and mental health service participants experience service delivery?

3) How does the CWP address community members’ mental health needs?

Methods. The above research questions were explored through the use of a case study design with a phenomenological qualitative approach. Methods of data collection included:

 1) Twenty one semi-structured individual interviews with service providers and mental health service participants;

2) Participant observation of four staff meetings, one routinely offered parenting group, and four hour-long periods in the program waiting area;

3) Collection of 17 agency documents.

Interviewees were recruited through a purposive sampling strategy. All interviews were audio recorded and transcribed, and field notes were written for all observation activities. Data across interviews, observations, and documents were analyzed through an inductive open coding process.

Results. Findings indicated that at the CWP, services are not only informed by an understanding of community members’ cultural values and beliefs, but also by an understanding of their lived experiences within their sociopolitical and local community contexts. This cultural and contextual understanding shapes strategies for facilitating mental health service access, engaging community members in services, and addressing mental health needs. This presentation will outline how the CWP facilitates service access by addressing context-specific barriers stemming from poverty and marginalization; how it promotes service engagement through community-based and relationally focused strategies; and how it addresses mental health needs through holistic and anti-oppressive practices, as well as practices informed by an understanding of community members’ acculturative experiences. These culturally competent practice strategies promote wellness at the levels of the individual, family, and community.

Conclusions & Implications. The CWP’s model of service delivery offers an alternate paradigm for conceptualizing cultural competence. As illustrated through this model, culturally competent practice does not only require cultural and linguistic understanding, but it also requires an understanding of community members’ experiences within their sociopolitical and local community contexts. Social workers can promote cultural competence within their organizations by advocating for the development and implementation of programming that is informed by and aligned with community members’ context-specific needs.