Student Experiences in an Interprofessional, Culturally Responsive, Behavioral Health Workforce Training Program – a Mixed-Method Study

Background & Purpose

Disparities in behavioral and mental health outcomes among Black, Indigenous, and People of Color (BIPOC) raise persistent concerns in the US. For LGBTQIA+ youth, 54% of those who wanted counseling not receiving it; for BIPOC youth who are also LGBTQIA+, rates exceeded 60%. The significant disparities in health and mental health outcomes and quality of care among marginalized groups are partly due to a lack of cultural competency among providers; however, there is no evidence-based training or pedagogical model for this purpose. Since clients are oftentimes involved with multiple systems (e.g., mental health, healthcare, schools), an interdisciplinary approach is critical to provide effective, culturally responsive, behavioral healthcare. Funded by Health Resources & Services Administration (HRSA), this one-year training program prepares clinical graduate students to provide culturally responsive and respectful behavioral healthcare for BIPOC and LGBTQIA+ youth and their families. The corresponding pedagogical model includes practicum at a behavioral or mental health setting; ongoing anti-oppressive coaching/mentoring; regular interprofessional seminars; training modules on topics related to BIPOC and LGBTQIA+ youth and families, trauma-informed care, and healing justice; and a course on child and adolescent mental health.

Methods

This study adopts a mixed methods design to understand student experiences within a training program focused on culturally responsive behavioral healthcare. Data were collected across three cohorts of graduate students from social work, nursing, and school psychology at a big-ten university (n=78). Quantitative data from three waves of student surveys was collected and triangulated with qualitative data from focus groups held with students at the end of each training year. The survey inquired about a range of concepts, including skills and self-efficacy in clinical practice with diverse populations; interprofessional collaboration; professional quality of life; self-reflection; career plans; and others. Follow-up surveys asked students about satisfaction with and helpfulness of program components and the program’s impact. Three focus groups were conducted with students each year to explore their experiences in the program and how the program supported their learning.

Results

Statistically significant increases were found from enrollment to graduation on students’ post-graduation goals, skills, and self-efficacy in providing cross-cultural behavioral healthcare, and beliefs about interprofessional practice. Students rated the stipend, mental health course, and trainings as among the most helpful elements.

Thematic content analyses from focus group data yielded the following themes: increased knowledge of and comfort/confidence in working with LGBTQ+ and BIPOC communities; helpful elements of the program (e.g., simulations, site visits, psychiatric nursing course, seminars); helpfulness of peer consultation within the program; development of social relationships and community; improvements in self-insight; greater purpose and motivation; benefits of interdisciplinary engagement; stipends as a facilitator for personal/professional growth; and recommendations for a more balanced focus across academic disciplines.

Conclusion and Implications

Intentional pedagogical preparation of the behavioral health workforce to provide culturally responsive, services for diverse youth and their families should be an integral part of coordinated educational and professional efforts to facilitate equitable behavioral healthcare. Students’ lived experience contributes to ongoing efforts to further strengthen evidence-based training for this pedagogical effort.