All of these strategies are relevant to cultural competence, a concept for delivering effective mental health services that received particular attention in the DSM-5. Of strategies and tools relevant to this topic in the DSM-5, Dr. Díaz indicated that the Cultural Formulation Interview (CFI) should be considered particularly important for aiding clinicians in understanding mental health issues in a cultural context.
“For us as psychiatrists, the interview is our tool. ” Dr. Díaz asked. She led a recent study demonstrating that the CFI can help clinicians identify unique needs and preferences in a Hispanic population (Psychiatr Serv. 2017 Feb 1;68[2]:112-4). She said the principles of the CFI are relevant to any cultural group.
For evaluating and demonstrating efficacy of mental health services developed for a target cultural group, Dr. Díaz recommended identifying goals and then performance measures to track success. At her own center, quarterly reports track effectiveness and communicate value to the community and those providing funding its activities.
In the period during 2008-2017, 950 adult patients received mental health or substance use services from LBHS, Dr. Díaz reported. In addition to the full-time staff, LBHS has provided training to social workers and psychologists. In addition, 11 psychiatric residents in their third or fourth year of training have worked in LBHS during this period. Many of the peer counselors trained at LBHS have been hired away because of the skills they acquired.
Of the many elements that Dr. Díaz believes are important to the success of the LBHS, “confianza” has provided a key to patient willingness to stay with care through recovery. This word, Spanish for trust, recognizes that patients must have confidence in the ability of clinicians to understand and resolve their problems.